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IMPORTANT REMINDER
FOR ALL TESTING AT ANY CARDIOLOGY GROUP OFFICE: Please bring a referral,
if required by your Insurance carrier, or a Physician's note/prescription
for test to be performed. This will insure the appropriate and specific
test has been performed as ordered by your physician.
24 Hour Holter
Monitor (Ambulatory Monitor)Holter Monitoring is a
continuous recording of your heart rhythm for 24 hours while you perform
normal daily activities. The purpose of this monitoring is to detect the
presence of abnormal heart rhythms, to evaluate the effectiveness of heart
medications, to rule out the heart as the cause of your symptoms
(dizziness, palpitations, fainting spells), to evaluate pacemaker function
and to determine if the heart is receiving an adequate blood
supply.
Procedure:
- Areas of your chest will be cleansed with an abrasive alcohol pad
- Several electrodes (adhesive patches) are placed on your chest,
attached to wires and connected to a small, portable recorder
- Recorder is placed in a disposable pouch with a strap placed over
your shoulder
Special
Instructions while Wearing Holter Monitor:
- All wires and electrodes must remain in place for the entire 24 hour
period
- Do not allow electrodes, wires or recorder to become wet - Do not
take a bath, shower or swim while wearing monitor
- Avoid coming into contact with electric blankets, magnets or metal
detectors during monitoring period
- A diary will be provided for you to record all activities and
symptoms. Please include the time of your activities and/or symptoms.
- Please report to the Cardiology office to have the recorder removed
at the time provided by the Holter Technician along with the completed
diary .
Your monitor recordings will
be scanned by a computer and interpreted by a Cardiologist. A complete
report of the Holter Monitor test results will be sent to your physician
who ordered the Holter Monitor.
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Event
MonitorEvent Monitoring records your
heart rhythm for a period of time up to 2 weeks. Recordings are not
continuous and are initiated when you press an Event button when you
experience symptoms such as dizziness, lightheadedness and/or
palpitations. These recordings are transmitted to a scanning service that
provide a summary of events and heart rhythm tracings to The Cardiology
Group physicians for interpretation.
Procedure:
- Areas of your chest will be cleansed with an abrasive alcohol pad
- 2 electrodes (adhesive patches) are placed on your chest, attached
to wires and connected to a small, portable recorder (size of a
beeper/pager)
- Recorder is attached to belt, waistband or can be placed in shirt
pocket
Special
Instructions while wearing Event Monitor:
- All wires and electrodes must remain in place when recording
symptoms. May be removed for bathing, however, follow instructions,
provided by EKG Technician when re-attaching electrodes and wires - Do
Not allow electrodes, wires or recorder to become wet.
- Please return the event monitor, promptly, to the Cardiology Office,
when notified by the EKG Technician
Your monitor recordings will
be interpreted by a Cardiologist and a complete report of the test results
will be sent to your physician who ordered the Event Monitor.
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Electrocardiogram
(EKG)
Most common cardiac test
which measures electrical activity of the heart. Performed to
evaluate:
- Heart Rate and rhythm
- Patients experiencing chest pain, irregular heart rhythms
- Inadequate blood flow to the heart muscle
- Detects prior heart attacks
- Effectiveness of cardiac medications
- Pacemaker function
Procedure:
- 10 electrodes (adhesive patches) will be applied to your chest arms
and legs
- Electrodes are connected to wires attached to an EKG machine
- Recording obtained
- Wires and electrodes are removed
Preparation for
Test: None
Time for
Testing: 15 Minutes
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Echocardiogram
(Cardiac Ultrasound)An Echocardiogram is a
noninvasive test that transmits pulses of sound (ultrasound waves) from a
transducer (microphone) that produces pictures of your heart on a
television type screen. Testing to evaluate:
- Heart Murmurs (abnormal heart sounds)
- Size of the heart chambers
- Motion and function of heart chambers
- Heart valve function
- Blood clots or masses in the heart
- Presence of fluid around the heart
- Presence of openings/holes between the chambers of the heart
- Prior injury, damage to heart muscle caused by heart attack
- Presence of Congestive Heart Failure and other cardiac conditions
Types of
Echocardiograms: Transthoracic, Stress:
- M-Mode - measures heart chamber size
- Two Dimensional - evaluates shape and motion of heart structures
- Doppler /Color Flow Doppler - assesses blood flow through the heart
- Stress Echocardiography: performed before and after exercise to
evaluate tolerance to exercise, heart problems caused by exercise and
detects reduced blood flow to heart muscle during exercise/stress
Procedure:
Transthoracic:
- 3 Electrodes (adhesive patches) are placed on chest by Echo Tech
- You will be instructed to lie on your back and left side during the
test. A water soluble gel is applied to the transducer to transmit
pictures over various areas of your chest.
