Cardiovascular Testing is used to determine the type and severity of cardiovascular disease, and the most effective treatment methods.
Left Heart Catheterization
During left heart catheterization, your doctor passes a thin flexible tube (catheter) into the left side of your heart to diagnose or treat certain heart problems. The procedure is done to evaluate:- Cardiac valve disease
- Cardiac tumors
- Heart defects
- Heart function
Left heart catheterization may also be done to repair certain types of heart defects, or to open a clogged heart valve. When this procedure is done with coronary angiography, it can open blocked arteries or bypass grafts. The procedure can also be used to:
- Collect blood samples from the heart.
- Determine pressure and blood flow in the heart's chambers.
- Examine the arteries of the heart (coronary angiography).
- Take X-ray pictures of the left side of the heart.
Right Heart Catheterization
Right heart catheterization, or Swan-Ganz catheterization, is the passing of a thin tube (catheter) into the right side of the heart and the arteries leading to the lungs to monitor the heart's function and blood flow, usually in persons who are very ill.
The procedure is done to evalute how the blood moves (circulates) in people who have:- Abnormal pressures in the heart arteries
- Burns
- Congenital heart disease
- Heart failure
- Kidney disease
- Leaky heart valves (valvular regurgitation)
- Shock
It may also be done to monitor for complications of heart attack and to see how well certain heart medications are working. Right heart catheterization can also be used to detect abnormal blood flow between two usually unconnected areas.
Conditions that can also be diagnosed or evaluated with right heart catheterization include:
- Cardiac tamponade
- Pulmonary hypertension
- Restrictive cardiomyopathy
Peripheral Angiography
The word peripheral refers to those arteries, which are located away from the center of the body or the heart. This procedure is safe and a commonly used diagnostic procedure, which will help in the management of your peripheral vascular disease.
With the knowledge obtained from the peripheral angiogram, the cardiologist will be able to discuss your best treatment options. The purpose of this procedure is to open blocked arteries and is accomplished by maneuvering a catheter with a small balloon on the tip across the arterial blockage. Once it is positioned, the balloon is inflated, compressing the fatty deposits against the wall of the blood vessel and remodeling the vessel's shape. The diameter of the vessel is increased and blood flow is improved.
One of the most common reasons for peripheral angiogram is the need to visualize the arteries which supply blood flow to the legs; however, an angiogram is also performed to obtain information regarding blood flow in the abdominal region (aorta, intestinal and renal systems) as well as the upper body (subclavian, pulmonary, or carotid systems).
After your evaluation and recommendation for peripheral angiogram, certain blood tests will need to be obtained. This will include tests, which give information concerning blood count, blood coagulation, kidney function, electrolytes and lipid (blood fat) status.
EKG (electrocardiogram)
An electrocardiogram (also called EKG) is a test that records the electrical activity of your heart through small electrode patches on leads (small wires) attached to the skin of your chest, arms and legs. An EKG may be part of a routine physical exam or it may be used as a test for heart disease. An EKG can be used to further investigate symptoms related to heart problems.
EKGs are quick, safe and painless tests that are routinely performed if a heart condition is suspected, or as a routine pre-operative screening test.
Your Doctor Uses the EKG to:
- Assess your heart rhythm
- Diagnose poor blood flow to the heart muscle (ischemia)
- Diagnose a heart attack
- Evaluate certain abnormalities of your heart, such as an enlarged heart.
During an EKG, a technician will attach electrodes with adhesive pads on leads to the skin of your chest, arms and legs. You will lie flat while the computer creates a picture, on graph paper, of the electrical impulses traveling through your heart. This is called a "resting" EKG. It takes about 10 minutes to attach the electrodes and complete the test, but the actual recording takes only a few seconds.
A more involved version of this same test may also be used to monitor your heart during exercise. This is called a "stress" test. Cardiolite stress tests are performed in OP Radiology/Nuclear Medicine, and can be treadmill, Adenosine, or Lexiscan for the stress agent. We also perform standard treadmill tests, without other imaging, in the stress echo lab.
To prepare for an EKG:
- No appointments needed for this exam. This exam is done on a walk-in basis through the lab draw/nuclear medicine department.
