Many patients first come to the Institute for diagnostic testing. Diagnostic testing performed by qualified technologists at Glenwood include:
These are noninvasive procedures, as they do not invade the body’s surface. They are safe, painless and normally performed on an outpatient basis. Examples of these type of procedures done at Glenwood include: electrocardiogram and echocardiogram. The electrocardiogram or EKG is used to detect and record the electrical activity generated by the heart. Most people are familiar with the EKG because the test is often given as part of a general physical exam.
Echocardiography is another type of noninvasive test. This test relies on high frequency soundwaves that are bounced off tissue in the heart and are reflected back through a transducer (a small microphone-like device) held on the patient’s chest. A computer uses the information coming from the transducer to construct an image of the heart, which is displayed on a television screen and can be recorded on videotape or printed on paper.
The various diagnostic techniques complement each other and provide more information about the patient’s heart to his physician.
Another vital diagnostic tool in the care of the heart is a stress test or exercise test combined with an EKG. The stress test is used to see how the heart performs when it is asked to work harder. While the patient is walking, he is connected to EKG equipment so that the heart rate and rhythm can be monitored.
Another type of stress test is a medication- induced stress test. If a patient is unable to walk, a medication (e.g. persantine) may be given to produce an effect on the heart as though the patient were exercising.
To make a stress test more useful, it may be combined with infusion of a nuclear material (called a nuclear stress test) in which a radioactive isotope is injected through a vein. It moves through the bloodstream and settles in the heart muscle. A special camera is then used to picture the heart and blood flow in the heart muscle to determine if there are blockages. The stress test may also be combined with echocardiography (stress echo). Your doctor will know exactly which type of stress test is best for you.
Ambulatory electrocardiography (also, Holter Monitoring)
Holter Monitoring is another noninvasive diagnostic procedure, where a patient wears a small recording device as he or she goes through their normal life. The device records the heart’s electrical currents, allowing it to document any abnormalities. The patient normally wears the Holter monitor 24-48 hours.
This diagnostic process involves the use of radioactive dyes which are injected into an individual’s blood stream, where they flow to the heart. Advanced technology including x-rays, CT scans, and MRI are then used to examine the heart for abnormalities
The non-invasive tests often point the way to a need for additional procedures, such as cardiac catheterization. The cardiac cath has been described as the most important cardiac diagnostic method developed in recent years. Glenwood offers two fully equipped catheterization labs. A cardiac cath involves inserting a flexible narrow plastic tube (catheter) into a vein or artery in a patient’s upper leg (groin) or arm. The catheter is then passed through the blood vessel into a heart chamber or to a coronary artery. Special X-ray dye, called contrast, is injected and allows the doctor to visualize the coronary arteries and evaluate the heart chambers and valves. X-rays are made and other tests are done such as taking blood samples and measuring the pressure inside the heart. The quality of the equipment in a cath lab is important. State of the art equipment provides more information and a quicker turnaround time in making a diagnosis and treatment plan.
Patients can have difficulty with the heart’s rhythm and electrical signaling. There are many different forms of arrhythmias, or irregular heart beats. Some include tachycardia (heart beats too fast), bradycardia (heart beats too slow), atrial fibrillation, supraventricular tachycardia, Wolfe Parkinson White syndrome, neurogenic (syncope), ventricular tachycardia, and other complex arrhythmias.
Heart rhythm disorders can be treated with medications, and our specialists work with the most current medical regimens available. Arrhythmias may also require the use of devices, such as pacemakers, often done through catheters, for the greatest control of the problem.
Pacemakers and Defibrillators
There are a variety of heart rhythm disorders including tachycardia (heart beats too fast), bradycardia (heart beats too slow), and irregular heart rhythms. These abnormal rhythms usually cause palpitations or a feeling of skipped beats, and range from benign to life threatening. Many abnormal rhythms are treated with medications, but some respond best to pacemaker insertion. We offer highly specialized approaches to heart rhythm problems including:
- Full range of the newest pacemakers to treat slow heart rhythms and help prevent recurrence of the tachycardia.
- Implantable cardioverter-defibrillators (ICDs) which are on standby to convert or shock life-threatening rhythms and also function as pacemakers.
- Biventricular pacemakers which can help to improve left ventricular function in selected patients with congestive heart failure and also treat the bradycardia.