Diagnostic Testing

Stress Test

An electrocardiogram performed as the patient exercises in a controlled manner, such as on a treadmill or stationary bicycle at varied speeds and elevations. A stress test helps detect heart irregularities, disease and damage.

Echocardiogram (ECHO)

Performed in our ICAEL certified ECHO laboratory, this is a test using sound waves to produce a moving image on a video screen of the patient’s heart. Your doctor uses an echocardiogram to study thickness, size and function of the heart, as well as the motion pattern and structure of the four heart valves.

Nuclear Stress Test

A supervised test where physical exercise (treadmill) or medication is used to stress the patient’s heart. The patient is monitored using an EKG device and a radioactive tracer is injected. Following the procedure, an image of the patient’s heart is made. Upon completion of a second (rest) image, the doctor interprets the test.

Doppler (Venous and Carotid)

A non-invasive test that evaluates blood flow in the major veins and arteries of the arms and legs, and in the extracranial cerebrovascular system.

Holter Monitor

An electrocardiogram, or EKG, that is temporarily attached to patients for 24 hours. The electrocardiogram continuously records the heart’s electrical activity as the patients go about their daily routines.

Vascular Angiography

A test to permit a radiographic image of the vascular system after a contrast material has been injected.

Cardiac Computed Tomography Scanning

Computed tomography (CT) is a non-invasive diagnostic method of body imaging. It uses a combination of x-rays and computer technology to create detailed pictures of structures inside the body. CT imaging allows medical professionals to capture various angles of organs and blood vessels by using a dye (contrast) to highlight them. The dye makes structures and organs easier to see for the purpose of diagnosis. Each rotation of the scanner provides an image, or virtual “slice” of the area. A computer then uses these slices to reconstruct highly-detailed, 3-D images of the heart, other organs, and blood vessels throughout the body. In most cases, a patient is injected with a contrast solution to increase the visual detail. To ensure the maximum safety of our patients, BHC uses the lowest amount of radiation possible.

BHC utilizes the award-winning Toshiba Aquilion 80-slice CT scanner to provide top-quality computed tomography imaging, allowing for easier, faster and more accurate diagnoses. BHC has a highly-trained and experienced team of technologists to perform your exam. For patients experiencing symptoms associated with heart disease, the scanner provides improved resolution of images of the coronary arteries that may prevent the need for more invasive testing, such as cardiac catheterization.

By providing this non-invasive study called cardiac CT, the physician can quickly distinguish normal or blocked coronary arteries, and can determine who is and is not at high risk of having a heart attack. This can reduce the time a patient must spend in the emergency department, or eliminate the need for hospitalization, if the exam is normal.

This test also helps to identify narrowed carotid arteries that put patients at risk of having a stroke. It helps to evaluate blood flow in other areas as well, such as the aorta, legs, and kidneys.

PET Scanning

PET Scans Cardiac Positron Emission Tomography (PET) scans help to evaluate heart health by measuring the blood flow brought by the coronary arteries to the heart muscle. The images produced are clearer and sharper, resulting in improved opportunities for our cardiologists to diagnose patients and choose the best treatment options for them.

Cardiac Calcium Scoring

Coronary calcium is a marker for plaque (fatty deposits) in a blood vessel or atherosclerosis (hardening of the arteries).  The presence and amount of calcium detected in a coronary artery by the CT scan, indicates the presence and amount of atherosclerotic plaque.  These calcium deposits appear years before the development of heart disease symptoms such as chest pain and shortness of breath.

A calcium score is computed for each of the coronary arteries based upon the volume and density of the calcium deposits.  This can be referred to as your calcified plaque burden.  It does not correspond directly to the percentage of narrowing in the artery but does correlate with the severity of the underlying coronary atherosclerosis.

This score is then used to determine the calcium percentile, which compares your calcified plaque burden to that of other asymptomatic men and women of the same age.  The calcium score, in combination with the percentile, enables your physician to determine your risk of developing symptomatic coronary artery disease, and to measure the progression of disease and the effectiveness of treatment.

A score of zero indicates that there is no calcified plaque burden.  This implies that there is no significant coronary artery narrowing and a very low likelihood of a cardiac event over at least the next 3 years.  It does not absolutely rule out the presence of soft, non-calcified plaque or totally eliminate the possibility of a cardiac event.

A score that is greater than zero indicates at least some coronary artery disease.  As the score increases, so does the likelihood of a significant coronary narrowing and the likelihood of a coronary event over the next 3 years, compared to people with lower scores.  Similarly, the likelihood of a coronary event increases with increasing calcium percentiles.

Calcium Score Testing

High resolution, non-contrast, limited CT images of the heart, coronary arteries, and proximal great vessels.

Coronary artery calcium scanning and three-dimensional scoring was done according to a standardized protocol.  Interactive image viewing, volumetric display and analysis were performed.

Calcium Scoring Key

LMCA= left main
LAD= left anterior descending
CX= left circumflex
RCA= right coronary artery
PDA= posterior descending artery

CALCIUM PERCENTILE SCORE

Your total calcium score of is between the CACS percent low and CACS percent high percentile for patient-gender between the ages of CACS ages low and CACS ages high.  This means that CACS percent low percent of people this age and gender had less calcium than was detected in this study.   The following graph shows the distribution of total calcium scores for each age group by percentiles.  Your calcium score, relative to other age groups, is indicated by the highlighted square in the graph.

TRANSLATION OF CALCIUM SCORE

Calcium Score (2, 3) Implication Risk of Coronary Artery Disease
0 No identifiable plaque Very low, generally less than 5 percent