Springfield Clinic's Cardiology team offers a wide variety of tests and procedures that help diagnose and treat heart disease. The election of which and how many of these tests to perform is dependent on several criteria, including:
Springfield Clinic Cardiology offers emergent treatment to patients with symptoms of an acute myocardial infarction (heart attack) that have an abnormal EKG. By utilizing rapid response protocols in local emergency rooms, patients can be stabilized, transported to Springfield hospitals and treated by a Springfield Clinic Cardiologist in less than 90 minutes.
An electrocardiogram (EKG/ECG) is a test that measures the electrical activity of one's heartbeat. With each beat, an electrical impulse travels through the heart. This impulse causes the muscle to squeeze and pump blood. A normal heartbeat on EKG will show the timing of the top and lower heart chambers.
An EKG gives two major kinds of information. First, by measuring time intervals on the EKG, a doctor can determine how long the electrical impulse takes to pass through the heart, indicating if the electrical activity is normal, slow, fast or irregular. Second, by measuring the amount of electrical activity passing through the heart muscle, a cardiologist may be able to find out if parts of the heart are too large or are overworked.
There is no pain or risk associated with having an electrocardiogram.
The Holter monitor is a device used to record the heart's rhythm continuously for 24 to 48 hours, during which time every heartbeat is recorded. Electrodes are connected to the chest, and the patient carries a monitor throughout testing.
This recording allows the physician to obtain a variety of information, including the heart rate and any abnormalities. A journal is provided for the patient to keep track of any symptoms and information.
Event monitors manually record heart rhythms over a longer period of time, usually a month. The patient pushes a button to record an "event", such as a rapid heartbeat. Recordings are transmitted via phone call to the physician for evaluation.
Neither of these monitoring procedures cause any harm of discomfort.
Nuclear imaging is used, often in combination with a stress test, to assess bloodflow to the heart.
Nuclear imaging tests include:
Your doctor may deem it necessary for you to be seen by our department for cardiac clearance prior to undergoing surgery.
An evaluation of your risk factors for coronary arterial disease and your health status will be done as well as a physical examination to aid in determining your risk for cardiac complications during surgery. Review of an EKG (electrocardiogram) or stress testing may be required to aid in risk stratification prior to clearing you for surgery.
Our department provides prompt appointments and testing with results communicated to your provider so that you may proceed with your surgical procedure in a timely manner.
This is one of five diagnostic tests, that include routine stress test, exercise cardiolite stress test, adenosine cardiolite stress test, dobutamine stress echo and stress echocardiogram (EKG). One of the preferred examinations is the Stress EKG that is performed while walking on a treadmill. Images are taken of the heart at rest and during stress.
A treadmill stress test allows one's physician to see how well the heart deals with exertion. As one's body works harder, it requires more fuel and the heart pumps more blood. This test indicates any lack of blood supply through the arteries that go to the heart. The test monitors heart rate, breathing, blood pressure, EKG and exhaustion levels.
There is no more discomfort or risk involved with this test than there is with general walking or jogging, and physicians and medical professionals are on hand throughout the examination.
Automatic Implantable Cardioverter Defibrillators (AICD/ICD) have been useful in preventing sudden death in patients with known sustained ventricular tachycardia or fibrillation. Studies have shown they may have a role in preventing cardiac arrest in high risk patients who have not had, but are at risk for life-threatening ventricular arrhythmias.
A battery-powered pulse generator is implanted in a pouch under the skin of the chest or abdomen, often just below the collarbone. Wires or leads run from the pulse generator to positions on the surface of or inside the heart. When the ICD detects ventricular tachycardia or fibrillation, it shocks the heart to restore the normal rhythm.
Percutaneous Coronary Interventions (PCI/PTCA/Angioplasty/Balloon Angioplasty) are used to open blocked arteries and restore normal blood flow to heart muscles that have become clogged from a build up of cholesterol, cells or other substances.
A catheter tube is threaded through the arterial system via a small insertion in the groin or arm until it reaches the coronary (heart) artery. A very thin wire is threaded across the blockage. Over this wire, a catheter with a thin, expandable balloon on the end is passed to the blockage. The balloon is inflated, which compresses the plaque and dilates the artery. A stent (wire mesh tube) may be locked into position to keep the artery open so that the heart receives the blood it needs.
Beta-Radiation is a cardiac treatment used to prevent re-closure of an artery using a small amount of radiation therapy.
Stents (a wire metal mesh tube) are used depending on certain features of an artery blockage. This includes the size of the artery and where the blockage is located. A stent is collapsed to a small diameter and put over a balloon catheter, then moved into the area of the blockage. When the balloon is inflated, the stent expands, locks in place and forms a scaffold which holds the artery open, improving blood flow to the heart muscle and relieving symptoms.
In certain patients, stents reduce the re-narrowing that occurs after balloon angioplasty or other procedures that use catheters. Stents also help restore normal blood flow and keep an artery open if it’s been torn or injured by the balloon catheter.
Re-closure (restenosis) is an issue with the stent procedure. It is very important that patients take their anti-clotting medicines as directed by their cardiologist.
Electrophysiologic tests examine why a heart is beating irregularly.
A radiofrequency ablation is a non-surgical procedure used to treat some types of rapid heartbeating, such as atrial fibrillation, atrial flutter and atrial tachycardia. It is most often used to treat supraventricular tachyarrhythmias.
Transcatheter ablative therapy utilizes a technique of an electrode catheter being inserted through a blood vessel to perform targeted electrocautery in the heart. This therapy is rapidly becoming the treatment of choice for many supraventricular tachycardias.
Laser Angioplasty opens coronary arteries blocked by plaque. In this technique, a catheter with a laser at the tip is inserted into an artery. The catheter is then advanced through the artery to the blockage in the coronary artery. When the laser is in position, it emits pulsating beams of light that vaporize the plaque.
A pacemaker uses batteries to send electrical impulses to the heart to help it pump properly. An electrode is placed next to the heart wall and small electrical charges travel through the wire to the heart. Most devices are demand pacemakers, which have a sensor that turns the signal off when the heartbeat is above a certain level and turns it back on when the heartbeat is too slow.
PVD refers to diseases of blood vessels outside the heart and brain. It is often a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys. There are two types of these circulation disorders, functional and organic. Functional peripheral vascular diseases do not involve defects in the blood vessels’ structure. They are usually short term effects related to spasms that come and go.
Organic peripheral vascular diseases are caused by structural changes in the blood vessels, such as inflammation and tissue damage. Peripheral artery disease (PAD) is caused by fatty buildups in arteries that block normal blood flow. These blockages restrict blood circulation mainly in arteries leading to the kidneys, stomach, arms, legs and feet. People with PAD often have fatty buildup in the arteries of the heart and brain.
Tilt Table Studies/Tilt Table Testing (TTT’s): A tilt table test may be advised for some people who have had recurrent fainting episodes (syncope). This test shows how your heart rate and blood pressure respond to a change in position from lying down to standing up. In this test, an intravenous line is usually started in case medications need to be administered during the test. A catheter may also be placed in the artery to monitor blood pressure from inside the artery.
Transesophageal Echocardiography (TEE): A TEE is a special type of echocardiogram. A tube with an echocardiogram transducer on the end is passed down a person’s throat and into the esophagus. The esophagus is right behind the heart, therefore images from the TEE can provide very clear pictures of the heart and its structures.
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