Diagnostic test for Heart Diseases

ElectroCardioGram (ECG or EKG) -An electrocardiogram (also called EKG or ECG)

is a test that records the electrical activity of your heart through small electrode patches attached to the skin of your chest, arms, and legs Uses of ECG: - 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.

Preparation: - Avoid oily or greasy skin creams and lotions the day of the test. They interfere with the electrode-skin contact. -Avoid full-length hosiery, 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.

EXAMPLE of an ECG:

CHEST X-RAY (chest radiography) -The chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-ray makes images of the heart, lungs, airways, blood vessels and the bones of the spine and chest. -An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

What are some common uses of the procedure? A chest x-ray is typically the first imaging test used to help diagnose symptoms such as: -shortness of breath. -a bad or persistent cough. -chest pain or injury. fever. Examples:

Stress Test -Stress tests are tests performed by a doctor and/or trained technician to determine the amount of stress that your heart can manage before developing either an abnormal rhythm or evidence of ischemia (not enough blood flow to the heart muscle). The most commonly performed stress test is the exercise stress test. EXERCISE STRESS TEST -The exercise stress test -- also called a stress test, exercise ECG,treadmill test, graded exercise test, or stress ECG -- is a test used to provide information about how the heart responds to exertion. It usually involves walking on a treadmill or pedaling a stationary bike at increasing levels of difficulty, while your electrocardiogram, heart rate, and blood pressure are monitored.

The doctor uses the stress test to: -Determine if there is adequate blood flow to your heart during increasing levels of activity. -Evaluate the effectiveness of your heart medications to control angina and ischemia. -Determine the likelihood of having coronary heart disease and the need for further evaluation. -Check the effectiveness of procedures done to improve blood flow within the heart vessels in people with coronary heart disease. -Identify abnormal heart rhythms -Help you develop a safe exercise program.

There are many different types of stress tests, including: Treadmill stress test: As long as you can walk and have a normal ECG, this is normally the first stress test performed. You walk on a treadmill while being monitored to see how far you walk and if you develop chest pain or changes in your ECG that suggest that your heart is not getting enough blood. Dobutamine or Adenosine Stress Test: This test is used in people who are unable to exercise. A drug is given to make the heart respond as if the person were exercising. This way the doctor can still determine how the heart responds to stress, but no exercise is required. Stress echocardiogram: An echocardiogram (often called "echo") is a graphic outline of the heart's movement. A stress echo can accurately visualize the motion of the heart's walls and pumping action when the heart is stressed; it may reveal a lack of blood flow that isn't always apparent on other heart tests. Nuclear stress test: This test helps to determine which parts of the heart are healthy and function normally and which are not. A small amount of radioactive substance is injected into the patient. Then the doctor uses a special camera to identify the rays emitted from the substance within the body; this produces clear pictures of the heart tissue on a monitor. These pictures are done both at rest and after exercise. Using this technique, a less than normal amount of thallium will be seen in those areas of the heart that have a decreased blood supply.

EXAMPLES:

Echocardiogram -An echocardiogram is a test that uses ultrasound to evaluate your heart muscle, heart valves, and risk for heart disease. The doctor may perform an echocardiogram to: -Assess the overall function of your heart. -Determine the presence of many types ofheart disease -Follow the progress of heart valve disease over time. -Evaluate the effectiveness of medical or surgical treatments.

Types of Echocardiogram:
Transthoracic echocardiogram
This is the standard echocardiogram. It is a painless test similar to X-ray, but without the radiation. The procedure uses the same technology used to evaluate a baby's health before birth. A hand-held device called a transducer is placed on the chest and transmits high frequency sound waves (ultrasound). These sound waves bounce off the heart structures, producing images and sounds that can be used by the doctor to detect heart damage and disease.

Transesophageal echocardiogram
This test requires that the transducer be inserted down the throat into the esophagus (the swallowing tube that connects the mouth to the stomach). Because the esophagus is located close to the heart, clear images of the heart structures can be obtained without the interference of the lungs and chest.

Stress echocardiogram
This is an echocardiogram that is performed while the person exercises on a treadmill or stationary bicycle. This test can be used to visualize the motion of the heart's walls and pumping action when the heart is stressed. It may reveal a lack of blood flow that isn't always apparent on other heart tests. The echocardiogram is performed just prior and just after the exercise.

Dobutamine stress echocardiogram This is another form of stress echocardiogram. However, instead of exercising to stress the heart, the stress is obtained by giving a drug that stimulates the heart and makes it "think" it is exercising. The test is used to evaluate your heart and valve function when you are unable to exercise on a treadmill or stationary bike. It is also used to determine how well your heart tolerates activity and your likelihood of havingcoronary artery disease (blocked arteries), and evaluates the effectiveness of your cardiac treatment plan.

Intravascular ultrasound
This is a form of echocardiography performed during cardiac catheterization During this procedure, the transducer is threaded into the heart blood vessels via a catheter in the groin. It is often used to provide detailed information about the atherosclerosis (blockage) inside the blood vessels.

EXAMPLES

CT HEART SCAN
Computed tomography, commonly known as a CT scan, combines multiple X-ray images with the aid of a computer to produce cross-sectional views of the body. Cardiac CT is a heart-imaging test that uses CT technology with or without intravenous (IV) contrast (dye) to visualize the heart anatomy, coronary circulation, and great vessels (which includes the aorta, pulmonary veins, and arteries). There are several types of CT scans used in the diagnosis of heart disease: 1. Calcium-score screening heart scan 2. Coronary CT angiography (CTA) 3. Total body CT scan