- Please dress in loose, comfortable two-piece clothing.
- Avoid oily or greasy skin creams and lotions the day of the test. They interfere with the electrode-skin contact.
- Avoid full-length hoisery, because electrodes need to be placed directly on the legs.
- Wear a shirt that can be easily removed to place the leads on the chest.
Ambulatory EKG
In addition to the standard EKG, your doctor may recommend other specialized EKG tests, including ambulatory EKG monitoring. An ambulatory electrocardiogram or EKG records the electrical activity of your heart while you do your usual activities. Ambulatory monitors are referred to by several names, including ambulatory electrocardiogram, ambulatory EKG, Holter monitoring, or 24-hour EKG. Many heart problems become noticeable only during activity, such as exercise, eating, sex, stress, bowel movements or even sleeping. A continuous 24-hour recording is more likely to detect any abnormal heartbeats that occur during these activities.
Many people have irregular heartbeats (arrhythmias) from time to time. The importance of irregular heartbeats depends on the type of pattern they produce, how often they occur, how long they last and whether they occur at the same time you have symptoms. Because arrhythmias can occur off and on, it may be difficult to record an arrhythmia while you are in the doctor's office.
NO appointment needed for this exam.
This exam is done on
a walk-in basis through the lab draw/nuclear medicine department. Please dress
in loose, comfortable two-piece clothing. NO body lotion on your chest the day
of your exam.
An electrophysiology study, or EP study, is a test to see if there is a problem with your heartbeat (heart rhythm) and to find out how to fix it. In this test, the doctor inserts one or more flexible tubes, called catheters, into veins in your groin, arm or neck. Then he or she threads these catheters into the heart. At the tip of these catheters are electrodes, which are small pieces of metal that conduct electricity. Your doctor can tell what kind of heart rhythm problems you have and where those problems are.
The doctor can use the electrodes to do what is called "pacing." This means sending electrical currents through the catheters to try to re-create your heart rhythm problem. This can tell the doctor what kind of problem you have and the best way to treat it. The doctor may also use pacing to see how well medicines work to control your problem. The electrodes also send information to a computer. The computer uses the information to draw pictures of your heart and its rhythm problems. This is called "mapping," because the pictures serve as maps that show the doctor exactly where the problem areas are. Sometimes the problem can be fixed at the same time. A procedure called catheter ablation uses the catheters to destroy (ablate) small areas of your heart that are causing the problem.
An electrophysiology study is used to:
- Identify heart rhythm problems
- See how well heart rhythm medicines work for you
- Check your heart before you have a pacemaker or an implantable cardioverter-defibrillator (ICD) implanted
- Treat certain problems with catheter ablation
To prepare for an Electrophysiology Study
Tell your doctor if you:
- Are allergic to any medicines, including iodine, or to
latex.
- Have any bleeding problems or take blood-thinning medicine
(anticoagulants), including any nonsteroidal anti-inflammatory drugs (NSAIDs)
like aspirin or ibuprofen
- Are, or might be, pregnant
- Have diabetes
- Have ever had clots in your legs, groin or pelvis
- Have a filter in a large vein to prevent clots from
traveling to the heart.
Additional tips for preparation:
- If you are taking blood-thinning medicine, your doctor will
likely have you stop taking it a few days before the test.
- Arrange for someone to take you home after the test. You may
not have to stay in the hospital overnight.
- Do not eat or drink for 6 to 12 hours before the test. If
you are taking any medicines, ask your doctor if you should take them on the
day of the test.
- Take off any nail polish. That will make it easier for
doctors and nurses to check the circulation in your fingers and toes.
- Be sure to empty your bladder completely just before the
test.
The head-up tilt table test is a way to find the cause of fainting spells. The test involves lying quietly on a bed and being tilted at different angles (30 to 60 degrees) for a period of time while various machines monitor your blood pressure, electrical impulses in your heart and your oxygen level.
To Prepare for the Tilt Table Test:
- Take all your medications as prescribed.
- Do not eat or drink anything after midnight the evening
before your test.
- When you come for your test, bring with you a list of all
your current medications, including the dose.
