Tests Performed

Echocardiogram

An echocardiogram (also called an echo) is an imaging test that uses harmless sound waves to view your heart.  It shows how well your heart muscle and valves are working and how large your heart is.   Results are usually available within one week.  The results may be available sooner if there is a priority placed on the test by the physician ordering the test or by the cardiologist reading the test.

There are a variety of reasons for ordering the test which include the following:

-Look for the cause of abnormal heart sounds (murmurs or clicks), an enlarged heart, unexplained chest pains, shortness of breath or irregular heartbeats.

-Check the thickness and movement of the heart wall.

-Look at the heart valves and check how well they work.

-See how well an artificial heart valve is working.

-Measure the size and shape of the heart’s chambers.

-Check the ability of your heart’s chambers to pump blood (cardiac performance).  During an echocardiogram, your   doctor can see how much blood your heart is pumping during each heartbeat (ejection fraction).  You might have a      low ejection fraction if you have heart failure or failure of any of the valves to function properly.

-Detect a disease that affects the heart muscle and the way it pumps, such as cardiomyopathy.

-Look for blood clots and tumours inside the heart.

-Look for congenital heart defects or to check the effectiveness of previous surgery to repair a congenital heart defect.

-Check how well your heart works after a heart attack.

-Identify the specific cause of heart failure.

-Look for a collection of fluid around the heart (pericardial effusion) or a thickening of the lining (pericardium) around  the heart.

Potential Indicators and Symptoms for ordering an Echocardiogram:

Age Alcohol and Drug Consumption Arrhythmias
Blood Glucose Blood Pressure: 140/90
Body Mass Index > 30
Cardiac Disease (i.e. Cardiomyopathy) Cardiac Tumours/Blood Clots Cholesterol
Congenital Heart Defects/Prior Surgery Diet Dizziness
Enema Endocarditis Family History
Heart Murmurs Post MI Smoker
Shortness of Breath/Fatigue/Chest Pain Testing Cardiac Performance
(i.e. ejection fraction)
Waist Circumference

Stress Testing

Also called exercise treadmill test. It is useful for screening high risk populations, preoperative clearance, following patients with known heart disease, or in the diagnosis of chest pain or shortness of breath.

Stress Echocardiography

An exercise stress test which utilizes echocardiography to provide information on exercise tolerance, ischemic burden (identify and monitor reduced blood flow to heart muscle- ischemia) , and structural heart disease including vascular disease, pericardial disease and to provide analyses of LVF (left ventricular function).

A positive stress echocardiogram is defined by stress-induced decrease in regional wall motion, decreased wall thickening, or regional compensatory hyperkinesis.  In experienced hands, this can have a diagnostic accuracy similar to that of nuclear stress testing. The advantage to stress echocardiography is that it is a faster test to perform than a nuclear stress test because delayed images are obtained much sooner.  It has no associated radiation exposure.  It is less costly than nuclear stress testing, and therefore performs well on cost analysis studies. The test can be more readily performed in an office setting.

Arrhythmia Monitoring

An arrhythmia is an abnormality or disturbance in the rate or rhythm of a person’s heartbeat. Arrhythmia monitoring refers to tests physicians use to identify the type and the cause of irregular heart rhythms.  One way that physicians monitor arrhythmias is by using ECG (electrocardiograph).  ECG testing typically is used for arrhythmias that occur frequently. Many arrhythmias occur infrequently, so to record the heart’s electrical activity under real-life conditions, physicians use continuous monitor recording, also called ambulatory electrocardiography (event recording). The patient wears portable ECG devices that record arrhythmic events while the patient is away from the physician’s office.

HHD provides the physicians and patients with easy-to-use non-invasive cardiac monitors.  The monitors are lightweight, portable, and come with all the necessary supplies to perform cardiac studies with the focus on quality and convenience.  We provide the latest technology for accurate and rapid turnaround of results.  Our labs are open seven days a week to assist the needs of both the physician and the patient.  An HHD technician will perform an in-service demonstration on the use and proper hook-up of all monitors used.

What are the symptoms of arrhythmias?

Symptoms of arrhythmias can vary, depending on the severity of the condition.  If the arrhythmia  is intermittent and “comes and goes”, the symptoms develops suddenly, and can go just as suddenly. Some of the more common symptoms include the following:

-Palpitations (an abnormal awareness of your heartbeat).

-An abnormally fast, slow, or irregular pulse.

-Dizziness or feeling faint.

-Shortness of breath.

-Chest pains.

Some arrhythmias are more serious than others.  A heart rate that is very fast or very slow can result in too little blood flowing through the heart. In some cases this can lead to heart failure.

Ambulatory Monitoring Devices: Holter

A Holter monitor is a device that records the electrical activity of the heart for a 24-72 hour period. The Holter monitor records every heartbeat giving the patient’s physician access to an inclusive report of all cardiac activity occurring during the study.  It does this by utilizing 5-12 leads attached to the patient’s skin with electrodes.  The data is sent to our lab after the study is complete, and a report is created by one of our cardiologists reading the study.  The report is then sent to the patient’s physician who then uses the information provided by the Holter monitor to diagnose and recommend further treatment for the patient.

Patients keep a diary of their activities, such as sleeping or eating, so that the cardiologist reading the study can associate any arrhythmia with a specific activity.  During Holter monitor testing, patients should avoid taking showers or baths.

Ambulatory Monitoring Devices: Cardiac Loop Event Recorder (LOOP)

A Cardiac Event Recorder is a device that is used to record the electrical activity of the heart for an extended period of time.  Just like the Holter device, it is also portable with electrodes that are on the patient’s chest, connected to the loop recorder enabling constant monitoring of the heart’s electrical activity.

When a patient experiences arrhythmia symptoms, they push the record button on their Cardiac Event recorder and a cardiac event is recorded.  All our devices have auto-triggers built in, and automatically record non-symptomatic events (various arrhythmias such as atrial fibrillation).  All data is sent to our lab and read by a technician who filters the useful data which is then sent to one of our cardiologists who reads the data and write up a report.  The final report is sent to the patient’s physician.  The physician then uses the information provided by the Cardiac Event Recorder to diagnose and recommend further treatment for the patient.

Benefits of Ordering a Loop Event Recorder over a Holter are the following:

(a) Increases diagnostic yield over 90%, in comparison to Holter.

(b) Built-in auto trigger records patient activated events and asymptomatic events.

(c) Detects transient cardiac ischemic episodes.

Potential Symptoms for Ordering a Loop Event Recorder:

Chest Pain Dizzy Spells Edema
Light Headedness/Syncope Events Numbness in Finger Tips
Pain in Arm or Neck
Palpitations Shortness of Breath (Dyspnea) Sudden Fatigue