At The Heart Hospital at Providence, physicians, surgeons, nurses and other healthcare professionals are dedicated to providing the highest level of patient heart care. In order to achieve this goal, areas of expertise have been developed, combining research, education and clinical practice to provide innovative and scientifically based testing and treatments for heart, vascular and thoracic disease. The end result is better outcomes for our patients.
Non-Invasive Cardiology Testing
The Non-Invasive Cardiology Department
M – F 8 a.m. – 4:30 p.m.
An EKG shows the electrical activity of the heart. From this simple test, doctors can easily identify patterns of a heart attack or other signs of irregular heart rhythm reasons for palpitations or syncope. EKGs are quick and easy to perform.
Images of the heart produced by using sound waves and color Doppler. Sonographers are able to take moving images of the heart and internal structures including valves to determine the overall function.
Regular and Nuclear Stress Testing
Stress testing is performed to monitor changes in EKG patterns during exercise. Adding nuclear imaging gives the cardiologist more information than just treadmill stress tests. Doctors are able to see images of the heart after the stress test to determine if there may be problems such as blocked arteries.
The accuracy of the nuclear cardiology testing is dependent upon the experience and training of both the physician and the technologist. During the procedure, both the pump function and the blood flow of the heart are assessed. Physicians are then able to detect the presence of cardiovascular disease and possible risk of future heart attacks.
Ankle Brachial Index (ABI)
ABI is quick and easy study that shows the pressure of the ankles compared to the arms as a ratio. This is a great screening tool for detecting the presence of vascular disease.
Pulse Volume Recording (PVR)
PVR uses blood pressure cuffs to examine the quality of blood flow to the legs or arms. Waveforms and pressures are compared at each segment for large drops in amplitude or pressure that may indicate vascular disease.
Imaging procedures, invasive diagnostic, and therapeutic medical procedures are available to both inpatients and outpatients in the cardiac catheterization (cath) labs.
Testing performed in the cath lab is not limited to the heart but may include vessels in the legs, kidneys, or other organs. Therapeutic procedures, such as balloon angioplasty and stenting, may also be performed in these vessels. A team approach to care is provided by cardiologists, registered nurses, cardiovascular technologists and registered radiology technologists. The Providence team has received national recognition for performance excellence in Cath Lab Digest, a leading industry publication.
In cardiac catheterization (cardiac cath), a very small hollow tube, or catheter, is advanced from a blood vessel in the groin through the aorta into the heart. Once the catheter is in place, several diagnostic techniques may be used. The tip of the catheter can be placed into various parts of the heart to measure the pressure within the chambers. The catheter can be advanced into the coronary arteries and a dye injected into the arteries. By the use of fluoroscopy (a special type of X-ray), the cardiologist can tell where any blockages in the coronary arteries are located as the dye moves through the arteries. A small sample of heart tissue can be obtained (called a biopsy) during the cardiac catheterization to be examined later under the microscope for abnormalities.
Also, a cardiac catheterization may be ordered by your cardiologist if a screening examination such as an EKG suggest a possibility of some type of heart disease process that needs to be explored further. A cardiac catheterization may also be scheduled to include evaluation of myocardial perfusion (blood flow to the heart muscle) after following certain cardiac procedures or to further diagnose other cardiac conditions.
The term electrophysiology study also called an EP study, is an invasive procedure that tests the heart’s electrical system. The electrical system of the heart generates the heartbeat. The heart is a pump made up of muscle tissue. Like all pumps, the heart requires a source of energy in order to function. The heart’s pumping energy comes from an indwelling electrical conduction system.
An electrophysiology study may be performed for a number of reasons. During an electrophysiology study, a small, plastic catheter (tube) is inserted through a vein in the groin (or arm, in some cases) and is threaded into the heart, using a special type of x-ray, called fluoroscopy, to guide the catheter. Once in the heart, electrical signals are sent through the catheter to the heart tissue to evaluate the electrical conduction system contained within the heart muscle tissue.
There are several ways in which an electrophysiology study may be performed to assist in diagnosing electrical conduction system abnormalities of the heart. For example, a dysrhythmia /arrthythmia (an abnormal rhythm) may be stimulated by the electrical signal, in which case medication may be given to treat the dysrhythmia. In order to evaluate the effectiveness of the medication given, another attempt is made to stimulate the dysrhythmia. Mapping, another type of electrophysiology study, may be done to locate the point of origin of a dysrhythmia. If a location is found that is the cause of the dysrhythmia, an ablation (removal of the spot by freezing or radiofrequency) may be done, which could stop the dysrhythmia.
Peripheral Vascular Program
Peripheral vascular disease refers to disease of blood vessels outside the heart and brain. It’s often a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys.
Peripheral artery disease (PAD) is a condition similar to coronary artery disease and carotid artery disease.
In PAD, fatty deposits build up in the inner linings of the artery walls. These blockages restrict blood circulation, mainly in arteries leading to the kidneys, stomach, arms, legs and feet. In its early stages a common symptom is cramping or fatigue in the legs and buttocks during activity. Such cramping subsides when the person stands still. This is called “intermittent claudication.” People with PAD often have fatty buildup in the arteries of the heart and brain. Because of this association, most people with PAD have a higher risk of death from heart attack and stroke.
About 62 million US adults have one or more forms of vascular disease and one person in five suffers from some form of vascular disease.
It is possible to reduce your risk of vascular disease – by eliminating the risk factors you can control, and managing the risk factors you cannot control.
A non-surgical procedure that can be used to dilate (widen) narrowed or blocked peripheral arteries. A thin tube called a catheter with a deflated balloon on its tip is passed into the narrowed artery segment. The balloon is then inflated, compressing the plaque and dilating the narrowed artery so that blood can flow more easily. Then the balloon is deflated and the catheter is withdrawn.
Often a stent – a cylindrical, wire mesh tube – is placed in the narrowed artery with a catheter. There the stent expands and locks open. It stays in that spot, keeping the diseased artery open.
If the narrowing involves a long portion of an artery, surgery may be necessary. A vein from another part of the body or a synthetic blood vessel is used. It’s attached above and below the blocked area to detour blood around the blocked spot.