- Slight pressure may be applied by the transducer to your chest in
order to obtain quality pictures and you may be asked to hold your
breath for brief periods of time.
- Exam room will be darkened to allow Echo Tech better visibility
during testing
- Upon completion of Echo, electrodes are removed and chest is cleaned
of gel
Preparation for
Test: None
Time for Test: 30
- 45 Minutes
Stress
Echocardiography:
- You will be asked to review and sign a consent form for the test
- Areas of your chest will be cleansed with an abrasive alcohol pad
- 6 Electrodes (adhesive patches) are placed on chest
- During preparation by EKG Technician, a demonstration of walking on
the treadmill will be provided for you
- Cardiologist performs a resting Echocardiogram, obtaining pictures
of your heart while moving the transducer over various areas of your
chest
- You will be assisted to the treadmill for the Stress portion of the
test
- Stress test continues until you need to stop, you reach the target
heart rate predicted for you or until the test is stopped by the
Cardiologist
- You will be assisted back to the exam table table for a repeat
Echocardiogram
Preparation for
Test:
- Nothing to eat or drink 2 ½ hours prior to test
- Take your current medications, UNLESS otherwise instructed by your
Physician
- Wear comfortable, flat shoes/sneakers and loose fitting clothing,
appropriate for exercise
- Please bring a list of medications you are currently taking
- No smoking on the day of the test
Time for
Test: 1 Hour
Test
Results: Test will be interpreted by the Cardiologist and
report sent to your physician who ordered
test.
If you are unable to
keep your appointment or if you have any questions, please call
856-234-3332.
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Stress Test (Stress
EKG)
Cardiac Diagnostic
Test to evaluate:
- Heart function and functional capacity of heart
- Abnormalities of the heart or heart rhythm during exercise
- The presence or absence of heart disease
- The supply of blood to the heart during exercise
- Symptoms such as chest pain or shortness of breath
Types of Stress
Tests:
- Standard Stress Test (Treadmill)
- Nuclear Stress Test - Myoview (Treadmill)
- Nuclear Stress Test - Persantine (Pharmacologic/Medication)
Standard Stress
Test:
Procedure:
- Consent form for Stress test is reviewed and signed
- You will be instructed by the EKG Tech to remove clothing from waist
up and will be provided with a gown
- Areas of your chest will be cleansed with an abrasive alcohol pad
- 6 Electrodes (adhesive patches) are placed on chest, connected to
wires and attached to Stress Machine
- EKGs will be performed at rest, sitting and during hyperventilation
- Demonstration of walking on the treadmill will be provided by EKG
Tech
- Cardiologist or Physician Assistant will review indication for
stress test, your symptoms and answer any questions you may have
regarding the test
- Baseline Blood Pressure is obtained and BP cuff remains in place on
arm throughout test
- You will be assisted to the treadmill and exercise begins
- Treadmill speed and height will increase every 3 minutes (EKG Tech
will inform you prior to treadmill change)
- The Cardiologist/P.A monitors your Blood Pressure and EKG,
continuously.
