Electrocardiogram is also known as an ECG or EKG. Small plastic patches known as electrodes are placed on the chest, arms, and legs. The electrodes are connected to a machine to measure the electrical signals of your heart. This electrical activity is recorded by the machine and printed out providing a snapshot of your heart’s rhythm that can be interpreted.
Both holter and event monitoring use a device to monitor the heart’s electrical activity. Similar to the electrocardiogram patches will be placed on your body in order to measure and record the activity. A Holter monitor allows for continuous monitoring and can be worn for 24 or 48 hours. An event monitor is similar to the holter monitor, however it does not measure continuously. The event monitor records when the device detects irregularities or when the individual triggers it. Event monitors are typically worn for about a month.
Zio patch/MCOT is a small patch that can be worn for 7-14 days and continuously monitor’s the heart’s electrical activity.
A test that uses sound waves producing pictures of your heart. A probe is placed on your chest and uses sound waves (ultrasound) that bounce off the structures of your heart. The probe picks up the returning sound waves that “echo” off the heart structures and produces images of your heart on a monitor. The image of your heart is also referred to as an echocardiogram or an echo. The video images provide key information on the size, thickness, and movement of the heart in addition to the heart valves and blood flow through the heart.
Exercise and nuclear stress testing
Stress tests can show your risk for heart disease and provides information on the heart as it works under stress. There are multiple types of stress tests that can help identify problems with the blood flow within your heart. Determining the type of test is specific to each individual and based upon many factors. Both exercise and medicine can be used to stress the heart.
Exercise stress test shows how the heart works under physical stress. Patches are placed on your body to obtain an electrocardiogram. The electrocardiogram monitors your heart rhythm during the test. You will also have a blood pressure cuff on to measure your blood pressure throughout the test. You will walk on a treadmill while your blood pressure and heart rhythm will be monitored as the treadmill slowly increases in speed and incline at set intervals. The exercise forces your heart to work more by pumping harder and faster thereby, identifying potential problems within your heart.
A stress echocardiogram is similar to the exercise stress test. This procedure combines the aforementioned exercise stress test with an echocardiogram. Prior to walking on the treadmill images of your heart will be obtained at rest. You will then perform the same exercise stress test as explained above. Once the treadmill portion of the stress test has been completed you will immediately lie down to obtain the stress echocardiography pictures of the heart.
A dobutamine stress echocardiogram (DSE) uses medicine to stress the heart and is often used when people are unable to exercise on a treadmill. Dobutamine is a medicine that causes the heart to beat harder and faster thus “mimicking” stress on the heart. An IV will be placed in order to attach and use the medicine. Patches will be placed in order to monitor your heart’s electrical activity. A blood pressure cuff will also be placed in order to measure your blood pressure throughout the procedure. Echocardiography is used to obtain images of the heart prior to starting the medicine. Once all of the images have been completed the Dobutamine will be started to increase the heart rate to achieve a maximum targeted heart rate. More images of your heart will obtained while the dobutamine is running. Once all the images have been completed the medicine is turned off and your heart rate and blood pressure are monitored until they normalize.
Nuclear stress test is another form of stress testing that uses medication to identify blockages in the coronary arteries. A small amount of radioactive dye is injected through an IV to produce images of the heart. This medication can be used in combination with exercise with the treadmill and is often referred to as a nuclear stress test with exercise. First, the radionuclide is injected followed by a series of pictures taken. This is followed with an exercise portion where you will walk on a treadmill. Once at peak the radionuclide is injected through the IV and more pictures taken to obtain the stress images.
The radionuclide can also be used in conjunction with another medication to medically or pharmacologically stress the heart. Similar to the nuclear stress test with exercise, the radioactive dye is injected and rest images are obtained. This is then followed by medication, such as adenosine or regadenoson, to increase the heart. Once at peak the radioactive dye is once again injected and stress images obtained.