Getting Ready For Procedures

Echocardiogram | Bubble Study | Treadmill Stress Test | Stress Echocardiogram | Myoview Treadmill Stress Testing | Dipyridamole Myoview Stress Test

Echocardiogram:

An echocardiogram is an ultrasound of your heart. It shows the function of the valves in your heart, the heart muscle walls and the squeezing function of the heart. No preparation is needed for this exam. You will be asked to remove your clothing from the waist up.

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A bubble study is added onto some echocardiogram studies. It is used to evaluate whether or not there is communication (an opening) between the left and right sides of the heart. An IV is started and then we inject saline with tiny bubbles while you have a limited echocardiogram. The results of this test will be reviewed with you by the cardiologist the day of the test.

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Stress Testing:

Stress tests are designed to evaluate for partial blockages within the arteries supplying the heart. Arteries are blood vessels that bring oxygenated blood to tissues in the body. Stress tests will identify significant blockages of 50% or more. There are several different stress test procedures described below.  

Treadmill Stress Test:

During a treadmill stress test you walk on a treadmill while your heart rate, blood pressure, overall status and EKG tracing are continuously monitored. The speed and the slope of the treadmill are increased every 3 minutes. You are asked to walk to your peak ability unless the physician feels the need to stop you sooner. We continue to monitor you for at least 5 minutes after you are done exercising.

We ask you to wear comfortable walking shoes and clothes for this exam. You will be asked to remove your clothing from the waist up.

Sometimes the physician will ask that you hold certain medications for a day or two prior to your stress test.

We ask you not to eat or drink for 2-3 hours before you exercise, but make sure you do have something to eat earlier in the day so you do not become lightheaded during the test.

The cardiologist will review the results of the test with you that day and a full report will be sent to your primary physician.

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Same as the treadmill test above except with added ultrasound pictures of your heart before you exercise and again when you are at peak exercise. The two sets of pictures are then compared and added to the data obtained from the treadmill/EKG portion of the test.

The cardiologist will review the test results with you that day and a full report will be sent to your primary physician.

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The same procedure is followed as the above treadmill stress test, with following additions: Myoview is a tracer with small amount of radioactivity that is picked up by a special camera. It is given though an intravenous placed in your arm and travels freely through your blood vessels to your heart.

An IV will be started in your arm when you arrive for your test. Baseline EKGs, blood pressures and heart rates will be obtained. When you are near your peak exercise on the treadmill the Myoview will be injected and you are asked to continue walking for 1-2 more minutes. We will continue to monitor you for at least 5 minutes and then you will be allowed to get dressed.

We then ask you to drink 2 large glasses of fluids in our waiting area. Approximately 30 minutes after the injection the technician will take your "stress pictures". After the first set of pictures are  taken you will be able to leave the office. We will need to take "resting" pictures in 2-3 hours. During this time you may wait in our office or leave and come back. You may eat, drink and resume any medications held for the test at this point.  When you return to our office you will get a second injection of Myoview, asked to drink 2 large glasses of fluids and wait 30 minutes prior to the pictures.  Once the cardiologist has reviewed the data obtained from this test, you and/or your primary physician will be notified of the results.

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For different reasons there are some patients that cannot have a treadmill stress test. Dipyridamole is a medication that is given via IV to temporarily expand (dilate) the coronary arteries similar to what would happen with vigorous exercise.

If you have been scheduled for this type of test it is particularly important for our physicians to know what medications you are on and if you have any medication allergies. We will ask you to hold certain types of medications for a couple of days before your test. We also ask patients not to consume any chocolate products, coffee (even decaf), tea (even decaf), and cola drinks (even decaf) for 24 hours before your test. We ask you to have nothing to eat or drink 6 hours prior to this test.

An IV will be started in your arm when you arrive. Baseline EKGs and blood pressures and heart rates will be obtained. The Dipyridamole is given through the IV over 4 minutes. A few minutes later the Myoview will be injected. We will continue to monitor your blood pressures and EKGs. You will then be asked to get dressed and drink 2 glasses of fluids. In approximately 30 minutes your "stress" pictures are taken. We will need to take "resting" pictures again in 2-3 hours. You are welcome to wait in our office or you can leave and come back. In that time, you can eat (even chocolate) and drink (even coffee) and resume your medications. When you return you will get another injection of Myoview, drink 2 glasses of fluids, wait 30 minutes and then the second group of pictures will be taken.

Once the cardiologist has reviewed all of the data obtained from this test, you and/or your primary physician will be contacted with the results.

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