Cardiovascular Tests & Diagnosis

Diagnosing Heart and Vascular Conditions

When you have a heart condition, you need treatment options you can count on. At University Health System, our cardiovascular program includes skilled cardiologists, cardiothoracic and vascular surgeons who treat patients with a wide range of cardiovascular conditions.

Our care begins with the initial and accurate diagnosis of your heart or vascular condition and continues through intervention and all the way through to your rehabilitation.

Leading-Edge Diagnostic Equipment and Highly-Trained Technicians

We perform hundreds of leading-edge heart and vascular procedures each year. Before our surgeons begin any kind of treatment, we rely on advanced testing and technologies to diagnose your condition. In addition, our clinical staff includes highly-trained, diagnostic technicians and American Nurses Credentialing Center (ANCC) Magnet-certified nurses.

Below, are some of the tests and imaging exams we use to help us determine the cause of your medical condition.

3-D EP Mapping

Electrical pathways of your heart are mapped to search for the “short circuit” causing your irregular heart rhythm. We use state-of-the-art, three-dimensional imaging technology instead of standard X-rays.

Pharmacologic Nuclear Stress Testing

This procedure is used with patients who can’t exercise on a treadmill. An IV line delivers a vasodilator drug and a nuclear radioisotope. The drug helps expand the coronary arteries, mimicking the effect of exercise. A nuclear scanner detects the radioisotope and reveals the parts of the heart muscle that are not receiving enough blood flow.

This test helps your doctor find irregular heart rhythms, areas of the heart not getting enough blood and oxygen and how quickly the heart recovers after exercise.

Angiography

Coronary Angiogram (Diagnostic Cardiac Catheterization)

A short, hollow tube is inserted into a blood vessel in your arm or leg. Then, a catheter is inserted into the tube and positioned to release dye into the heart. The dye shows up on X-ray and other tests. This allows your doctor to evaluate your heart function.

The procedure is used to confirm coronary artery disease, determine how your heart muscle functions and identify treatments that may be needed. It can be used for both diagnostic and interventional purposes.

Peripheral Angiogram

Your doctor uses X-rays to help find narrowed or blocked areas in one or more of your arteries. A catheter placed into the arteries delivers a dye into the bloodstream, visible by X-ray. Narrowed or blocked arteries appear on a video screen.

Arterial Testing

We conduct a number of arterial tests on the upper and lower extremities, most often to diagnose peripheral arterial disease (PAD). The series of tests typically includes one or more of the following:

  • Pulse and blood pressure checks
  • Ankle-Brachial Index (ABI) tests
  • Color Doppler Ultrasound
  • Magnetic Resonance Angiogram (MRA)
  • Computerized Tomography (CT) Angiogram

Echocardiography

Echocardiogram

This ultrasound test uses sound waves to take pictures of the heart. Sticky patches called electrodes are placed on your chest to monitor your heart rhythm. We use an ultrasound transducer to capture images of your heart. This allows your doctor to see your heart in motion and analyze its size, shape and function.

Stress Echocardiogram

This is an ultrasound-based test. You start on a treadmill until you reach your peak heart rate. (If you’re unable to walk on a treadmill, you’ll be given a drug to make your heart beat faster and harder as it would during exercise).

Once your heart rate increases, we use an ultrasound to take images of your heart’s reaction to the “stress” and determine if you have coronary artery disease.

Transesophageal Echocardiogram (TEE)

During transesophageal echocardiogram, sound waves bounce off your heart to create an image. A long, thin, flexible tube is inserted through your mouth and down your esophagus. A tiny transducer at the tip of the probe sends and records the sound waves.

This test detects a number of conditions, such as:

  • Blood clots inside the heart
  • Function of heart valves, including artificial ones
  • Holes between the chambers of the heart, dissection or tear in the lining of the aorta
  • Infections of the heart valves

Electrophysiology (EP) Studies

EP studies record your heart’s electrical activity. We conduct tests if you are experiencing:

  • heart rhythms are too slow (bradycardia)
  • heart rhythms are too fast (tachycardia)
  • feelings of dizziness, passing out or an episode of losing consciousness
  • symptoms that may indicate the need for a pacemaker or an ablation procedure

Exercise Treadmill Testing

This test measures the effect of exercise on your heart. Your technician places sticky patches called electrodes on your chest. The electrodes are attached to a monitor that follows the electrical activity of your heart and takes your blood pressure while you walk.

The test ends when you reach a target heart rate, you are too tired, or readings show your heart muscle is not getting enough oxygen.

Exercise Nuclear Stress Testing

This test uses a nuclear isotope to help your doctor understand how well blood flows to the heart muscle at rest and during exercise. An IV line distributes the nuclear radioisotope so your doctor can take pictures of your heart before and after you exercise on the treadmill.

This test can show the extent of any coronary artery blockage and if surgical or nonsurgical treatment is necessary.

Heart Biopsy

Small pieces of tissue taken from the heart muscle help your doctor diagnose a condition that may require a change in your medical therapy. Heart biopsies often help determine if a virus has caused inflammation of the heart muscle (myocarditis) or to check for signs of a heart transplant rejection.

Ambulatory Monitoring

We use this technique to continuously record your heart’s activity for 24 to 48 hours to detect changes in its rhythm.

Sticky patches called electrodes are placed on your chest and connected to a portable monitor you wear during your regular activities (eating, sleeping, working). The monitor helps detect an arrhythmia – your heart beating too fast, too slow or irregularly – and if treatments are working. You also keep a diary of activities while wearing the monitor.

Hypertrophic Cardiomyopathy (HCM) Evaluation

We use this diagnostic strategy to detect this inherited disease of the heart muscle. HCM can cause the wall of the heart muscle to thicken, obstructing blood flow from the heart. This genetic heart disease can cause sudden cardiac death in the young and heart failure at any age.

Optical Coherence Tomography

This imaging technology is similar to intravascular ultrasound, though it uses light instead of sound to look inside the coronary artery. It captures high-resolution, three-dimensional images from within the coronary arteries to give your doctor a clear image of your arteries to identify areas of plaque buildup or blockage.

Additional Ultrasonography

Carotid Ultrasound

This test is painless and harmless. As with any form of ultrasound, it uses high-frequency sound waves to create pictures of the insides of your carotid arteries on each side of your neck. Carotid ultrasound scans for blocked or narrowed carotid arteries, which can indicate an increased risk of stroke.

Intravascular Ultrasound

During this test, a small ultrasound transducer is advanced through a narrowed blood vessel to measure blood flow in real time. We also use it to test the results of a coronary angioplasty/balloon angioplasty, the need for a stent or for monitoring purposes.

Intracardiac Ultrasound

We perform this procedure with an ultrasound machine that has been adapted to create images of the heart from the inside out. A tiny ultrasound camera sits on top of a flexible catheter and provides detailed pictures to clearly identify heart structures during cardiac procedures.

Venous Ultrasound

Doctors use this exam to see the flow of blood through your veins and to search for blood clots, especially in your leg veins. This condition is often called deep vein thrombosis. These clots can break off and pass into the lungs, where they can cause a pulmonary embolism.