Diagnostic Cardiology

A variety of diagnostic services for cardiac disease are available at WMHS on both the Sacred Heart and Memorial Campuses.

Electrocardiogram

An electrocardiogram, better known as an EKG, is a diagnostic test thatuses electrodes to record the electrical activity of the heart. It can assist in diagnosing a number of heart conditions, including problems with heart size, heart rhythm, or the heart muscle. Even when there is no suspicion of heart disease, an EKG is often part of a general physical examination and the results used as a baseline for comparison with any future testing.

Echocardiogram

This diagnostic test uses ultrasound (high frequent sound waves) to form a picture of the heart valves and heart muscle. The image of heart is created on a TV-like monitor and recorded on videotape so the cardiologist can study it. An "echo" provides information about the heart size, heart valves, heart muscle, and blood flow inside the heart.

Stress Tests

Patients with heart disease will often develop signs and symptoms of heart dysfunction with exercise that are not present when at rest. A stress test helps to determine how the heart functions during exercise. During the stress test, the patient uses a treadmill or stationary bike while his heart rate, blood pressure, and EKG are monitored. Stress tests can show if the blood supply is reduced in the arteries that supply the heart and also evaluate the patient's exercise capability.

When a more detailed assessment of blood flow to the heart during exercise and rest is indicated, a myocardial perfusion scan or thallium stress test is ordered. A radioactive isotope (thallium) and a nuclear camera are used during the stress test to give more detailed information about the presence and severity of the coronary artery disease.

Holter Monitor

A holter monitor is a 24-hour continuous recording of an electrocardiogram (EKG) to study the electrical activity of the heart. This test uses electrodes and a small recording device about the size of a transistor radio that is worn on a shoulder harness or attached to the patient's belt. The patient wears the holter monitor for 24 hours and keeps a record of his activities and any angina symptoms. The record is helpful in comparing the symptoms and activities with changes in the EKG. A holter monitor evaluates irregular heartbeats and coronary artery disease.

Transesophageal Echocardiography

Transesophageal echocardiography (TEE) is a specialized imaging procedure that gives very clear pictures of the heart and its structures. A small tube with a transducer on the end is passed down the patient's throat and into the esophagus to do an echocardiogram. Since the esophagus is close to the heart, the images are much clearer than a standard echocardiogram. TEE is used to determine problems with the heart valves and blood flow, the function of the heart muscle, and the aorta—the heart's main artery.

Cardiac Catheterization

A cardiac catheterization is basically a diagnostic x-ray of the heart and coronary arteries. In this procedure, a cardiologist guides a thin plastic tube called a catheter through an artery or vein in the arm or the leg and into the coronary arteries in the heart. A contrast dye is then injected into the catheter to highlight any blockages of the coronary arteries or defects of the heart so they are visible when high-speed x-ray motion pictures are taken from various angles.

A cardiac catheterization provides the most detailed assessment of the heart's performance. It can help determine

• the presence and severity of blockages in the coronary arteries
• how well the heart valves work
• the strength of the heart muscle and how well it pumps blood
• any evidence of prior heart muscle damage

This procedure is done under sterile conditions in the Cardiac Cath Lab. This lab is equipped with high-resolution fluoroscopic (x-ray) video and film equipment, a heart monitor to record blood pressure and heart rate, and TV monitors used to guide the catheter into the heart.