Diagnostic testing is generally safe, uncomplicated for the patient and causes little if any discomfort. The results of these tests are extremely valuable in determining the health of your heart.
Your doctor will begin be reviewing your medical history and giving you a complete physical examination, which often includes blood tests. This will help your doctor to determine if you have any risk factors that may contribute to the development of heart disease.
In most cases, your evaluation will continue with an electrocardiogram, commonly called an ECG or EKG. Like all muscles, the heart is made up of cells. Heart cells generate tiny electric impulses with each heartbeat, and together the billions of heart cells produce enough electricity to be measured on the surface of the skin, by use of electrodes or leads. An electrocardiogram is a recording or the heartbeat made by those electrical impulses. The pattern of the line can tell the doctor many things about the heart.
Berkeley Heart Lab Blood Test
sdfasdfA special test that measures the types and amounts of cholesterol in the blood. Certain types of cholesterol ("small LDL") can contribute to Coronary Artery Disease. It is especially important to monitor and control cholesterol levels in patients with a history of cardiovascular disease.
In cardiology parlance, "Lipids" refers to a test to measure cholesterol and triglyceride levels in the blood. Blood is drawn, usually from veins in the arm or back of the hand, and analyzed by a lab for its concentration of triglyceride and the different forms of cholesterol: HDL (high density lipoprotein), LDL (low density lipoprotein), and VLDL (very low density lipoprotein). These concentrations are measured in units of milligrams per deciliter (mg/dL) and compared to levels normally found in healthy patients.
Generally, higher cholesterol levels signal risk of heart disease. The "total cholesterol" level, the sum of HDL, LDL, and VLDL cholesterol levels, should be below 200 mg/dL. It is very important to note the contributions of HDL, LDL and VLDL to the total cholesterol figure. VLDL and LDL are considered "bad cholesterol", which remains in the body; HDL is considered "good cholesterol" because, in HDL form, cholesterol is removed from the body by the liver. Thus, high levels of LDL are unacceptable (above 160 mg/dL in healthy individuals, or 100 mg/dL in patients with history of heart disease), while high levels of HDL are favorable (above 60 mg/dL). HDL levels below 40 mg/dL are a sign of possible heart disease.
Triglycerides are a related indicator of heart disease. Triglyceride levels substantially greater than 150 mg/dL suggest heart disease, even when accompanied by acceptable cholesterol concentrations.
A2D Echo with Doppler
Transesophageal Echocardiogram (TEE)Transthoracic Echocardiogram (TTE)
Basically a 24-hour ECG, a Holter Monitor is a small device that measures the heart rhythm during normal activity. Electrodes connected to the Holter are secured to the skin, and the monitor records activity as the subject continues with a normal day. Later, the monitor is removed and the physician examines its recordings for abnormal activity.
Like a Holter, an Event Monitor is basically a portable ECG. A patient usually wears the beeper-sized Event Monitor for about one month, activating it by pressing a button whenever abnormal heart rhythms are felt. The Event Monitor records the heart's activity for the physician to examine at a later time.
Impedance cardiography is a non-invasive test that uses measurements of electrical impedance across the chest to determine changes in the volume of the heart. The various ICG measurements tell the doctor how well the heart functions as a pump, including how much blood moves through the heart in each beat and how much vascular resistance the heart must overcome.
A test to examine the flow of blood through the heart. Via injection, the subject is administered Cardiolite, a radioactive isotope that is formulated to target the heart. After a few hours, this isotope has spread throughout the body and into the heart. Because it is radioactive, the isotope emits gamma rays that can be detected by special Nuclear Imaging equipment and transformed into moving images of blood flowing through the heart. The doctor uses these images to detect abnormal blood flow and diagnose disease.
Like X-ray imaging, a Nuclear Study exposes the body to radiation. Although excessive radiation can have damaging effects, exposure to the patient is carefully minimized and monitored to ensure safety.
See the Nuclear Imaging for yourself. Magnify the image for a closer look at blood flowing through the heart. Subsequent to a Nuclear Study your doctor will discuss these test results with you.
In addition to observing heart activity while a patient is resting, it is important to know how the heart responds to exercise. This is the purpose of a Treadmill (or Stress) Test. A technician attaches electrodes to the subject's body that monitor the activity of the heart. Next, the patient walks on a treadmill while the heart activity is recorded. The speed of the treadmill gradually increases from a leisurely pace to quick enough that the patient's heart rate is substantially increased. This often reveals heart problems that do not manifest while at rest.
Assessment of the ventilatory pump and gas exchanger is further enhanced by the information provided by pulmonary function testing. Measurement of lung volume is important in assessing the full extent of COPD, specifically, the degree of hyperinflation and air trapping, which are important criteria for interventions such as lung volume reduction surgery, or in determining whether restrictive lung disease is present, that is whether total lung capacity is reduced. Respiratory muscle strength is assessed by measurement of maximal inspiratory and expiratory pressure and should be determined if neuromuscular disease is suspected.
The lungs diffusing capacity for carbon monoxide (DLCO) provides insight into the status of the membrane between the pulmonary capillaries and the alveoli. In disease that result in destruction of lung tissue (e.g., emphysema, pulmonary fibrosis) or inflammation of the pulmonary interstitium, DLCO is reduced. In contrast, patients with mild CHF have an increase in pulmonary vascular blood volume and a mild increase in DLCO.
Sleep Apnea is a condition in which the individual repeatedly stops breathing during sleep. The two main causes of this condition are blockage of the airway by the soft tissues of the throat, and failure of the brain to initiate breathing. Sleep Apnea is a rather common affliction, especially in overweight males over the age of 40.
Untreated Sleep Apnea can cause a variety of problems, including cardiovascular disease. Because of this, we ask our patients to complete a short survey that may indicate presence of the condition.