Q: What is an Electrocardiogram?
A: Electrocardiogram or ECG is the oldest heart test that is still in routine use today. The ECG is a method of recording the electrical activity of the heart. Each heartbeat is caused by a section of the heart generating an electrical signal, which then conducts through specialized pathways to all parts of the heart. These electrical signals also get transmitted through the chest to the skin where they can be recorded.
Q: How is the test performed?
A: An ECG is performed by placing 12 recording leads at certain specific locations on the body. They only record the heart’s electrical activity. They do not produce any electricity of their own. The recording itself takes only a few seconds, Including the setup time and the time to disconnect the leads, the whole procedure takes about 5 minutes.
Q: How to prepare for taking the ECG?
A: It does not require any preparation, except for possibly shaving chest hair to get a better recording Before the ECG, tell your doctor if you are taking any medications. There are no restrictions for food or fluids.
However, ingestion of cold water immediately before an ECG may produce changes in one of the waveforms recorded (the T wave). Exercise (such as climbing stairs) immediately before an ECG may significantly increase your heart rate. You may be asked to remove all jewelry and to wear a hospital gown.
Q: How will the test feel?
A: An ECG is painless. The test has no know side effects When first applied, the electrodes may be cold and in rare circumstances, you may develop a localized rash or irritation where the patches are placed.
TMT
Q: What is TMT?
A: Treat Mill Test. The most common way to stress a person’s heart is to have them perform exercise. Walking on a treadmill is most commonly used. For patients who are unable to exercise, intravenous medicines can be given in place of exercise to make the heart work as hard as if the person was running.
The most common way to stress a person’s heart is to have them perform exercise. Walking on a treadmill is most commonly used for patients who are unable to exercise to make the heart work as hard as if the person was running. Stress tests are commonly used tests for initial screening for CAD. These tests are able to detect the presence of flow-limiting blockages in the coronary arteries, generally in the range of at least a 50% reduction in the diameter of at least one of the three major coronary arteries.
Q: Why is TMT done?
A: TMT is done for the following reasons
1. To see if an asymptomatic person has silent Coronary artery disease,i.e. blockages or hardening of the arteries of the heart. In many patients, the first manifestation of heart disease is a heart attack or death without any preceding warning symptoms.
2. To determine if a person’s symptoms, such as chest discomfort or difficulty in breathing are due to heart disease or some other problem.
3. To check whether the treatment given for a patient for blocked arteries is working properly.
4. To assess a person’s exercise tolerance before beginning an exercise or cardiac rehabilitation program.
5. To determine if exercise causes an abnormal heart rhythm (arrhythmia)
Q: How is the test performed?
A: All stress tests are performed with continuous monitoring of the electrocardiogram (ECG). As the heart works harder, certain characteristic abnormalities can develop in the ECG in patients who have underlying heart disease.
Q: What are the preparations required for a stress Test?
A: The only preparation for a stress test is that you must not eat or drink for the six hours preceding the test. If it is an exercise test, make sure you wear loose fitting comfortable clothes and good running shoes.
High heels don’t work on a treadmill! Your physician may want you to skip some of your usual medications on the day of the test. Be sure to check with your physician about this.
Q: What if I can’t perform an exercise test or am unable to exercise adequately for a TMT?
A: Sometimes you can’t do an exercise test because you’re too sick or have physical problems. In this case, some drugs are given. This drug increases blood flow to the heart and thus “mimics” an exercise test.
Q: What is an Echocardiogram? Why is the test performed?
A: This test is performed to evaluate the valves and chambers of the heart in a non-invasive manner.
The echocardiogram allows doctors evaluate heart murmurs, check the pumping function of the heart, and evaluate patients who have had heart attacks. It is a very good screening test for heart disease in certain groups of patients.
Q: What is the procedure?
A: A highly trained technician or doctor places a hand-held plastic ultrasound probe against the patient’s chest.The probe is connected to large computer with a video screen. The probe emits sound waves that pass through the chest to the heart. The heart then reflects those sound waves back to the probe.
The probe transmits those reflected signals to the computer, which reconstructs them into a picture of the heart. This picture is displayed on the screen and recorded on videotape or on a digital storage medium.
Sometimes, an ultrasonic contrast agent is injected intravenously to enhance the quality of the sound wave pictures and give additional information about the amount of blood flow to the heart muscle.
Q: Is the Echocardiogram test safe?
A: There are no known harmful side effects from these sound waves. The test does not hurt because no needles are routinely used and nothing is placed inside the patient.
The average test takes about 10-30 minutes. No patient preparation is required for an enchocardiogram. The test can be done anywhere, at any time. You’re even allowed to eat before this test!
Q: What is a TEE?
A: Transesophageal echocardiogram (TEE) uses the same sound wave technology that a regular echocardiogram uses but the pictures are taken by inserting a special probe into the esophagus (the food tube that connects the mouth with the stomach) rather than by placing it on the patient’s chest wall. An overnight fasting is required for this test.
CORONARY ANGIOGRAPHY
Q: What is Cardiac Catheterization and Coronary angiography?
A: A Cardiac catheterization is a method by which long, thin plastic tubes called catheters, are inserted into a blood vessel in the leg or arm using a local anesthetic and then pushed under x-ray guidance to the heart. Once they are in the heart, the catheters can measure the pressures within the chambers of the heart as well as how much blood the heart is actually pumping to the rest of the body. This lets doctors know how well the heart is working.
It is also used to assess diseases of the heart valves and congenital heart disease. However, the most common reason a cardiac catheterization is done is to perform a Coronary Angiogram(CAG), i.e. take a
picture of the arteries that supply blood to the heart muscle. This is done by injecting
an X-ray dye that can be seen on X-ray film through the catheters into the coronary arteries. Any constriction gives an indication of blockages in these arteries. An actual X-ray movie is made of the coursing through the arteries.
Q: What is Angiography indicated in patients with chest pain or heart attack?
A: Angiography is advised when the decision to undergo angioplasty or by pass is made. This happens when the chest pain is not relieved in spite of adequate medical treatment or when the chest pain is unstable.
After a heart attack, if there is continued chest pain or exercise testing or if any other non-invasive methods show decreased blood flow, then to avoid future complications; angiography is done to know the extent and location of blockages.
Q: What are the preparations for Coronary Angiogram?
A: The only preparations for the procedure are that the patient should not eat or drink anything after midnight the night before. The patient’s usual medications can be taken the morning of the test with a small sip of water.
Some medicines may have to be stopped the day of or several days before the test such as the power full blood thinner and diabetic medications. The test is done in a room in a hospital called a cardiac catheterization lab.
