Coronary artery disease is the buildup of plaque within the arteries of the heart. Over time, this buildup can result in reduced blood flow to parts of the heart resulting in heart damage and decreased heart function—a heart attack is the result of a complete blockage of an artery within the heart.
Cardiac catheterization a procedure in which a small flexible tube, the catheter, is advanced to the coronary arteries through an area in the groin or wrist of the patient using X-ray as a guide. It is performed in a sterile environment and sedation is given to the patient during the test for comfort. Through the catheter, solution is injected into the arteries while the X-ray is being used to determine the presence or absence of plaque within those arteries.
If significant plaque is detected, an intervention can be performed through similar equipment during the same procedure. The possibilities for this procedure are discussed prior to the patient coming to the lab. Depending on the amount and location of the plaque, a surgical consult may be required post procedure.
Cardiac Stress Test
Cardiac stress testing is used as a non-invasive method to diagnose the likelihood of coronary artery disease. The two primary types of stress tests that are performed are treadmill and medication (pharmacological) induced testing.
For treadmill tests, patients walk with a gradual increase in speed and elevation. Patients are monitored for changes in the EKG as difficulty and heart rate increase. This type of testing may also include a nuclear imaging component where a scan is performed to check for signs of poor blood circulation to areas of the heart.
A medication (pharmacological) test is performed when a patient has a condition where a walking treadmill test is not possible or effective in diagnosing the likelihood of coronary artery disease. Patients lie on an exam table and are monitored while medication is administered. Most exams of this type will have a nuclear imaging component and scan to identify areas of poor circulation in the heart if they exist.
Cardiac Ultrasound Studies, Includes Echocardiogram, Transesophageal Echocardiogram or TEE
Cardiac ultrasound, also known as echo, is a non-invasive study to visualize the chambers, valves, and function of the heart. Patients lie down on their side while a sonographer places a small probe on the bare chest to record images of the heart while in motion. Measurements are taken and various structural diagnoses can be made by the cardiologist who later interprets the study.
When more detailed information is needed, a transesophageal echo may be performed. This is a study which requires the probe to be inserted by mouth. It is performed by a cardiologist when images obtained through the chest are not detailed enough to get a proper diagnosis. Ror comfort, sedation is administered during this procedure.
Electrophysiology (EP) Study
The heart is controlled by a series of electrical signals that are spread throughout the heart in an organized manner. When this organization gets disrupted, heart function can be reduced dramatically and patients may need to take medication to control heart rate or as a safeguard from having a stroke.
An electrophysiology study can be performed on those who have been diagnosed with such disturbances. Similar to a cardiac catheterization, special catheters are inserted through an area in the groin and advanced into chambers of the heart. It is performed in a sterile environment and sedation is given to the patient during the test to achieve desired comfort level. Electrical signals from the catheters are transmitted to a monitor and interpreted for abnormalities. When an abnormality is discovered, an ablation catheter is inserted and the area is treated to correct the disturbance.
When the heart has trouble regulating how fast or how slow it beats, a patient may need a pacemaker. A small generator is implanted in the upper chest underneath the skin and leads (wires) are connected from this to the heart. The generator is much more than simply a battery. Inside are a series of circuit boards that continually analyze the heart rate and adjust it accordingly by introducing an electrical sign directly to the heart when needed. It is performed in a sterile environment and sedation is given to the patient during the test to achieve desired comfort level.