- Plan to have someone drive you home after the test.
- If you have diabetes, ask for specific instructions on
taking your medications and eating/drinking before the
procedure.
Holter Monitoring
A Holter monitor is a small,
wearable device that records your heart rhythm. You usually wear a Holter
monitor for one to three days. During that time, the device will record all of
your heartbeats. A Holter monitor test is usually performed after a traditional
test to check your heart rhythm (electrocardiogram) isn't able to give your
doctor enough information about your heart's condition.
A Holter monitor has electrodes
that are attached to your chest with adhesive and then are connected to a
recording device. Your doctor uses information captured on the Holter monitor's
recording device to figure out if you have a heart rhythm problem. The Holter monitor
may be able to detect irregularities in your heart rhythm that an
electrocardiogram couldn't, since an electrocardiogram usually takes only a few
minutes.
A Holter monitor may also be used
if you have a heart condition that increases your risk of an abnormal heart
rhythm, such as hypertrophic cardiomyopathy. Your doctor may suggest you wear a
Holter monitor for a day or two, even if you haven't had any symptoms of an
abnormal heartbeat.
Cardiac Stress Echocardiogram (Echo)
Your doctor may suggest a cardiac stress echocardiogram (or echo) if he or she suspects problems with the valves or chambers of your heart or your heart's ability to pump. An echocardiogram can also be used to detect congenital heart defects in unborn fetuses.
Some heart problems — particularly those involving the coronary arteries that supply blood to your heart muscle — occur only during physical activity. For a cardiac stress echocardiogram, ultrasound images of your heart are taken before and immediately after walking on a treadmill or riding a stationary bike. If you're unable to exercise, you may get an injection of a medication to make your heart work as hard as if you were exercising.
Bicycle Stress Echocardiogram (Echo)
A bicycle stress echocardiogram is a test performed to evaluate your heart. The test involves an echocardiogram, ultrasound of your heart, an electrocardiogram (ECG) and a supine bicycle attached to a bed. The supine bike allows the patient to pedal (exercise) while lying flat on the bed. This allows the echocardiogram to be performed.
The bicycle stress echocardiogram compares the performance of your heart at rest to the performance of your heart during exercise, or stress. This can be helpful in the diagnosis of cardiac disease in the early stages of development, or to assess the progress of patients with known cardiac disease. During the test, you will lie on your back on the examination bed and pedal a bike that is attached to the bed. You will be asked to pedal as long as possible in order to evaluate your heart during exercise. You will be continuously and closely monitored. The entire examination is approximately an hour. It is not unusual for a test to run longer if the structures of your heart are difficult to visualize because of chest shape or lung interference.
Treadmill stress testing is the most basic cardiovascular stress test we perform at Hoag Hospital. After fasting for at least four hours, patients arrive 30 minutes before their appointment time to register and complete paperwork. The cardiovascular technologist then leads the patient to the stress lab and prepares them for the test by abrading the skin with a washcloth and prep gel, then placing 10 electrodes for recording the stress EKG during exercise.
The object of the stress test is to determine the health of the patient’s cardiovascular system by increasing the physical workload to the point where the patient needs to end the test. The end point may be caused by leg fatigue, shortness of breath, chest discomfort, attainment of the patient’s age-predicted maximal heart rate, or other factors as determined by the supervising nurse practitioner or cardiologist.
During the stress test, the cardiovascular technologist records blood pressure and heart rate changes while the nurse practitioner or cardiologist observe the electrocardiogram to note any abnormal changes in the electrical activity of the heart.
Patients should wear comfortable clothing, preferably workout clothes, and expect to be tired following the stress test. They should hydrate well the day before the scheduled test, and drink fluids during the day after the stress test has been completed.
Cardiolite® Stress Test
A Cardiolite® stress test takes pictures of your heart muscles and arteries (blood vessels). This test will be done while you exercise. This test will show doctors how your heart performs when it needs to work hard. This is a type of nuclear medicine scan that is also called cardiac imaging. The test helps doctors diagnose coronary artery disease. The test helps doctors find areas of heart muscle that do not get enough blood supply. The test can also show areas that have been damaged after a heart attack.
