Cardiovascular specialists at University of Missouri Health Care provide a full range of diagnostic and nonsurgical tests.
EKG (Electrocardiogram) is a painless diagnostic test that takes about 10 minutes. Patients who schedule an appointment with a cardiologist can expect to have an EKG performed during the first appointment. During the test, the patient lies quietly, while electrodes are placed on the wrists, chest and ankles. The resulting signals provide information about the strength of the heart and its rhythms. Sometimes, the physician may need additional information. He/she may order other, more involved forms of EKG testing that take anywhere from 30 minutes in the hospital to 30 days at home with a portable monitor about the size of a small cassette player.
Echocardiography, like the EKG, is a common screening test. It uses an ultrasound image and Doppler sound waves to examine blood flow through the heart's valves and chambers. This tells the physician about the size of the heart and also reveals much about other structures in and around the heart. During a basic echo, electrodes are placed on the patient's chest to record the heart's electrical activity. Then a device called a transducer is passed across the left side of the chest. This test usually takes 45 minutes to an hour.
Stress testing reveals how a patient's heart and blood pressure respond to physical activity. During the test, the patient exercises on a treadmill or pedals a stationary bicycle while the physician monitors the heart's electrical activity. Test results can indicate possible blockage of an artery and where the blockage is occurring. In addition, results are useful in determining whether the patient should undergo a cardiac catheterization. For patient's who are unable to exercise, several different types of stress testing that use medication to mimic the effect of physical activity on the heart can be utilized.
Transesophageal echocardiogram is a more sophisticated type of echo. A tube about the size of an index finger, equipped with an ultrasound probe, is placed in the patient's esophagus. This technology produces images of the heart's valves and structures that are clearer than those provided by a regular echo. This test is especially useful for checking for blood clots in the heart.
Holter monitoring and cardiac event monitoring are EKGs that are performed over a long period of time. A patient receiving holter monitoring wears electrodes attached to a portable monitor, about the size of a small cassette player, for 24 hours. The test can be done at home. Cardiac event monitoring is performed the same way as holter monitoring, although cardiac event monitoring can take as long as a month.
Cardiac catheterization or angiogram involves threading a catheter through the femoral artery in the thigh or the radial artery in the wrist into the left side of the heart. This procedure allows the physician to check for blockages inside the coronary arteries. Because it is an invasive procedure, it is only performed when the physician is unable to obtain necessary information by using other less extensive tests.
Electrophysiology studies, like cardiac catheterization, are used only when simpler tests are inadequate. During an electrophysiology study, electrodes are threaded through blood vessels to the heart. The study shows the heart's electrical impulses.
Nuclear tests or heart scans involve injecting the patient with a small amount of radioactive material and taking pictures of the heart. The radioactive material identifies red blood cells that are counted as the heart pumps. The tests or scans reveal how well the heart is pumping blood through the body. One type of scan, the Gated heart scan, takes about an hour.