Office Services

Cardiology:

Electrocardiogram (ECG or EKG)
This is a simple test where leads are applied to the body that record a tracing of the electrical impulses of the heart. This can aid in the diagnoses a variety of heart problems including blockages of arteries, abnormal heart rhythms, and other heart abnormalities.

Holter Monitor
This is a portable device worn for a period of 24 to 48 hours that records the heart rhythm and ECG tracings. It is used to evaluate the cause of symptoms such as palpitations, dizziness, and passing out.

Exercise Stress Test
This is a test to evaluate how the heart responds to exercise and strenuous physical activity. Performed by walking on a treadmill while monitoring the heart rate, EKG, and blood pressure, while evaluating for symptoms. It can aid in evaluating the cause of chest pains and other symptoms.

Ambulatory Blood Pressure Monitoring
Hypertension, or high blood pressure, can be difficult to diagnose. Single readings in the office may not always reflect someone’s true average blood pressures. Often patients experience “white coat hypertension” when pressures are elevated in the office but not at home. Ambulatory blood pressure monitoring is a device that checks blood pressures throughout a 24 hour period at home to accurately diagnose hypertension and to assess it in patients on medications.

Event Monitor
Event monitors are similar to Holter monitors that are worn during normal daily activities. Most event monitors have wires that connect the device to sensors. The sensors are stuck to your chest using sticky patches.They only record heart rhythm during symptoms and there is usually a button that needs to pressed to start recording. Some event monitors start automatically if they detect abnormal heart rhythms. These are small and are connected via the cell phone technology. These can be worn from few days to few weeks.

Device Interrogation
Pacemaker or Defibrillator interrogation is a process for checking on the function of a device to make sure it is working properly and the batteries are in good condition. In this procedure, a doctor/nurse waves a wand connected to a computer over the patient’s chest. The wand and pacemaker communicate wirelessly, allowing the computer to extract data from the pacemaker’s memory. The computer will also check on the pacemaker’s battery life. This is not painful to the patient, although sometimes patients feel lightheaded or strange during a pacemaker interrogation.

Cardiac Imaging:

Echocardiogram (Echo)
This is a sonogram of the heart that evaluates the function of the heart and it’s valves, the size of the various chambers, and the pressures within the heart.

Exercise Stress Echocardiogram (Stress Echo)
One is exercised on a treadmill, and the function of the heart is monitored when under physical stress by an ultrasound probe (echocardiogram). This can assess for any blockages of blood flow in the arteries that supply the heart (coronary artery disease).

Nuclear Stress Test
Another type of stress test that uses imaging. One is exercised on a treadmill and then a radioisotope is injected. Pictures are then taken of the heart and can detect how well the blood flow is to various parts of the heart muscle. This can aid in diagnosing blockages in the coronary arteries.

Lexiscan Myocardial Perfusion Study
A way to diagnose coronary artery disease, or blockages in the heart. A medication called Lexiscan (regadenoson) is injected followed by a radioisotope. Then pictures of the heart are taken by a nuclear camera. This is able to detect any areas of the heart that have decreased blood flow that may suggest a blockage of one of the coronary arteries.

MUGA
A resting nuclear scan where a radioisotope is injected into the blood, and an accurate assessment of the heart’s pumping function, or “ejection fraction” is obtained.

Vascular:

Carotid Ultrasound
A simple procedure where images are taken of the arteries in the neck that supply blood flow to the brain. This can detect plaque buildup that is a risk for having a stroke. Early detection of this disease in the right people can prompt surgery or a stenting procedure that can prevent strokes before they happen.

ABI’s
The arterial-brachial-index is a very simple test that involves comparing the blood pressures between the arms and the legs. In certain people, this can aid in the diagnosis of blockages in the arteries of the legs, or “peripheral arterial disease”. Symptoms include pain or cramping of the calves or thighs after walking.

Peripheral Arterial Duplex
This is a painless ultrasound test performed on the blood vessels in the abdomen and legs, and occasionally the arms, to image the arteries, and to evaluate the blood flow. It can identify areas that have build up of plaque and calcium and blockages that may compromise blood flow. This can cause symptoms of peripheral arterial disease, such as “claudication” – or pain and cramping while walking. This can also assist in planning out an approach for fixing these blockages through angioplasty or stenting that can alleviate symptoms.

Aorta Ultrasound
A very simple test where a sonogram is taken of the aorta in the abdomen to assess blood flow, and to rule out the presence of an abdominal-aortic-aneurysm (AAA). People at risk include those with a history of smoking over the age of 55. Early detection of an aneurysm can prompt repair and prolongation of life.

Renal Ultrasound
A sonogram performed on the abdomen to evaluate the renal arteries – which supply blood to the kidneys. Often patients can have a blockage in a renal artery that can cause uncontrolled blood pressures and sometimes dysfunctional kidneys. In some cases these can be fixed with a stent if indicated.

Mesenteric Ultrasound
An ultrasound that looks at the mesenteric arteries, which are the arteries that supply blood flow to the intestines. Sometimes patients can have a blockage in one of these arteries that can cause abdominal pain, weight loss, and malabsorption. In some cases these can be fixed with a stent procedure.

Venous Duplex Study
An ultrasound examination of the veins in the legs and the abdomen to rule out the presence of any blood clots, or “Deep Vein Thrombosis” (DVT). Symptoms of of a DVT include swelling and pain in one of the legs.

Venous Reflux Study
This evaluates the competence of the veins of the legs. If the veins don’t function properly, it can cause blood to back up in the legs, cause painful swelling, varicose veins, and ulcers. If identified, some of these incompetent veins can be ablated through a simple office procedure and relieve symptoms.

Vein Ablation
Certain veins in the leg can become “incompetent”, or not function properly. This can cause swelling, pain, varicose veins, and ulcers. If certain superficial veins are dysfunctional and are identified as the culprit of these symptoms, they can be burned, or “ablated” by a simple office procedure. A catheter is inserted into the vein and heat is applied through a special laser to ablate the vein, and thus alleviate the symptoms.