Adenosine 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 camera, called a gamma camera, detects the radiation released by the tracer to produce computer images of the heart.
Combined with a medication, the test can help determine if there is adequate blood flow to the heart during activity versus at rest. The medication does not increase your heart rate. The medication dilates blood vessels leading into the heart, increasing blood flow, therefore simulating exercise for patients unable to exercise on a treadmill.
Lexiscan is a stress agent that works by increasing blood flow in the arteries of the heart. Lexiscan is given in preparation for a radiologic (x-ray) examination of blood flow through the heart to test for coronary artery disease.
Transthoracic Echocardiogram (or Echo)
Transthoracic echocardiogram is a test that uses high frequency sound waves, called ultrasound, to examine and take pictures of your heart. It is a safe and painless procedure that helps doctors diagnose a variety of heart problems. During most echocardiographic procedures an additional test, called Doppler echocardiography, is performed to determine the direction and velocity of blood flow within your heart.
Transesophageal Echocardiogram (or Echo)
A transesophageal echo (TEE) test is a type of echo test in which the ultrasound transducer, positioned on an endoscope, is guided down the patient's throat into the esophagus (the "food pipe" leading from the mouth into the stomach). An endoscope is a long, thin, flexible instrument that is about 1/8th of an inch in diameter.
The TEE test provides a close look at the heart's valves and chambers, without interference from the ribs or lungs. TEE is often used when the results from standard echo tests are not sufficient, or when your doctor wants a closer look at your heart.
External Carotid Artery Imaging
Carotid artery imaging or ultrasound is a painless and harmless test that uses high-frequency sound waves to create pictures of the insides of the two large arteries in your neck. These arteries, called carotid arteries, supply your brain with oxygen-rich blood. You have one carotid artery on each side of your neck.
Carotid ultrasound shows whether a substance called plaque has narrowed your carotid arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Plaque builds up on the insides of your arteries as you age. This condition is called carotid artery disease.
Intracranial Doppler Ultrasound
Doppler ultrasound scanning measures blood flowing through the carotid arteries or the arteries at the base of the brain. This test assesses the risk of stroke.
This technique shows different speeds of blood flow in different colors on a computer screen. It also can show blocked or reduced blood flow in the arteries of the neck that could cause a stroke. Additionally, it can show blood clots in leg veins that could break loose and block blood flow to the lungs.
Transcranial Doppler (TCD) Ultrasound
Transcranial Doppler (TCD) is a non-invasive ultrasound
technique used to examine the blood circulation within the brain. The TCD uses sound waves which are
transmitted through the skull and tissues and reflect off moving blood cells
within the blood vessels. The sound waves are recorded and displayed on a
computer screen.
The TCD ultrasound can also be used to monitor blood flow in
the brain during surgical procedures.
TCD ultrasound is used to help in the diagnosis of:
- Emboli
- Stenosis
- Vasospasm
- Hemorrhage
- Arteriovenous Malformation
Transcranial Doppler (TCD), Emboli Detection
Transcranial Doppler (TCD) ultrasound is unique and the only
modality that noninvasively monitors local blood flow in real time and detects
moving microemboli. Emboli create
signals in the ultrasound display due to the higher reflection of sound waves
compared to the blood cells.
Identification of emboli provides critical information to
the physician to aid in therapy and reduce the risk of stroke. Emboli from
different sources have unique compositions and require specific therapy, such
as antiplatelet agents for emboli from large artery atherosclerotic plaque and
anticoagulants for cardiac emboli.
A headset will be placed around your head and adjusted to a
snug fit. Continuous wave Doppler
transducers will be fitted to each side of the headset. The headsets and Doppler transducers
are left in place for 20 minutes.
Microemboli can be detected and counted using the specific equipment for
this test.
Risk factors for microembolization:
- Stroke/TIA patients
- Carotid artery stenosis
- Arterial dissection
- Endarterectomy & Post
- Patent foramen ovale
- Atrial fibrillation
- Heart valve replacement
- Significant CHF
- Endocarditis
* Wear comfortable, loose fitting clothing.
