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Cardiac Tests & Diagnosis

The Heart Center team at Fort Sanders Regional Medical Center provides a comprehensive approach to cardiology starting with diagnosis and testing.

Echocardiography

Echocardiography is a diagnostic test that uses ultrasound waves to create an image of the heart muscle. Ultrasound waves that rebound or “echo” off the heart provides the physician with information regarding the size, shape, and movement of the heart’s valves and chambers as well as the flow of blood through the heart. Echocardiography may show such abnormalities as poorly functioning heart valves or damage to the heart tissue from a past heart attack.

Listed below are three echocardiography techniques:

The Transthoracic Echocardiogram, also referred to as a TTE, is the most common type of echocardiography. This procedure obtains views of the heart by moving a transducer to different locations on your chest or abdominal wall.

A Transesophageal Echocardiogram (also called a TEE) is an incredibly effective diagnostic ultrasound test that allows a physician to examine the heart by way of a tube that is inserted into the esophagus. Due to the limitations of the traditional echocardiogram, which views the heart through the chest wall, the TEE allows extremely clear images of many parts of the heart’s structures and blood flow that may be quite difficult or impossible to capture otherwise.

Echocardiographic Stress Testing is performed by completing an echocardiogram both before and after the heart is “stressed”. This stress is created by either having the patient to exercise or by injecting a medicine that causes the heart to beat harder and faster. This test is typically performed to assess the rate of blood flow to the heart.


Electrophysiology

The heart has an electrical system that produces tiny electrical impulses. These impulses travel from the upper to the lower chambers of the heart and tell the chambers to contract and pump blood. However, sometimes this electrical system may not be functioning properly.

When this happens it is necessary to study the electrical system with an intracardiac (within the heart) electrophysiologic procedure. In this procedure, one or more catheters (long, thin, flexible tubes) are placed into a blood vessel in the legs, arms or both. The tips of the catheters are strategically placed into the heart where they record the electrical signals. The precision of this procedure far exceeds that of an ordinary electrocardiogram (commonly referred to as an ECG or EKG).

The Tilt Table Test can help determine how your body responds to changes in position, in the event that you have had recurrent syncope (fainting spells). During the test, you lie on a table that can be moved to a nearly upright position while your symptoms, heart rate, and blood pressure are continuously monitored.

An Arrythmia Evaluation is preformed when the heart’s electrical system appears to not be working properly. This can cause abnormal abnormal heart rhythms, called arrhythmias. During an arrhythmia, the heart may beat too fast, too slowly, or irregularly. This is a fairly frequent occurence affecting as many as 2.2 million Americans are living with atrial fibrillation (one specific type of rhythm problem). Arrythmias can occur in a healthy heart and be of minimal consequence while some may indicate a very serious problem. These problems can lead to heart disease, stroke, or even sudden cardiac death.

Catheter Ablation is used to treat some types of arrhythmia (irregular heart rate or rhythm.) During catheter ablation, a series of catheters (thin, flexible wires) are inserted into your heart through a blood vessel in your groin or wrist. A special machine sends radiofrequency energy through the catheter to tiny areas of the heart muscle that cause the abnormal heart rhythm. The energy destroys and “disconnects” the pathway of the arrhythmia.

A Pacemaker is a small devise placed in the chest to help control arrhythmia (abnormal heart rate or rhythms). It sends electrical impulses to the muscle to prompt the heart to beat at a normal rate. A pacemaker may also be used to relieve some arrhythmia symptoms, such as fatigue and fainting spells.


Stress Testing

An Exercise Stress Test, sometimes referred to as a treadmill test, helps a physician to find out how well your heart handles exertion. As your body works harder during the test, it needs more oxygen and requires the heart to pump more blood. The test can demonstrate whether or not the blood supply is reduced in the arteries that supply the heart. Additionally, it allows the physician to assess the kind of level of exercise appropriate for the patient.

A Nuclear Stress Test is a diagnostic test used to evaluate blood flow to the heart. During the test, a small amount of radioactive tracer is injected into a vein. A special gamma camera detects the radiation released by the tracer to produce computer images of the heart. Combined with exercise, the test can help determine if there is adequate blood flow to the heart during activity versus at rest.