- Stress test continues until either you need to stop, you reach the
target heart rate predicted for you or until the test is stopped by the
Cardiologist
- After the test, you will be monitored for several minutes until
heart rate, blood pressure and EKG return to pre test levels
Preparation for
Test:
- Nothing to eat or drink 2 ½ hours prior to test
- No Smoking on day of test
- Take your current medications UNLESS instructed by your Physician
- Wear comfortable, flat shoes/sneakers and loose fitting clothing,
appropriate for exercise
- Please bring a list of medications you are currently taking
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2 DAY PROTOCOL -
MYOVIEW/PERSANTINE STRESS TESTAll patients weighing
270 Pounds or more must be scheduled for testing over a 2 Day period of
time (not necessarily 2 consecutive days) to insure quality heart scans
and test results
First Day: Resting
Scan
- Myoview Stress Test: Nothing to eat or drink 4 hours prior to test
- Persantine Stress Test: Nothing to eat or drink 6 hours prior to
test
- Consent form reviewed and signed
- Intravenous injection of radioisotope, Myoview
- Wait 30 minutes
- 15 Minute Heart Scan
- First Day Testing is completed
Second Day: Stress
Test/Persantine - 2-10 Days after Day One
- Myoview Stress Test: Nothing to eat or drink 4 hours prior to test
- Persantine Stress Test: Nothing to eat or drink 6 hours prior to
test and No Caffeine for 24 hours prior to test
- Intravenous started in arm by Nuclear Medicine Tech for injection of
radioisotope
- For Myoview Stress Test: Exercise on treadmill
- For Persantine Stress Test: Administration of medication Persantine
(in place of walking on treadmill)
- Wait 30 minutes
- Heart Scan performed
- Test is completed
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MYOVIEW STRESS TEST
(Treadmill) A diagnostic test to evaluate
chest pain or shortness of breath, to detect the presence of early heart
disease, to assess your functional capacity or to update the status of
your coronary circulation following a cardiac event. You will receive an
intravenous injection of Myoview, a radioactive tracer that identifies
areas of decreased blood flow to the heart muscle caused by heart disease.
There are no harmful effects from the radioactive substance.
Procedure:
- After the consent form has been signed, an intravenous is started in
your arm for use throughout the entire test, approximately 5 hours.
Please remain on The Cardiology Group Office premises throughout entire
test.
- After the IV has been started, you will receive the Myoview
injection and then wait 30-60 minutes. The first set of heart scans will
be taken. During this 15 minute scan, you will be asked to position your
arms over your head. There is a 2 hour wait period after the first set
of scans.
- After the first scan, ECG electrodes will be placed on your chest.
You will be connected to the Stress Monitor and a series of ECGs will be
taken before, during and after exercise.
- You will be asked to walk on the treadmill until you reach your
maximum heart rate or you need to stop exercise. During exercise, the
treadmill will increase in speed and elevation, every 3 minutes. The
length of time for your exercise test will depend on your exercise
tolerance.
- One minute prior to the completion of exercise, Myoview will be
injected into the IV. You will then exercise for a full minute after the
injection to circulate the Myoview.
- After exercise, you will have an additional scan for approximately
12 minutes.
Reminders and
Preparation:
(IN ORDER FOR YOU TO
BE APPROPRIATELY PREPARED FOR YOUR TEST - PLEASE READ ALL REMINDERS PRIOR
TO TESTING)
**VERY IMPORTANT: IF YOU ARE UNABLE TO KEEP
THIS APPOINTMENT, PLEASE CALL THE CARDIOLOGY GROUP, P.A. OFFICE 48 HOURS
PRIOR TO TESTING at 856-234-3332**
- Please bring all medications you are currently taking on the day of
your test.
- NOTHING TO EAT OR DRINK 6 HOURS PRIOR TO TEST*** FAILURE TO FOLLOW
THIS INSTRUCTION WILL RESULT IN CANCELLATION OF TEST*** You may take
morning medications with a small amount of water
- No caffeine or nicotine on the day of test.