Lower Extremity Arterial Ultrasound
Lower extremity arterial duplex ultrasound is a painless and
noninvasive ultrasound used to examine the blood circulation in the legs. Non-invasive means the procedure does not require the use of needles, dyes,
radiation or anesthesia.
During an arterial ultrasound, sound waves are transmitted through
the tissues of the area being examined. These sound waves reflect off blood
cells moving within the blood vessels allowing the technologist evaluate the
structure of the artery and calculate the speed of blood flow. The sound waves
are recorded and displayed on a computer screen.
The arterial ultrasound is used to detect:
- Patency of arteries
- Integrity of arterial walls, i.e., dissection
- Detect peripheral vascular disease (PVD)
- Evaluate ulcerations and cause
- Survey arteries for arterial bypass graft
- Monitor stents and/or bypass grafts for signs of blockage
- Check integrity of the arteries after a catheterization
procedure
* Wear comfortable, loose fitting clothing.
Arterial Lower Extremity Physiologic Exam / Treadmill
Exercise Testing
Arterial Physiologic Exam
Peripheral vascular disease (PVD) is common, and the
incidence increases with age. Symptoms may include intermittent claudication
(muscle pain, aching or fatigue with walking) or in severe cases critical limb
ischemia which may lead to chronic pain, non-healing wounds on the feet, or
gangrene.
Evaluation of the arterial supply to the lower limbs is done
by evaluation of the arterial pulse and measuring blood pressures at various
levels in the legs. Blood flow is evaluated with a continuous wave Doppler flow
probe. Arterial pressures in the lower extremities are compared to the
pressures measured in the arms. These tests are usually referred to as
segmental pressure measurements.
When the pressures are measured at only a single level in
the lower extremities — the ankle — they may be reported as the ratio of
the ankle pressure to the arm pressure. The ankle/brachial index (ABI), is a
very useful general measure of PVD severity. A normal ABI is usually 1.0 to
1.1. An ABI of 0.89 or less indicates PVD is present. Critical limb ischemia
may be present if the ABI is less than 0.50.
The arterial ultrasound is used to detect:
- Detect peripheral vascular disease (PVD)
- Evaluate ulcerations and cause
- Check integrity for arterial bypass grafts, stents
- Monitor stents and/or bypass grafts for signs of blockage
* Wear comfortable, loose fitting clothing.
Arterial Physiologic Exercise Test
The most common symptom of peripheral vascular disease (PVD)
is intermittent claudication. Muscles that have sufficient blood-flow
under resting conditions may not have sufficient circulation when exercise
increases the muscles’ demand for oxygenated blood. As a result, pain, aching
or fatigue may be experienced in the leg muscles when walking.
The ankle/brachial index (ABI) is an objective measurement
of lower-extremity arterial perfusion. The ABI is the ratio of the arterial
blood pressure at the ankle divided by the brachial arm blood pressure. An ABI
less than 0.89 may suggest a diagnosis of PVD.
Treadmill exercise testing and post-exercise measurement of
ankle/brachial indices may be used in addition to resting measurements of
lower-extremity arterial pressures. In patients with lower-limb pain, treadmill
testing can confirm or exclude PVD as a cause for pain. A drop in ankle
pressure after exercise in patients with claudication may be due to PVD.
A lower extremity arterial physiologic study may be requested
to determine whether peripheral artery disease is present, what vessels are
affected, and how severely the blood flow is impaired.
* Wear comfortable, loose fitting clothing.
Upper Extremity Arterial Ultrasound
An upper extremity arterial Duplex ultrasound is performed
to provide an overview of the location, extent and severity of vascular
disease. It is usually diagnosed on the basis of patients’ symptoms and
physical examination in the clinic, confirmed by evaluations in the Vascular
Laboratory with pressure measurements and other non-invasive tests. The
ultrasound evaluation can be performed from the subclavian artery to the wrist
to facilitate clinical management decisions.
