Cardiac Testing

Echocardiogram

An echocardiogram (echo) is an imaging study that allows doctors to evaluate the heart’s structure, function, blood flow and output to look for abnormalities. The most common type of echocardiogram is a noninvasive evaluation performed by a specially trained technologist. During the test, a gel is applied to the transducer and the device is methodically moved around the chest to provide different views of the heart. The patient may be asked to change positions or hold their breath to obtain the best quality pictures. After the images are created, they are sent to a physician for interpretation.

Carotid Artery Ultrasound

The carotid arteries are blood vessels that transport blood from the heart to the brain through the neck. They can become obstructed due to buildup of plaque, a condition called stenosis which increases the risk of stroke. A doctor may recommend a carotid artery ultrasound for patients who have medical conditions like high blood pressure, diabetes, high cholesterol, a recent transient ischemic attack (TIA) or coronary artery disease. If a significant narrowing or blockage of the carotid artery is detected, appropriate treatment may be initiated. Ultrasound is also used to monitor the state of a carotid artery after surgery to remove plaques or place a stent.

Lower Extremity Arterial and Venous Ultrasound

Lower extremity venous ultrasound may be undertaken if a doctor suspects a blood clot has formed in a vein deep in the body (deep vein thrombosis or DVT) and the patient is at risk for a life-threatening pulmonary embolism. Venous ultrasound is also used to look for chronic venous insufficiency, a condition that occurs when weakened valves in the leg veins don’t allow blood to flow back to the heart. Lower extremity arterial ultrasound may be recommended for patients with symptoms of peripheral arterial disease (PAD).

Upper Extremity Arterial and Venous Ultrasound

These tests are used to evaluate the arteries and veins in the arms, wrists, shoulders and neck for possible narrowing or blockage. Though deep vein thrombosis is most common in the legs, venous ultrasound is also used to check for blood clots in the upper extremities. A doctor may recommend upper extremity vascular ultrasound if a patient has a family history of DVT or symptoms including swelling, limb pain, tenderness, discoloration or shortness of breath.

Pacemaker Interrogation

Pacemakers are small electronic devices that stimulate the heart with electrical impulses to restore or maintain a normal heartbeat. Pacemakers are most commonly used for patients with bradycardia (slow heartbeat), and can either be permanent (internal) or temporary (external). Patients who have a permanent pacemaker require periodic surveillance (or “interrogation”) of the implanted device. These scans evaluate the programming of the device, confirm that its components are working correctly and check the remaining lifespan of the battery. The pacemaker’s programming can be adjusted if necessary.

ICD Interrogation

Implantable cardioverter defibrillators (ICDs) are devices that monitor heartbeat and suppress heart arrhythmias. ICDs deliver a strong electrical shock to the heart to restore a normal heartbeat when the device senses a life-threatening change in the heart’s rhythm. After an ICD system is implanted, monitoring of the device can be done during scheduled in-office visits. These appointments are used to retrieve information from the ICD and make adjustments to its programming. ICDs may be recommended for patients who are at risk for sudden death from ventricular arrhythmias.

Remote Cardiac Monitoring

In some cases, remote monitoring can be used to observe an implanted pacemaker or ICD. Remote monitoring allows a doctor to confirm the device is functioning correctly and obtain information from the device on an as-needed basis without the patient having to travel to the office for an in-person interrogation. This is a more convenient and efficient option for many physicians and patients.