Cardiovascular Integrated Physicians (CVIP) provides the following office-based diagnostic testing.
The body is a conductor of electricity, and the heart is one area where a lot of critical electrical conduction takes place to keep the heart beating and supplying blood to the body. The electrical activity produced by the heart is captured by a recording called an electrocardiogram, or ECG or EKG for short. The ECG is generated from the development and conduction of signals in the heart. The electrical impulses produced in different chambers of the heart correlate with the waves displayed in an ECG.
An ECG is a noninvasive, painless diagnostic test that is performed during routine doctor’s office visits. It is conducted to detect and evaluate heart conditions such as arrythmias, or abnormal heart rhythms, heart injuries (ischemia), and artery narrowing or blockage. Doctors also run ECG tests to assess the results and performance of heart devices or treatments, such as pacemakers.
Echocardiogram (Heart Ultrasound)
An echocardiogram is an ultrasound examination of the heart. It is used to evaluate the states of various cardiac chambers, valve functions, and structures. In the examination, a device called a transducer emits sound waves that are too high to hear, and when it is placed at various locations and angles on a patient’s chest, those waves travel through the skin and bodily tissues to the heart tissues. At the heart tissues, these sound waves bounce off areas of the heart in an echo-like fashion. The echoing waves are captured and used to generate computer images of heart structures like walls and valves. Viewing these images on a monitor, doctors can see the heart as it beats and pumps blood. With these visuals, doctors can obtain critical information and insight about a patient’s heart, such as heart muscle damage, heart defects, valve leakage, and changes in heart size. With echocardiograms, many heart conditions can be identified and/or analyzed, including heart failure, pericardial effusion, and congenital heart disease. This noninvasive test is conducted in a doctor’s office and typically takes up to 45 minutes.
To determine how well a patient’s heart performs during physical activity, a doctor may order a stress test, which can not only help evaluate heart performance but also aid in diagnosing critical heart conditions, such as arrythmias, and coronary artery disease. It can also aid in determining underlying causes of symptoms patients may experience, such as chest pain or shortness of breath. A stress test can be performed by exercise (walking on a treadmill) or by pharmacologic agents that simulate the effect of exercise on heart physiology. The test is a noninvasive, allowing evaluation of exercise tolerance and body response to physical activity by monitoring heart rate, blood pressure, and ECG activity during exercise or stress. The test also allows examination of how well blood flows through the heart muscle. Images of heart muscle showing blood flow are obtained by a myocardial perfusion scan (nuclear imaging) before and after stress. Another way to indirectly evaluate blood flow through heart muscle is an echocardiogram. This indirectly evaluates blood flow by assessing how vigorously the heart muscle contracts before and after stress. A stress test can show if there is an area of the heart muscle that is not receiving an adequate amount of blood flow after stress, indicating the possible presence of blockages within the coronary arteries. An abnormal finding in a stress test may necessitate additional tests or procedures, such as cardiac catheterization and coronary angiogram, for further evaluation.
Remote monitoring, Event Monitor
An event monitor is a portable device that captures and records the electrical activity of a patient’s heart. It is worn for various lengths of time (from 24 hours to several weeks). Event monitors enable doctors to detect and evaluate any abnormal heart rhythms (arrythmias) that happen temporarily or randomly, especially outside of the doctor’s office. Different heart rhythms can come and go, such as with atrial fibrillation. An event monitor will provide more information about any possible arrythmias, such as the type of arrythmia a patient is experiencing.
An implantable loop recorder, also known as an ILR, is a heart monitor that lasts up to 3 years. It is a small device that is inserted under the skin on the chest by a doctor in an officed-based, minor procedure that takes approximately 5 minutes. For patients with infrequent heart symptoms that cannot be observed with an event monitor, an ILR is an appropriate alternative because the ILR allows for further monitoring of symptoms by functioning as an ECG device that captures data on electrical signals generated by the heart. An ILR can help identify arrythmias that cause conditions such as fainting spells or unexplained strokes. Patients with a history of stroke or fainting predisposition are advised to have a loop recorder implanted for further evaluation of heart rhythms that can cause their symptoms.