Medical tests conducted for various health conditions
Also called: Doppler ultrasound or Carotid duplex ultrasound
Carotid ultrasound is a painless non-invasive test to take pictures of the blood vessels in your neck called carotid arteries. These blood vessels supply the brain. The test checks for narrowing of the carotid arteries by buildup of cholesterol (plaque) that could lead to stroke.
Most patients are referred for this study if they have had a stroke, a mini stroke or if your doctor hears a bruit (whoosh sound) on examining your neck.
The test is similar to baby ultrasounds during pregnancy and involves putting gel on your neck and testing with a probe. It usually takes around 30 minutes to do the test.
This is an ultrasound test that looks at your heart. It shows the size and thickness of the heart as well as the function of the heart and the valves. The usual reason the test is ordered is for swelling in the legs and shortness of breath. Sometimes after a stroke you may need an echocardiography to rule out a blood clot from the heart that could have caused the stroke.
Types of Echocardiography
The test is similar to baby ultrasounds during pregnancy and involves putting gel on your chest and testing with a probe. It usually takes around 30-40 minutes to do the test.
This is done to rule out any significant blockage in the blood vessels of the heart. You may be asked to exercise on a treadmill or be given a medication to speed up your heart. Pictures of your heart are taken both before and immediately after exercise or medication.
This test involves putting a thin tube, the thickness of your thumb, down your food pipe to get a closer look at the heart, especially the back part of the heart. Prior to the procedure, the back of your throat is numbed and you are given a sedative. The procedure takes around ½ hour and you are monitored during and after the procedure for around 2 hours. You are not able to eat for 2 hours after the procedure. Though usually safe, some patients may have throat soreness from the tube insertion and very rarely patients may have injury to the food pipe.
An electrocardiogram or EKG or ECG is a tracing of the electrical activity of your heart. It is a non-invasive test that is done in the office. Small quarter-sized sticky patches are put on your chest, arms and legs. Wires are attached to these patches on one end and to a machine at the other end that captures your heart’s electrical activity on a graph paper.
This test is usually done if you are having chest pain or palpitations.
Holter and Event Monitors
Holter and event monitors are medical devices that record the heart’s electrical activity. Doctors most often use these monitors to diagnose arrhythmias (ah-RITH-me-ahs). Arrhythmia may cause patients to feel palpitations (pal-pih-TA-shuns). Palpitations are feelings that your heart is skipping a beat, fluttering, or beating too hard or fast. You may have these feelings in your chest, throat, or neck. They may also cause patients to suffer fainting or feeling dizzy.
Holter and event monitors are similar to an EKG (electrocardiogram). However, a standard EKG only records the heartbeat for a few seconds. It won’t detect heart rhythm problems that don’t occur during the test. Holter and event monitors are small, portable devices that you can wear one while you do your normal daily activities. This allows the monitor to record your heart for a longer time than an EKG.
The monitor has sensors that attach to the skin on your chest. The sensors need good contact with your skin. Poor contact can cause poor results. When you have a symptom, stop what you’re doing. This will ensure that the recording shows your heart’s activity rather than your movement. Other everyday items also can disrupt the signal between the sensors and the monitor. These items include magnets; metal detectors; microwave ovens; and electric blankets, toothbrushes, and razors. Avoid using these items. Cell phones and MP3 players (such as iPods) may interfere with the signal between the sensors and the monitor if they’re too close to the monitor. When using any electronic device, try to keep it at least 6 inches away from the monitor.
While using a Holter or event monitor keep a diary of your symptoms and activities. Write down what type of symptoms you’re having, when they occur, and what you were doing at the time. Make sure to note the time that symptoms occur, because your doctor will match the data with the information in your diary. This allows your doctor to see whether certain activities trigger changes in your heart rate and rhythm.
Nuclear Heart Scan (Nuclear stress test)
A nuclear heart scan is usually done to check the blood flow to the heart muscle. For this test, a safe, radioactive substance called a tracer is injected into your bloodstream through a vein. The tracer travels to your heart and releases energy. Special cameras outside of your body detect the energy and use it to create pictures of your heart.
Usually, two sets of pictures are taken during a nuclear heart scan. The first set is taken right after a stress test, while your heart is beating fast. During a stress test, you exercise to make your heart work hard and beat fast. If you can’t exercise, you might be given medicine to increase your heart rate. This is called a pharmacological (FAR-ma-ko-LOJ-ih-kal) stress test. The second set of pictures is taken later, while your heart is at rest and beating at a normal rate.
Most scans take between 2–5 hours, especially if your doctor needs two sets of pictures. If you’re having an exercise stress test as part of your nuclear scan, you’ll walk on a treadmill or pedal a stationary bike, so wear comfortable walking shoes and loose-fitting clothes for the test. You may be asked to wear a hospital gown during the test. Before the test begins, the doctor or a technician will use a needle to insert an intravenous (IV) line into a vein in your arm. Through this IV line, he or she will put radioactive tracer into your bloodstream at the right time. You also will have EKG (electrocardiogram) patches attached to your body to check your heart rate during the test.
Most people can go back to their daily routines after a nuclear heart scan. The radioactivity will naturally leave your body in your urine or stool. It’s helpful to drink plenty of fluids after the test, as your doctor advises. The radioactive tracer used during nuclear heart scanning exposes the body to a very small amount of radiation. No long-term effects have been reported from these doses. Radiation dose might be a concern for people who need multiple scans. However, advances in hardware and software may greatly reduce the radiation dose people receive.
Coronary Calcium Scan
A coronary calcium scan is a test that looks for specks of calcium in the walls of the coronary (heart) arteries. These specks of calcium are called calcifications (KAL-sih-fih-KA-shuns). Calcifications in the coronary arteries are an early sign of coronary heart disease (CHD). CHD is a disease in which a waxy substance called plaque (plak) builds up in the coronary arteries. Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina (an-JI-nuh or AN-juh-nuh). If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. This is the most common cause of a heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries.
A coronary calcium scan is a fairly simple test that uses x rays to create detailed pictures of your heart. You’ll lie quietly in the scanner machine for about 10 minutes while it takes pictures of your heart. Your doctor may ask you to avoid caffeine and smoking for 4 hours before the test. The test will take about 10–15 minutes, although the actual scanning will take only a few seconds. During the test, the machine will make clicking and whirring sounds as it takes pictures. The scan causes no discomfort, but the exam room might be chilly to keep the machine working properly. You’ll be able to return to your normal activities after the coronary calcium scan is done.
Coronary calcium scans have very few risks. The test isn’t invasive, which means that no surgery is done and no instruments are inserted into your body. Unlike some CT scans, coronary calcium scans don’t require an injection of contrast dye to make your heart or arteries visible on x-ray images. Coronary calcium scans involve radiation, although the amount used is considered small.
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