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Cardiovascular Diagnostic Testing

Crozer-Keystone makes it easier to get a cardiac imaging test with four locations throughout Delaware County, including the newly renovated electrophysiology lab at Crozer-Chester Medical Center. Each site offers the same standard of high-level care that has become a hallmark of our cardiac program. 

Studies such as nuclear stress testing, stress echocardiogram testing, electrocardiogram and holter monitoring are performed in our cardiac imaging centers. These tests help a cardiologist determine next steps and a plan of care to manage a patient’s heart disease — such as medicine or other interventional procedures, like cardiac catheterization. 

Noninvasive, Semi-invasive Procedures

Cardiac Catheterization

Cardiac catheterization enables physicians to see the coronary arteries and heart valves, showing narrowed or blocked arteries, defective valves, or other problems. It is generally performed to diagnose a heart condition and determine whether a patient needs treatment to open a blocked artery or re-route the blood flow around it.

With the help of X-ray guidance, doctors can access a patient’s arteries using catheters and wires that are inserted through a small incision in the wrist, or sometimes in the arm or groin. General anesthesia is not required and a patient doesn’t need to spend multiple days in the hospital.

Echocardiogram

During the procedure, a transducer (like a microphone) sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves bounce or "echo" off of the heart structures. These sound waves are sent to a computer that can create moving images of the heart walls and valves.

Doppler Echocardiogram

The Doppler Echocardiogram is used to measure and assess the flow of blood through the heart's chambers and valves. The amount of blood pumped out with each beat is an indication of the heart's functioning. Also, Doppler can detect abnormal blood flow within the heart, which can indicate a problem with one or more of the heart's four valves, or with the heart's walls.

Stress Echocardiogram

A Stress Echocardiogram (ECG) is performed to assess the heart's response to stress or exercise. The ECG is monitored while a person is exercising on a treadmill or stationary bike.

Transesophageal Echocardiogram

During a transesophageal echocardiogram, the patient’s throat is numbed and an endoscopic probe is swallowed, providing a close-up image of the heart; patients remain conscious, but are sedated for their comfort during the procedure.

Electrocardiogram

An electrocardiogram (ECC or EKG) is a recording of the heart’s electrical activity which can show different rhythms that provide clues to symptoms and potential problems.

Holter Monitor

A Holter Monitor is a device the size of a camera that checks for abnormal heart rhythms; the monitor, connected to electrodes on the chest, is worn on a shoulder strap for 8 to 24 hours while the patient engages in normal activity.

Pharmacologic Nuclear Stress Echocardiogram

During a Pharmacologic Nuclear Stress Echocardiogram, a drug and a radioisotope heart scanning material are injected, then a scanning camera records images to determine whether there is reduced blood supply to areas of the heart.

Tilt Table Testing

A tilt table test is done while the person is connected to ECG and blood pressure monitors and strapped to a table that tilts the person from a lying to standing position. This test is used to determine if the person is prone to sudden drops in blood pressure or slow pulse rates with position changes.

Cardiac CT Calcium Scoring

Cardiac CT Calcium Scoring is a non-invasive test that reveals the presence, location and extent of calcified plaque in the coronary arteries. A Computed tomogrphay (CT) scan produces multiple images of the arteries and heart muscle and determines if there is coronary artery calcium and, if so, to what extent.

The results of a Cardiac CT Calcium Scoring procedure are described using a number system. A negative cardiac CT score shows no calcification within the coronary arteries (Calcium Score of 0). This means that the risk of having a heart attack over the next two to five years very low. A positive score means that coronary artery disease is present even if the patient is experiencing no symptoms. The amount of calcification can help in the prediction of the likelihood of a heart attack in the future. It also helps to determine what measures should be taken such as preventive medicine, and changes in diet, and increased exercise.

Invasive Procedures

Electrophysiology Studies

An electrophysiological study (EP study) is an invasive procedure that evaluated abnormal heart rhythm disturbances. During an EP study, small, thin wire electrodes are inserted through a vein in the groin (or neck, in some cases). The wire electrodes are threaded into the heart, using a special type of X-ray, called fluoroscopy. Once in the heart, electrical signals are measured. Electrical signals are sent through the catheter to stimulate the heart tissue to try to initiate the abnormal heart rhythm disturbances for evaluation. The electrophysiology lab at Crozer-Chester Medical Center features new, state-of-the-art imaging system and an intracardiac echocardiogram.

Intracardiac Echocardiogram

Performed under local anesthesia, an intracardiac echocardiogram is performed by passing a thin, flexible tube with a tiny transducer through an artery by way of a small nick in the arm, wrist or groin. The physician positions the catheter so that ultrasound images of the heart and its valves can be recorded and interpreted for potential problems or disease. The procedure produces more direct visualization of heart structures than most other tests and enables physicians to develop a precise treatment plan tailored to the patient’s needs.

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