Services and Treatments
Services and Treatments
The Echocardiogram is an ultrasound of the heart. Using standard ultrasound techniques, two-dimensional slices of the heart can be imaged.
In addition to creating two-dimensional pictures of the cardiovascular system, the echocardiogram can also produce accurate assessment of the velocity of blood and cardiac tissue at any arbitrary point using pulsed or continuous wave doppler ultrasound. This allows assessment of cardiac valve areas and function, any abnormal communications between the left and right side of the heart, any leaking of blood through the valves (valvular regurgitation), and calculation of the cardiac output as well as the ejection fraction.
Echocardiography was the first medical application of ultrasound. Echocardiography was also the first application of intravenous contrast-enhanced ultrasound. This technique injects gas-filled microbubbles into the venous system to improve tissue and blood delineation. Contrast is also currently being evaluated for its effectiveness in evaluating myocardial perfusion. It can also be used with Doppler ultrasound to improve flow-related measurements.
- Cardiac Catheterization
Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the heart. This is done for both investigational and interventional purposes. Coronary catheterization is a subset of this technique, involving the catheterization of the coronary arteries.
A small puncture is made in a vessel in the groin, the inner bend of the elbow, or neck area (the femoral vessels or the carotid/jugular vessels), then a guidewire is inserted into the incision and threaded through the vessel into the area of the heart that requires treatment, visualized by fluoroscopy or echocardiogram, and a catheter is then threaded over the guidewire.
If X-ray fluoroscopy is used, a radiocontrast agent will be administered to the patient during the procedure. When the necessary procedures are complete, the catheter is removed. Firm pressure is applied to the site to prevent bleeding. This may be done by hand or with a mechanical device. Other closure techniques include an internal suture. If the femoral artery was used, the patient will probably be asked to lie flat for several hours to prevent bleeding or the development of a hematoma. Cardiac interventions such as the insertion of a stent prolong both the procedure itself as well as the post-catheterization time spent in allowing the wound to clot.
A cardiac catheterization is a general term for a group of procedures that are performed using this method, such as coronary angiography. Once the catheter is in place, it can be used to perform a number of procedures including angioplasty, angiography, and balloon septostomy.
Stents are often used to alleviate diminished blood flow to organs beyond an obstruction in order to maintain an adequate delivery of oxygen. Although the most common use of stents is in coronary arteries, they are widely used in other tubular structures, such as central and peripheral arteries and veins.
- Vascular Ultrasounds
Carotid artery ultrasounds are used to determine the presence of plaque in these arteries. Significant plaque development in the carotid arteries is a risk factor for stroke. Patients with peripheral vascular disease and coronary artery disease are also at higher risk for carotid artery disease.
Abnormal aorta aneurysms (AAA) are also a cause of sudden death. Patients with history of cigarette smoking, hypertension and coronary artery disease are at risk. An abdominal ultrasound is used to screen for AAA. In addition, ultrasound is used to screen for renal artery stenosis, a cause of high blood pressure and renal insufficiency.
Ultrasound is also used to look for the cause of leg swelling. Deep vein thrombosis (blood clots in the leg veins) are a significant cause of leg swelling. Treatment of this can also prevent the development of pulmonary embolisms which can be fatal.
- 24-Hour Holter Monitor
This is a 24 hour continuous recording of the patient’s heart rhythm. It is used to help diagnose patients with symptoms of dizziness, loss of consciousness or palpations.
- Loop Monitor
This is a monitoring device that allows prolonged recording of a patient’s heart rhythm. Used in conjunction with event recorders to help diagnose patients with symptoms of dizziness, lightheadedness or palpations that are infrequent or intermittent.
- Peripheral Angioplasty
Balloons and stents can be used to alleviate decreased blood flow in arteries leading to the kidneys and legs. This can markedly improve the symptoms of leg pain. It can also improve kidney function and stabilize high blood pressure.