In-Office Cardiac Testing

This test is a measure of blood pressure at the ankle, as compared to blood pressure at the upper arm (brachium). An ankle-brachial index (ABI) is used when peripheral artery disease (PAD) is suspected. Blood pressure that is lower at the ankle than in the arm suggests the presence of PAD.

We regularly monitor our patients who take anticoagulant agents (blood thinners) to ensure that their medication levels continue to be effective and safe.

INR (international normalized ratio) blood tests, which measure how quickly your blood clots, are performed in our office. INR levels between 2.0 and 3.0 are considered appropriate for most patients on warfarin (Coumadin) – but check with your doctor to find out what your range should be. We will also review INR results with patients who prefer to have their blood work done by an outside lab.

We counsel patients on medication and dietary interactions with Coumadin products and the newer novel oral anticoagulants (NOACs) such as Xarelto and Eliquis. We also provide guidance for temporary cessation (and resumption) of blood thinners prior to various procedures or surgeries.

An echocardiogram is a Doppler ultrasound of the heart to evaluate heart function. It may also be referred to as transthoracic echocardiogram (TTE) or surface echo. Learn more about echocardiograms

A stress echocardiogram (“stress echo”) shows how the heart works during “stress” or exercise. The echocardiogram uses sound waves to produce an image of the heart on a monitor before and during exercise. A stress echocardiogram helps cardiologists diagnose coronary heart disease

 A transesophageal echo or TEE is a minimally invasive method of performing an echocardiogram, where the ultrasound transducer is inserted into a patient’s esophagus to produce detailed images of the heart and its blood vessels.

An electrocardiogram (ECG or EKG) identifies if the heart is beating normally by measuring the heart's electrical activity. When it is performed during periods of stress induced by exercise or drugs, it is referred to as a stress test. Learn more about electrocardiograms.

An event or Holter monitor is a portable device that records heart rhythms. It is worn for a period of time to record the heart's rhythm when you have symptoms of an issue with the heart. Event or Holter monitors are used to help heart doctors diagnose cardiac arrhythmia.

The progression of congestive heart failure or the effectiveness of therapies to combat it, is monitored with a variety of heart tests and heart imaging studies, which may include lab tests, electrocardiogram, echocardiogram, and coronary angiography.

Although congestive heart failure is a progressive heart disease, symptoms of heart failure can be managed with lifestyle changes, medications, and treatment of underlying medical conditions. Cases of sudden congestive heart failure may require surgery or hospitalization.

Our doctors can perform a number of diagnostic tests to identify heart beat or rhythm abnormalities.

These include electrocardiograms (EKG), echocardiograms (surface and stress echos) and event/Holter monitors.

We offer the option of short-term (24-hour) Holter monitors, intermediate-term (2-14 days) event monitors (patches), or long-term (several months) loop recorders to detect infrequent but potentially symptomatic or dangerous arrhythmias.

Nuclear cardiology studies (stress testing and heart-strength assessment) produce images of how the heart pumps blood while it is beating. These tests help heart doctors diagnose coronary artery disease and provide a prognosis for people with heart failure.

It involves the use of a small amount of radioactive tracers injected into a vein. A camera then captures how the heart functions at rest, during exercise, or with medication-induced stress testing.

Peripheral artery disease screening includes a review of your medical history and risk factors for peripheral artery disease, blood tests, ankle-brachial blood pressure measurements, and Doppler ultrasound. Additional imaging tests such as intravascular ultrasound or magnetic resonance angiography may be recommended if necessary.

A noninvasive vascular test used when peripheral artery disease (PAD) is suspected, pulse volume recordings (PVR) involve the use of blood pressure cuffs and an ultrasound transducer to measure blood flow in the limbs. An ankle-brachial index test is considered a type of PVR.

A cardiac stress test evaluates how the heart works during stress, either induced by exercise or drugs. Cardiac stress testing is also referred to as an exercise electrocardiogram, stress test, or treadmill test.

When used with radioactive tracers typical of nuclear cardiology, it is referred to as an exercise or pharmacologic nuclear stress test.

Stroke screening may include a review of your medical history and risk factors for stroke, lab tests, and specific stroke screening tests.

Ultrasound imaging is an easy way to create images of the carotid arteries in the neck and the blood flow through the blood vessels. Doppler ultrasound assesses the speed of blood flow and the amount of plaque buildup associated with carotid artery disease that may lead to a stroke.

Another simple test used for stroke screening is EKG testing for atrial fibrillation, which can contribute to blood clots that cause strokes.

A tilt table test can help identify possible causes of fainting. During the test, a patient  is strapped to a bed that is then tilted at different angles. Blood pressure, heartbeat, and oxygen levels are measured during the test.

This diagnostic test is often used to diagnose disorders of the autonomic nervous system – which controls involuntary bodily processes such as breathing, heartbeat, blood flow, and digestion.

We offer in-house carotid and vascular ultrasound, a noninvasive and painless imaging test, to screen for abdominal aortic aneurysm (AAA) and carotid stenosis.

AAA is the enlargement of the aorta at the abdomen. The aorta is the main artery of the body, responsible for supplying blood to the circulatory system.

Carotid stenosis is a narrowing of the carotid arteries, the two major arteries that carry oxygen-rich blood to the brain. A patient may not show any symptoms of this condition until a stroke occurs.

Vascular imaging shows how blood flows in the both the veins and arteries. An arterial ultrasound test can screen for stroke, peripheral artery disease of the legs, and aortic aneurysm, a common and potentially fatal disease.

Venous ultrasound is a simple imaging assessment that creates images of veins to identify direction of blood flow and blockages. Venous ultrasound is useful for identifying clots (deep vein thrombosis), varicose veins, and chronic venous insufficiency.

We carefully evaluate our patients' metabolic and cardiovascular function at their current weight, and can help develop a plan to lose weight to improve their heart health.

This may include discussion about a proper diet for cardiac health, nutritional guidance from the American Heart Association and American College of Cardiology, weigh-in visits, referral to obesity specialists and nutritional counseling, and referral and pre-op assessment for bariatric surgery.