Cardiac Care:

 diagnosis of heart disease

Saint John's phenomenal success in treating women with cardiac disease can be attributed to multiple factors: leading-edge physicians and dedicated nurses and technicians.  Also essential is the Health Center’s commitment to fast, accurate diagnosis and effective treatment through an array of breakthrough procedures and treatment options.

The Heart Institute at Saint John's Health Center is home to a full range of technologically advanced diagnostic testing, from the simple to the complex. Diagnostic tests available at Saint John’s include:

• Electrocardiogram (EKG) 
• Stress Test 
• Echocardiogram (Echo)
  
• Ultrafast CT Scan 
• Cardiac Catheterization (Angiogram) 
• Electrophysiologic Testing (EP) 
• Tilt Table Testing 
• Pacemaker / ICD Testing 
• Duplex Scan 

Electrocardiogram (EKG)

A test in which electrodes, placed on the surface of the chest, are used to record heart rhythm and rate as well as to detect enlargement and thickness of the various chambers of the heart.

Stress test

There are several types of stress tests performed at Saint John’s:

• Treadmill stress test.  This procedure is performed using a 12-lead ECG and a treadmill. You will be monitored while exercising on the treadmill to assess the heart's response to exercise.

• Nuclear stress test. While exercising on the treadmill, the patient will be injected with a radioactive substance called an isotope and images of the heart will be recorded afterwards. The test helps physicians see perfusion of  the heart muscle to determine if any heart muscle is damaged or if there is a serious narrowing in an artery.

• Pharmacological stress echocardiogram. This test uses an intravenous medication that approximates the effects of exercise. This test, used for patients who cannot exercise, is an alternative to the exercise echocardiogram and the nuclear stress test.
  

There are several types of echocardiograms performed at Saint John’s:

• Transthoracic echocardiogram. This is an ultrasound procedure that provides images of the heart's valves and muscle functions using Doppler and color flow to determine the severity of obstructed and/or leaky heart valves. Blood-flow patterns can also be analyzed.

• Transesophageal echocardiogram.  This test is an ultrasound procedure in which a miniature probe is placed down the esophagus to provide clear, detailed images of the heart chambers, valves and aorta. The test is invaluable for detecting heart valve infections and other abnormalities.

• Pharmacological stress echocardiogram
  

Ultrafast Computed Tomography(CT) scan (for coronary calcium score)

Using an Ultrafast CT Scan, physicians can measure the amount of calcium deposits in the coronary arteries and in turn evaluate the risk of future heart attacks.

Cardiac CT Angiogram (CTA)

An angiogram is a visualization of the heart and coronary arteries using a contrast dye, which is injected into the arm.  This contrast dye lights up the coronary arteries and helps highlight any plaque and/or blockages in your coronary arteries.

Electrophysiologic testing (EPS)

This test is designed to provoke arrhythmias and allow for their detailed analysis, including exact location of the origin of the arrhythmia. Cardiologists will insert small wires through a leg vein in the groin and guide them into the heart with an x-ray imaging machine. These wires send electrical signals to the heart to help the cardiologist determine where the arrhythmia is and attempt to treat the arrhythmia with electrical impulses.

After an intravenous line is inserted, the patient will lie flat on a table, which will slowly tilt to 80 degrees, so that the patient is almost standing straight. A medication called isoproterenol can be administered during the test to investigate patients with episodes of lightheadedness or fainting spells, known as syncope.

This is a test to check rhythm, pacemaker/ICD function and battery. Tests are repeated at intervals related to the age of the device.

There are two types of duplex scans:

• Venous duplex scan.  This ultrasound test takes pictures of the veins in the legs to detect obstructions and abnormal flow patterns.

• Arterial duplex scan (carotid and femoral). This ultrasound test takes pictures of the arteries in the neck (carotid) or legs (femoral) along with their patterns of blood flow (duplex). This test will detect plaques, obstructions and aneurysms.