Common indications are:
- Cold hands/fingers (vasospasm/Raynaud's)
- Non-healing finger wounds
- Hand or finger pain
- Suspected digital embolism
- Exercise induced pain
- Assessment of patients with documented arterial disease
- Pre-procedure assessment for planned intervention
- Follow up for adequacy of intervention, i.e., dialysis
bypass graft, stent placement
- Evaluation of aneurysm, pseudoaneurysm and arterial-venous
fistula
- Survey arteries for pre-op coronary bypass graft
* Wear comfortable, loose fitting clothing.
Arterial Physiologic Exam, Upper Extremity
An upper extremity physiologic arterial exam is to evaluate
the arteries to determine the presence and location or absence of, arterial
occlusive disease. Evaluation of the arterial supply to the arms is done by
evaluation of the arterial segmental pressures and waveforms at various levels
in the arms. Blood flow is evaluated with a continuous wave Doppler flow probe.
Arterial pressures in the upper extremities are compared to the pressures
measured in the upper arms.
Common indications include, but are not limited to:
- Arterial insufficiency
- Thoracic Outlet Syndrome (TOS)
- Raynaud’s Disease
- Ischemic ulcer
- Limb ischemia/ Digital ischemia
Duplex ultrasound offers the best noninvasive method for
evaluating the hemodynamics of the aortoiliac arteries. Aortoiliac disease, also called
aortoiliac occlusive disease, refers to disorders of the two major blood
vessels that feed the lower half of the body, the aorta and the iliac artery.
Impaired circulation in these arteries can result in
disorders of the pelvic organs, legs, or the kidneys. Additionally, aortoiliac disease can result in an aortic
abdominal aneurysm (AAA), a dangerous health condition.
An aneurysm is present when the aorta is dilated to more
than one and one half the size of the normal aortic diameter size. Evaluation of by a vascular surgeon is
recommended if an AAA measures four centimeters in size or greater, although
endovascular repair or surgery is not usually considered until the diameter of
the aneurysm is at least 5.0 to 5.5 centimeters. When treatment is not yet
needed, it is important to have follow-up evaluations every six to 12 months to
assess for aneurysm growth.
Aortoiliac disease occurs in one or more of the following
locations:
- The lower abdominal aorta
- The iliac arteries
- The point where the aorta divides and becomes the iliac
arteries.
*NO food or beverage seven (7) hours before your scheduled exam. It is
therefore best to have the examination performed after an overnight fast, and
it is important to avoid tobacco and caffeine prior to the test. A complete examination may take as long
as an hour. Wear comfortable,
loose fitting clothing.
Renal Artery Duplex Ultrasound
A renal artery duplex ultrasound is accurate, non-invasive
and cost-effective. Unlike angiography or CT scanning, no injection of X-ray
contrast material is required, avoiding the risk of kidney damage from the
contrast. Renal artery disease cannot be diagnosed without these specific
tests.
Blood-flow velocities and flow patterns are evaluated with
Doppler ultrasound in the aorta and renal arteries. Imaging of the kidneys can provide information about damage
to the kidneys from chronic poor blood flow and the potential for recovery of
kidney function with therapy.
Renal artery disease, including narrowing (stenosis) due to
atherosclerosis, can result in reduced blood flow to the kidneys. Renal artery
stenosis is the most common cause of hypertension (high blood pressure).
Chronically, untreated renal artery disease is also an important cause of
kidney failure.
* NO food or beverage seven (7) hours before your scheduled
exam. It is therefore best to have the examination performed after an overnight
fast, and it is important to avoid tobacco and caffeine prior to the test. Wear comfortable, loose fitting
clothing.
Lower Extremity Venous Ultrasound
A lower extremity venous ultrasound is typically performed
to evaluate for suspicion of deep vein thrombosis (DVT), superficial vein
thrombosis (SVT) in the legs, venous insufficiency (varicose veins) or
evaluation of leg ulcerations.
Duplex scanning of the deep and superficial veins can detect
obstruction. In addition, the function of valves in each segment of the evaluated
veins can be assessed by determining the direction of blood-flow using Doppler
ultrasound.
In the lower extremities, blood returns to the heart through
a network of deep and superficial veins. Normal venous flow patterns depend on
open venous channels and the function of numerous valves within the veins.