- Please wear comfortable clothing and shoes- including a SHORT SLEEVE
SHIRT/BLOUSE.
- IMPORTANT: If you are Diabetic, please contact your physician for
specific instructions for diet and/or Insulin and other Diabetic
medications prior to testing.
- If you are pregnant or currently nursing, please inform your
physician or technologist before this study is performed.
- If there is any possibility you may be pregnant, please notify the
Cardiology Group IMMEDIATELY (Test cannot be performed). If you are of
childbearing age you will be asked your Last Menstrual Period-if there
is any question regarding irregular or late menstrual period, you may be
required to have a pregnancy test (blood test) prior to testing to
safely administer this test (Pregnancy tests are not performed at The
Cardiology Group office)
- **Please bring a physician note/prescription or referral for this
test, on the day of the test (If your Insurance coverage has changed and
a Referral is no longer required, a Doctor's note/order for a specific
test/appointment MUST be provided to The Cardiology Group, P.A. office,
prior to testing).**
- If you have any questions about this test, please call us at
856-234-3332.
- *IMPORTANT: PLEASE REMEMBER TO REPORT FOR TESTING AT THE
TIME PROVIDED TO YOU. This test is timed for each patient. Reporting
late (15 MINUTES or more) will result in rescheduling test. Thank you
for your cooperation!
*Please Bring a Snack with you on the day of your test
(ie, crackers, juice)
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Pharmacologic Stress Test
(PersantineTM, AdenosineTM,
LexiscanTM)
Your physician has ordered pharmacologic
(PersantineTM, AdenosineTM, LexiscanTM or
"medication") Stress Test, to evaluate chest pain (or other
worrisome symptoms), to detect the presence of heart disease and/or to
evaluate the degree of damage following a heart attack. This test does not
require you to perform vigorous physical exercise on a treadmill. You may
be asked to perform mild physical activity (as you are able) such as hand
grip, leg kicking (while seated) or walking very slowly on a
treadmill. An intravenous (IV) will be started before
the test. A medication will then be given through the
IV to simulate certain physiologic changes that occur with
exercise. These medications usually DO NOT result in
significant changes in heart rate (demand on the heart) but rather
increase the heart's blood flow (supply) by dilating the blood vessels of
the heart. You will also receive an intravenous injection of a small
amount of radioactive medicine (MyoviewTM,
CardioliteTM and/or Thallium). These FDA
approved medications emit a small, safe, amount of radiation which is
used, with a camera, to pinpoint areas of decreased blood flow to the
heart muscle caused by heart disease. You will be monitored throughout the
test for blood pressure, heart rate, rhythm and EKG changes. Two sets of
heart scans will be taken; one at rest and one after the administration of
the pharmacologic stress medication.
Procedure: Test can take up 5 hours
(usually 3-4 hrs)
- After the Stress Test consent form has been signed, an
intravenous is started in your arm for use throughout the entire test.
IMPORTANT: Please inform the Heart Center staff if you are allergic
to PersantineTM (also called dipyridamole and is also present
in such medications as AggrenoxTM)
- You will receive the Myoview injection and then wait 30-60
minutes.
- The first set of scans will be taken and will take
approximately 15 minutes. There is a 2 hour wait period after first set
of scans.
- The pharmacologic stress medications
PersantineTM or AdenosineTM or
LexiscanTM will be given IV. Should you experience any side
effects, the antidote to the medication, Aminophylline, will be given
intravenously, to promptly reverse these effects.
- After the pharmacologic stress medication is given, Myoview will
be injected. After 30-60 minutes, a second set of heart scans will be
taken and will take approximately 12 minutes.
The entire test can take up to 5
hours (usual 3-4 hours).
