Cardiac and vascular testing uses ultrasound to take pictures and recordings of the heart and blood vessels. Ultrasound technology uses high frequency sound-waves to create pictures and recordings of the heart and blood vessels. The procedures are painless and have no known side-effects. After a water-based gel is applied to the skin, the sonographer places a small transducer on the surface of the skin and obtains and records the pictures for later interpretation by a specially-trained doctor. Ultrasound tests generally take from 20-45 minutes to complete. There are no special preparations for most ultrasound tests.
An Echocardiogram is a test to examine the structures of the heart including the walls, chambers, valves, and blood flow through the heart. The ultrasound transducer is placed on the center of your chest and along the side of your rib cage to obtain the pictures. You will be asked to remove your clothing from above the waist and be placed in a hospital gown.
Carotid Ultrasound examines the major arteries in the neck that provide blood-flow to the brain. The test is able to detect a build-up of plaque in the arteries that may cause narrowing, blockage, or disturbances in the blood flow. These disturbances can cause symptoms of a stroke such as lightheadedness, dizziness, passing out or numbness or weakness over half of the body. The ultrasound transducer is placed on the side of the neck to obtain pictures.
Venous Ultrasound examines the veins of your arms and legs that return blood to the heart. The test is able to detect a blood clot (deep vein thrombosis or DVT) within the vein that is blocking flow and causing pain and swelling, The entire leg or arm is scanned with the ultrasound transducer even if the swelling and pain is located to a particular area. You will be asked to remove your clothing over the affected area.
Renal Ultrasound examines blood flow to the kidneys. The test is able to detect any blockages or narrowing within the arteries leading to the kidneys which can cause high blood pressure or kidney failure. You will be asked to remove your clothing from above the waist and placed in a hospital gown. The ultrasound transducer is placed over your abdomen to obtain pictures. This test requires that you fast and have nothing by mouth for 6 hours prior to the exam (you may take your morning pills with sips of water). You may return to your normal diet immediately after the test.
Peripheral Arterial Testing
Arterial testing examines the arteries of the arms or legs for narrowing or blockages causing poor circulation or pain. No needles or dye are used. Arterial testing has three parts: First, a small ultrasound probe is placed over several areas of the extremity and directed towards the artery to record the blood flow pattern. Next, blood pressure cuffs are applied to the arms or legs to record blood pressures at 3 to 4 levels. Finally, overall blood flow is tested by recording waveform patterns through the blood pressure cuffs. If symptoms occur while walking, a treadmill test may also be done.
Stress Echocardiogram (exercise or dobutamine)
The stress echocardiogram examines what happens to the heart when it is stressed. First, the patient is attached to an EKG and blood pressure cuff. Next, a sonographer will obtain resting ultrasound images of the heart from different locations on the chest. With a physician present, the patient will then either exercise on a treadmill or be given a medication to increase the heart rate along. Ultrasound pictures are again recorded immediately after the heart has been stressed and compared with images before stress or at rest. EKG recordings are also obtained before, during, and after exercise. The physician interpret the test based on any changes to the heart occurring immediately following the stress procedure.
Transesophageal Echocardiogram (TEE)
The TEE procedure is used when structures of the heart, such as the chambers and valves, need to be viewed in very fine detail. After the throat is sprayed with a numbing medication and medication is given to make the patient sleepy, a tiny ultrasound transducer, placed on the end of a long tube, is passed down the espophagus to a position that is next to the heart. Multiple recordings and pictures of the heart are taken. This test requires the patient to fast and have nothing by mouth for 6 hours prior to the exam (morning pills may be taken with sips of water). Since medication is used, someone will need to drive the patient home following the procedure.
Nuclear Stress Test (exercise or lexiscan)
This test uses a small amount of radioactive tracer, given through an IV, to provide pictures of the heart taken by a special camera. The tracer is given at rest and then again following exercise or medication administration. The images taken by the camera allow the cardiologist to compare the amount of blood flowing to the heart muscle before and after exercise.