Venous insufficiency may occur if veins are obstructed from chronic thrombus or
if the valves are incompetent. Untreated chronic venous insufficiency in the
deep or superficial venous system can cause pain, swelling, skin changes and
eventually tissue breakdown.
* Wear comfortable, loose fitting clothing.
Upper Extremity Venous Ultrasound
An upper extremity venous ultrasound is typically performed
to evaluate for suspicion of deep vein thrombosis (DVT) or superficial vein
thrombosis (SVT) in the arms or neck.
Thrombosis or clot formation in the veins of the upper limbs can lead to
discomfort and swelling.
Thrombosis can be a cause of long-term swelling, pain and other
symptoms.
A number of factors can contribute to risk of DVT. These
include prior DVT or clotting disorders; trauma; recent major surgery; medical
problems, including cancer and blood diseases; immobilization; obesity and
others.
* Wear comfortable, loose fitting clothing.
Abdominal ultrasound is an imaging procedure used to examine the internal organs of the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. The blood vessels that lead to some of these organs can also be looked at with ultrasound.- An abdominal ultrasound is performed to help:
- Determine the cause of abdominal pain
- Determine the cause of kidney infections
- Diagnose a hernia
- Diagnose and monitor tumors and cancers
- Diagnose or treat ascites
- Learn why there is swelling of an abdominal organ
- Look for damage after an injury
- Look for stones in the gallbladder or kidney
- Look for the cause of abnormal blood tests such as liver function tests or kidney tests
- Look for the cause of a fever
Carotid Ultrasound
Carotid ultrasound is a painless and noninvasive test that
uses high-frequency sound waves to create images of the insides of your carotid
arteries. There are two common
carotid arteries, one on each side of your neck. They each divide into internal
and external carotid arteries.
The internal carotid arteries supply oxygen-rich blood to
your brain. The external carotid arteries supply oxygen-rich blood to your
face, scalp, and neck.
Carotid ultrasound is used to screen for blockages that may
indicate an increased risk of stroke. Results from a carotid ultrasound can
help your doctor determine what kind of treatment you may need to lower your
risk.
Indications for a carotid ultrasound:
- Detect a collection of clotted blood that may slow and
eventually stop blood flow.
- Detect a dissection of the carotid artery wall.
- Evaluate the carotid artery after pre and post surgery.
- Evaluate the position and patency of a stent.
* Wear a comfortable, loose-fitting, open necked shirt or
blouse for your ultrasound exam.
Venous mapping is a non-invasive Duplex ultrasound
evaluation of the veins in your legs or arms. It is a preoperative exam to
evaluate vein segments for dialysis fistula grafts, lower extremity arterial
bypass grafts and coronary artery bypass grafts. The information is provided to
the surgeon to help guide the planned surgical procedure.
When lower extremity arterial bypass surgery is required, a
bypass graft using a vein often provides the best long-term result. Using the
person’s own tissue reduces the risk of infection or thrombosis (clotting) of
the graft. The great saphenous
vein is the most commonly used vein, although other superficial veins may be
used.
* Wear comfortable, loose fitting clothing.
Saline Bubble Study
An ultrasound of the heart is called an Echocardiogram. It is done to get pictures of the heart and the areas around the heart. Better pictures are sometimes seen if a material called “contrast” is used during the ultrasound. One type of contrast is saline (sterile salt water). When saline is used, it is called a “bubble study.”
During a bubble study, the nurse will shake (agitate) the salt water until it forms small bubbles. The bubbles are then injected into the vein through an intravenous line (IV). In a normal heart, the bubbles are filtered by the lungs and are seen only on the right side of the heart. If the bubbles are seen on the left side, it shows that there is an opening between the two sides of the heart, which is abnormal.
The abnormality can be a Patent Foramen Ovale (PFO), Atrial Septal Defect (ASD) or a Ventricular Septal Defect (VSD). The bubble study helps to identify those abnormalities.
This is a safe and relatively painless procedure that helps your physician diagnose a variety of heart problems. It can be especially helpful if someone has had a stroke or what is called a transient ischemic attack (TIA) or cerebral vascular accident (CVA). The length of the exam varies, and can take approximately 35-50 minutes depending on the number of images that are obtained. |
|