A cardiac stress test is done to determine what you risk of heart disease may be. It measures the adequacy of blood flow to the heart muscle. There are various types of stress tests. Your doctor will determine which the best test is for you.
1.Treadmill test: With this test, you would exercise on a treadmill while your EKG and blood pressure are monitored to see how long you can walk and if you get any chest pain.
2.Nuclear stress test: During a nuclear stress test, you would walk on the treadmill but also be injected with a small amount of radioactive substance. This substance will go to the heart muscle and allow pictures of the heart to be taken by a special camera. You would lie on a table and have these pictures taken both before and after the treadmill test. The test gives good information about blood flow to and squeezing action of the heart.
3.Adenosine nuclear stress test: Adenosine would be used in place of walking on a treadmill during the nuclear stress test if a person is unable to walk. This medication dilates the arteries, which simulates what occurs during exercise.
4.Stress echo: This is a combination of a treadmill stress test and an echocardiogram. At the peak of exercise, you would then immediately lie down on the exam table and have an echocardiogram done. This test shows how well the heart muscle pumps in response to exercise.
An echocardiogram is a special test (sonogram) that uses sound waves to evaluate the pumping action and valves of the heart.
1.Transthoracic echo: A device called a transducer is run over the chest. It bounces sound waves off the heart and sends them back to the echo machine, where the heart can be seen on a monitor.
2.Transesophageal echo: A special transducer is inserted into the esophagus to get clearer pictures of the heart and valves. This test is performed in the hospital under some sedation. It is done when a closer examination is needed of the heart valves, walls, or chambers.
3.Stress echo: This is a combination of a treadmill stress test and an echocardiogram. At the peak of exercise, you would then immediately lie down on the exam table and have an echocardiogram done. This test shows how well the heart muscle pumps in response to exercise.
A holter monitor is a 24 hour continuous electrocardiogram recording. It is helpful in determining if there are any heart rhythm abnormalities that could be causing symptoms such as palpitations, dizziness or fainting. EKG electrodes are placed on the chest and the monitor, which looks like a small tape or MP3 player, is attached to the electrodes by wires. You should continue your regular activities while wearing the monitor. It is important record on a piece of paper any symptoms you have while wearing it so the doctor has complete information. Once the monitor is returned, the information is downloaded and a report is generated.
An event recorder, unlike the holter monitor, does not recorder continuously. Instead, it records the rhythm when a button is pushed. It is used for patients who have symptoms like palpitations or dizziness that occur occasionally but are a cause for concern. When the symptom is felt, the button is pushed and the device records the activity of the heart and transmits it wireless to the monitoring company. An event recorder work on a loop so it is able to record multiple events and can be worn for up to 60 days. Because it does not record continuously, it can be removed and reapplied if needed.
Vascular ultrasound uses sound waves to look for narrowing or blockages in the arteries and veins, typically in the neck, arms, and legs. A special device, called a transducer, is gently rubbed over the area being examined and sends pictures to the monitor on the ultrasound machine.
This is an invasive test where the doctor inserts a small plastic tube into an artery in the leg, which allows for passage of special catheters up to the heart. A small amount contrast is injected into the arteries so that they may be seen on the x-ray monitor. This test allows the doctor to see if there are any blocked or narrowed areas in the arteries. The pumping action of the heart is also seen.
ANGIOPLASTY & STENTING
If narrowed arteries are found in the heart and it is determined that they could be opened without surgery, the doctor will perform an angioplasty. This means that a small balloon on a catheter will be advanced into the artery to the narrowed point and inflated to open the blockage. The doctor may also place a stent in the area. This is a small metal scaffold which expands and is left in the artery, holding it open.
EPS is an invasive test that is done when a patient has rhythm problems. The doctor places a small plastics tube in a vein in the leg to facilitate passage of special catheters to the heart. The catheter will gather information about the electrical activity that cannot be obtained with an EKG. Based on the information obtained, the doctor will decide on the best treatment for the condition.
Some abnormal rhythms found in an Electrophysiological Study can be treated with ablation. A non-surgical ablation is done in the catheterization lab. A special catheter is placed at the sight of the origination of the abnormal rhythm and a small current is used to disconnect the pathway of the abnormal rhythm.
When a person has a heart rate that is too slow or irregular, a pacemaker may be needed. It is a very small computer and battery that is implanted under the skin of the chest with wires that are threaded through the large vein in the chest to the heart. The wires emit a small current of electricity that paces the heart, thereby allowing the person to have a normal rate. Pacemakers are usually considered when a person has complaints of dizziness or passing out and are found to have a slow heart rate. This is called symptomatic bradycardia. If correctable reason can be found for the rhythm problem, a pacemaker is needed.
IMPLANTED CARDIOVERTER DEFIBRILLATOR
An ICD is a special kind of pacemaker that is also a defibrillator. Its main purpose is to shock the heart into a normal rhythm if the person experiences an abnormal, potentially deadly rhythm. It is implanted in much the same way as a pacemaker and also has pacemaker functions. It is implanted in people who have had certain potentially deadly rhythms called ventricular tachycardia or ventricular fibrillation. It is also implanted in people whose heart muscle is very weak, as they are more susceptible to one of the deadly rhythms.