Diagnostic Cardiology Tests

Our Cardiology Department offers a full spectrum of clinical services and diagnostic testing. This section is designed to introduce you to the numerous tests we offer at each of our campus. Please feel free to call the Cardiology Department Capital Health Medical Center - Hopewell at 609-303-4000 or at Capital Health Regional Medical Center at 609-394-6084 should you require more information. All tests require a script with a reason for the test (or referral) from your physician, and can be scheduled through Capital Health Central Scheduling at 609-394-6695, unless otherwise noted.

Diagnostic Cardiology Tests

  • Echocardiogram - An echocardiogram is an ultrasound of the heart. The “echo” allows the cardiac ultrasonographer to view and record the structures and motion of the patient’s heart; such as, the walls, valves, muscles and blood vessels. The cardiologist can accurately diagnose acquired, as well as congenital heart defects. An echocardiogram is a painless non-invasive test utilized to help diagnose structural defects, CAD, cardiomyopathy, and the cause of cardiac murmurs. The patient should bring a list of their current medications. An echocardiogram takes approximately 30-45 minutes.
  • Electrocardiogram (EKG or ECG) - An electrocardiogram is a graphical recording of the heart’s electrical activity. The signal is associated with the muscular contraction, which produces the pumping action. Electrodes are positioned on the chest, arms and legs. The EKG is painless and takes about 5-10 minutes. An EKG does not require any special preparation.
  • Event Monitor (Loop Monitor Pre/Post) - An event recorder is a patient-activated monitor that captures EKG data prior to and after the patient experiences a symptom. The event recorder provides a method of collecting EKG strips over an extended period of time for patients with intermittent cardiac symptoms or events.

    • The patient should wear a comfortable two-piece outfit and bring a list of their current medications.
    • The patient will be able to take the monitor off as necessary, and will be given extra electrodes to reconnect the monitor.
    • The patient will be instructed in how to send their recordings over the telephone, and when the monitor is to be returned.

        The time required for patient hook up and explanation is approximately 20 minutes.

  • Exercise Stress Test - An exercise stress test allows the cardiologist to assess the patient’s ability to tolerate increasing intensities of exercise while EKG, blood pressure, and symptomatic responses are monitored for signs of myocardial ischemia, electrical instability, or other abnormalities. The test can help reveal abnormalities that are not apparent at rest. An exercise stress test can help to evaluate the cause of symptoms, as well as the efficacy of medications the patient is on.

    • The patient should wear a comfortable two-piece outfit, rubber-soled shoes, and bring a list of current medications.
    • The patient must be able to walk on a treadmill.
    • The patient must also fast three hours prior to the test time and abstain from food and drinks containing caffeine 24 hours prior to their test.

        The test takes approximately one hour.

  • Holter Monitor - A holter monitor is a small lightweight digital recorder that continually records a person’s heart rhythm for 24 or 48 hours. The purpose of a holter monitor is to determine the effectiveness of medication therapy, evaluate arrhythmias, or to correlate a symptom with EKG findings. Four adhesive electrodes are placed on the chest, which are connected to wires and the monitor. The patient receives a diary to keep track of symptoms, and is to return the following day to be disconnected from the monitor. When the monitor is returned, the digital recorder is then scanned. The cardiologist reads the printout and dictates a report.

    • The patient should wear a comfortable two-piece outfit and bring a list of their current medications.
    • The patient will not be able to bathe or take a shower until the monitor is disconnected.

        The time for patient hook up and explanation is approximately 20 minutes.

  • Nuclear Stress Test -A nuclear stress test involves the injection of a radionuclide tracer (a radioactive material carried by the blood stream and taken up by the heart muscle) at rest and again at the time of peak exercise, pharmacologically induced vasodilation (dypyridamole, adenosine, or regadenoson), or adrenergic stimulation (dobutamine). The exercise allows the cardiologist to see how the patient’s heart responds to increasing workloads as the patient walks on a treadmill. The patient will lie under a camera for 15 minutes after each injection of radioisotope. During the test, the patient’s EKG and blood pressure will be monitored. The patient should wear a comfortable two-piece outfit and rubber soled shoes.

    • The patient should bring a list of their current medications.
    • The patient should fast for three hours prior to their test and abstain from drinks or food containing caffeine for 24 hours prior to their test.

        The patient should expect to be at the hospital for this test, for approximately three-four hours.

  • Stress Echo - A stress echo involves having an echocardiogram performed while at rest (described above), then walking on a treadmill at increasing speed and incline. Immediately after the patient has exercised enough to reach an age predicted heart rate, the patient has another echocardiogram performed while their heart is still beating fast. The cardiologist can then see how the heart functions under stress. The stress echo helps to diagnose coronary artery disease.

    For patients who are not able to walk on a treadmill, the physician may order a Dobutamine stress echo. Dobutamine is a medication that is able to increase the patient’s heart rate and contractility without exercise

    • The patient should wear a comfortable two-piece outfit and rubber-soled shoes.
    • The patient should bring a list of current medications.
    • The patient should fast for three hours prior to their test.