**VERY IMPORTANT:
IF YOU ARE UNABLE TO KEEP THIS
APPOINTMENT, PLEASE CALL
THE CARDIOLOGY GROUP OFFICE 48 HOURS PRIOR TO TESTING at
856-234-3332**NO SHOWS ON DAY OF TEST WILL BE CHARGED FOR THE COST
OF THE RADIOISOTOPE**
- Bring all medications you are currently taking on the day
of your test.
- NOTHING TO EAT OR DRINK 6 HOURS PRIOR TO ARRIVAL TIME
from______. No Nicotine on the day of test.
- NO CAFFEINE PRODUCTS FOR 24 HOURS PRIOR TO TEST such
as : Coffee-with and without caffeine; all forms of tea-with or
without caffeine; chocolate; all cola beverages (including sugar-free
and decaffeinated) which include: Dr. Pepper, Ginger Ale, Mountain Dew,
Orange Crush, Root Beer
PLEASE NOTE** Test will be cancelled if
caffeine is consumed within 24 hours of test **
- MEDICATIONS CONTAINING CAFFEINE should be avoided
24 hours prior to test such as: Medications for Migraines,
Pain medications-Percocet, Darvon Compound, Fiorinal. Anacin, Excedrin
- MEDICATIONS for ASTHMA CONTAINING THEOPHYLLINE (interferes
with action of PersantineTM) should be avoided
36-48 hours prior to test: Aerolate, Bronkodyl, Constant-T,
Elixophylline, Quibron-T/SR, Respid, Slo-bid Gyrocaps, Slo-Phyllin
Gyrocaps, Sustaire, Theo-24, Theobid Duracap, Theochron, Theoclear L.A.,
Theo-Dur, Theo-Dur Sprinkle, Theolair-SR, Theospan-SR, Theospan Jr.,
Duracap, Theophylline S.R., Theovent Long-Acting, Uniphyl.
- MEDICATIONS for CIRCULATION and BLOOD THINNING
(interferes with the action of PersantineTM)
should be avoided 3 days prior to the test.
These include TrentalTM (also known as
pentoxifylline), PletalTM (also known as cilostazol) and
AggrenoxTM (a combination of dipyridamole and aspirin).
- IMPORTANT: If you are Diabetic, contact your physician who
manages your Diabetes for specific instructions for diet and/or
medication (such as Insulin and other Diabetic medications) prior to
testing. Please bring a Snack on day of test.
- If any medications need to be withheld prior to testing, a
Technician will contact you. If you are taking a diuretic (water pill),
hold AM of test and take after test is done.
- If you have lung problems such as asthma, emphysema or
COPD, please inform the nurse/tech prior to the test
- If you have claustrophobia, or have been claustrophobic
before during medical testing, please notify the Cardiology Group staff
(scanner used for this test does not encircle you, however, the scanner
comes close to your face/chest during scanning).
- If there is any possibility you may be pregnant, please
notify the Cardiology Group IMMEDIATELY (Test cannot be performed). If
you are of childbearing age, you will be asked for the date of your Last
Menstrual Period (LMP). If there is any question
regarding irregular or late menstrual period, you may be required to
have a pregnancy test (blood test) prior to testing to safely administer
this test (Pregnancy tests are not performed at The Cardiology Group
office)
- Please inform the staff if you have a history of any liver
problems/disease (such as Hepatitis B or C)
- DO NOT take alcohol, tranquilizers or sedatives prior to
testing.
- **IMPORTANT: Please bring a physician note/prescription or
referral for this test, on the day of the test (If your Insurance
coverage has changed and a Referral is no longer required, a Doctor's
note/order for a specific test/appointment MUST be provided to The
Cardiology Group, P.A. office, prior to testing).**
- If you have any questions about this test, please call us
at 856-581-5193.
- *IMPORTANT: PLEASE REMEMBER TO REPORT FOR
TESTING AT THE TIME PROVIDED TO YOU. This test is timed for each
patient. Reporting late (15 MINUTES or MORE) will result in
rescheduling test. Thank you for your
cooperation!
*Please bring a snack on day of test (i.e., crackers,
juice/water)*
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