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Echocardiogram
An echocardiogram, is a sonogram of the heart. Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart. The latest ultrasound systems now employ 3D real-time imaging. In addition to creating two-dimensional pictures of the cardiovascular system, an echocardiogram can also produce accurate assessment of the velocity of blood and cardiac tissue. This allows assessment of cardiac valve areas and function, any abnormal communications between the left and right side of the heart, any leaking of blood through the valves (valvular regurgitation), and calculation of the cardiac output
Treadmill Stress Test
A cardiac treadmill stress test is a medical test that indirectly reflects arterial blood flow to the heart during physical exercise. When compared to blood flow during rest, the test reflects imbalances of blood flow to the heart's left ventricular muscle tissue – the part of the heart that performs the greatest amount of work pumping blood. The results may also be interpreted as a reflection on a person's overall physical fitness. The patient walks on a treadmill connected with the standard 10 electrodes used to record a 12-lead ECG. The level of exercise is increased in 3-minute stages of progressively increased grade (% incline) and speed (mph, km/h, etc.). The patient's symptoms and blood pressure response are repeatedly checked. The American Heart Association recommends ECG treadmill testing as the first choice for patients with medium risk of coronary heart disease based on the risk factors of smoking, family history of coronary stenosis, hypertension, diabetes, and high cholesterol.
Nuclear Stress Test (Lexiscan)
A nuclear stress test uses radioactive nuclides. After a suitable waiting period to permit circulation of the radiotracer, pictures are taken with a gamma camera to capture resting images of the blood flow. Then, pictures are captured after exercise to compare with the patient's resting images in order to assess the status of the patient's coronary arteries. Given the ability to visualize the relative amounts of radioisotope within the heart muscle, nuclear stress tests are more accurate in detecting regional areas of decreased blood flow. A nuclear stress test, what we call myocardial perfusion imaging is a test that looks at the blood flow to your heart muscle. We do that while you're resting and also with some form of stress, either exercise or sometimes we give a medicine to simulate the effects of exercise. An artery may be narrower supplying enough blood when you're resting, but when you exercise, that narrowed artery can't increase the flow to the heart muscle. The nuclear stress test measures the blood flow to the heart; it compares where the flow increases normally, compared to those areas where it doesn't increase.
Holter and Event monitor
A Holter monitor is a portable device for continuously monitoring various electrical activity of the heart for 24-48 hours . An event monitor is used for longer monitoring and up to 30 days. Its extended recording period is sometimes useful for observing occasional cardiac arrhythmias which would be difficult to identify in a shorter period of time. The Holter monitor records electrical signals from the heart via a series of electrodes attached to the chest. Electrodes are placed over bones to minimize artifacts from muscular activity. These electrodes are connected to a small piece of equipment that is attached to the patient's belt or hung around the neck, and is responsible for keeping a log of the heart's electrical activity throughout the recording period. The units record onto digital flash memory devices. The data are uploaded into a computer which then automatically analyzes the input, counting ECG complexes, calculating summary statistics such as average heart rate, minimum and maximum heart rate, and finding candidate areas in the recording worthy of further study by the technician.