    The test takes approximately 1 hour.
  • Tilt Table Test - A tilt table test may be ordered to diagnose and evaluate complaints of dizziness or syncope focusing on hypotension or bradycardia related causes. A nurse starts an IV on the patient and connects the patient to a monitor to observe and record the patient’s heart rate and blood pressure. When the cardiologist arrives, the table that the patient is secured to with comfortable safety straps will be tilted to approximately 80 degrees. The patient remains standing on the footboard of the table for about 25 minutes to see if the patient passes out or experiences dizziness. The cardiologist may have the nurse inject a medication through the IV, then wait to see if the patient passes out or experiences dizziness. The test may uncover a dysrhythmia of the heart, which may be causing the syncope. A tilt table test requires a cardiac consult. The patient should have nothing to eat or drink six hours prior to the test. Regular medication should be taken unless instructed by the physician. The test takes approximately 1 to 2 hours.
  • Transesophageal Echocardiogram - A transesophageal echocardiogram or “TEE” is a test used to visualize the heart structure and function with an ultrasonic beam from the esophagus, unobstructed by lung or chest wall. The TEE sends ultrasound waves to the heart through a tube put down your throat. Reasons to have a TEE include looking for endocarditis (infection in the heart), to look for blood clots, or other abnormalities that cannot be visualized with a transthoracic (standard) echocardiogram. The patient must have a cardiac consult, and may require pre-admission blood work done prior to the day of their TEE. The patient is to be NPO from midnight, and should arrive at the hospital 1 1/2 hours prior to his or her appointment time. The patient will be receiving conscious sedation for the test, so should have someone available to drive them home.
     

Pulmonary Tests (Only available at Capital Health Medical Center - Hopewell)

  • Flexible Fiberoptic Bronchoscopy - A bronchoscopy is a procedure that allows the pulmonary physician to look inside the patient’s trachea and bronchial tubes using a small flexible scope. The pulmonary physician is able to take specimens during the procedure for analysis by the lab. A bronchoscopy is typically done if the patient has coughing or wheezing that does not go away, blood in the sputum, an abnormal chest x-ray, or if the patient has aspirated a foreign object. The patient must have a pulmonary consult, and may have pre-admission testing prior to the day of their procedure. The patient is to be NPO since midnight, and should arrive to the hospital 1 1/2 hours prior to their appointment time. The patient will be receiving IV conscious sedation for the test, and must have someone available to drive him or her home.
  • Methacholine Challenge (Bronchial Provocation) - A Methacholine challenge is a test to diagnose bronchial airway hyperactivity in patients who do not have clinically apparent asthma. The test involves a breathing maneuver that is repeated following the inhalation of a medication (Methacholine). A pulmonary physician may order a Methacholine challenge if the patient has a chronic recurrent cough, recurrent respiratory infections, or a history of wheezing not present at the time of the physical exam.

    • The patient should refrain from caffeine ingestion for at least six hours prior to the test.
    • The patient should refrain from smoking for at least six hours prior to the test.

    Medication abstinence should include:
    • Any steroids, leukotriene inhibitors, and/or antihistamines for 10 days prior to test date.
    • Short acting beta-agonists for 6 hours, Xopenex for 12 hours prior to test time.
    • Serevent, Theophylline, and Cromolyn sodium for 3 days prior to test date.
    The test takes approximately 1 to 2 hours.
  • Pulmonary Function Test - A Pulmonary function test (PFT) is a study comprised of several breathing maneuvers requiring coordination and cooperation of the patient. A PFT provides the ability to quantitate the degree of lung disease and to evaluate the course of the disease process and it’s response to treatment (age six years and older).

    • The patient must abstain from smoking for four hours prior to their test, and must not use their inhalers for four hours prior to their test.
    • The patient should bring a list of current medications.

    The test takes approximately one hour. The test requires a script with a reason for the test (or referral), and whether the patient is to receive a bronchodilator treatment.
  • Pulmonary Stress Test (Exercise Oximetry) - An Exercise Oximetry is a test to determine the degree of oxygen desaturation and/or hypoxemia that occurs with exertion. The patient is expected to walk slowly on a treadmill. The patient’s EKG and oxygen saturation is monitored during the study.

    The patient should wear a comfortable 2-piece outfit and rubber soled shoes, and bring a list of their current medications.
  • Cardiac Catheterization Lab - A cardiac catheterization allows the physician to look at the blood vessels and chambers of the heart. It can show where the arteries are narrowed or blocked, or if there are any problems with the valves or muscle of the heart. The procedure is performed by inserting a thin catheter (tube) through a main artery in the leg or arm. The catheter is guided to your heart using x-ray. The cardiologist injects a clear x-ray blocking liquid (contrast) containing iodine to visualize the coronary arteries. The pictures are recorded onto CD-ROM for the physician to study. Because our equipment uses digital technology, the patient may expect faster diagnosis and reporting to their primary care physician, and lower x-ray exposure from traditional technology.

    Pre-procedure lab work is required. The patient will be required to be NPO from midnight prior to their procedure. On the day of their procedure, the patient will report to Capital Health Medical Center - Hopewell. The patient will need to report two hours prior to the procedure time and expect to stay four-six hours after the procedure is complete. The patient will be receiving IV conscious sedation and must have someone available to drive them home.
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