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None| CARDIOLOGY DIAGNOSTIC TESTS & PROCEDURES |
| Cardiac |
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1. Echocardiography: An echocardiogram, often referred to in the medical community as a cardiac ECHO or simply an ECHO, is a sonogram of the heart (it is not abbreviated as ECG, which in medicine usually refers to an electrocardiogram). Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart. The latest ultrasound systems now employ 3D real-time imaging.
2. Cardiotocography: In medicine (obstetrics), cardiotocography (CTG) is a technical means of recording (-graphy) the fetal heartbeat (cardio-) and the uterine contractions (-toco-) during pregnancy, typically in the third trimester. The machine used to perform the monitoring is called a cardiotocograph, more commonly known as an electronic fetal monitor or external fetal monitor (EFM). CTG can be used to identify signs of fetal distress. Simultaneous recordings are performed by two separate transducers, one for the measurement of the fetal heart rate and a second one for the uterine contractions. Each of the transducers may be either external or internal. External measurement means taping or strapping the two sensors to the abdominal wall. The heart ultrasonic sensor, similar to a Doppler fetal monitor, overlays the fetal heart. The pressure-sensitive contraction transducer, called a tocodynamometer (toco), measures the tension of the maternal abdominal wall - an indirect measure of the intrauterine pressure. Internal measurement requires a certain degree of cervical dilatation, as it involves inserting a pressure catheter into the uterine cavity, as well as attaching a scalp electrode to the child's head to adequately measure the pulse. Internal measurement is more precise, and might be preferable when a complicated childbirth is expected. A typical CTG reading is printed on paper and/or stored on a computer for later reference. Use of CTG and a computer network allows continual remote surveillance: a single nurse, midwife, or physician can watch the CTG traces of multiple patients simultaneously, via a computer station.
3. Electrocardiography: Electrocardiography (ECG or EKG) is a transthoracic interpretation of the electrical activity of the heart over time captured and externally recorded by skin electrodes.[1] It is a noninvasive recording produced by an electrocardiographic device. The ECG works by detecting and amplifying the tiny electrical changes on the skin that are caused when the heart muscle "depolarises" during each heart beat. At rest, each heart muscle cell has a charge across its outer wall, or cell membrane. Reducing this charge towards zero is called de-polarisation, which activates the mechanisms in the cell that cause it to contract. During each heartbeat a healthy heart will have an orderly progression of a wave of depolarisation that is triggered by the cells in the sinoatrial node, spreads out through the atrium, passes through "intrinsic conduction pathways" and then spreads all over the ventricles. This is detected as tiny rises and falls in the voltage between two electrodes placed either side of the heart which is displayed as a wavy line either on a screen or on paper. This display indicates the overall rhythm of the heart and weaknesses in different parts of the heart muscle.
4. Electrophysiology study: An electrophysiology study (EP test or EP study) is a minimally invasive procedure which tests the electrical conduction system of the heart to assess the electrical activity and conduction pathways of the heart. The study is indicated to investigate the cause, location of origin, and best treatment for various abnormal heart rhythms. This type of study is performed by a specialist (an electrophysiologist) and is performed using a single or multiple catheters situated within the heart through a vein or artery. This procedure is performed in a cath lab which is a specially equipped operating room. More modern cath labs contain a video X-ray machine and large magnets (2-3 tesla, 2 ft. diameter) for manipulating the electrodes, in addition to other necessary equipment. An IV tube is generally inserted to keep the patient hydrated and to allow for the administration of sedatives, anesthesia, or drugs. In order to reach the heart with a catheter, a site will be prepared that will allow access to the heart via an artery or vein, usually in the wrist or groin. This site is then described as the insertion point. A metal plate is placed underneath the patient between the shoulder blades, directly under the heart. An automated blood pressure cuff is placed on the arm which periodically measures the patient's blood pressure. A pulse oximeter is placed on one of the patient's fingers which steadily monitors the patient's pulse and oxygen saturation of the blood. The insertion point is cleanly shaved and sterilized. A local anesthetic is injected into the skin to numb the insertion point. A small puncture is then made with a needle in either the femoral vein in the groin or the radial vein in the wrist, before a guide wire is inserted into the venous puncture. A plastic sheath (with a stiffer plastic introducer inside) is then threaded over the wire and pushed into the vein(the Seldinger technique). The wire is then removed and the side-port of the sheath is a
5. Myocardial perfusion imaging: Myocardial perfusion scan is a nuclear medicine procedure that illustrates the function of the heart muscle (myocardium). It evaluates many heart conditions from coronary artery disease (CAD) to hypertropic cardiomyopathy and myocardial wall motion abnormalities. The function of the myocardium is also evaluated by calculating the left ventricular ejection fraction (LVEF) of the heart. This scan is done in conjunction with a cardiac stress test.
6. Cardiac catheterization/Coronary 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. Local anaesthetic is injected into the skin to numb the area. A small puncture is then made with a needle in either the femoral artery in the groin or the radial artery in the wrist, before a guidewire is inserted into the arterial puncture. A plastic sheath (with a stiffer plastic introducer inside it) is then threaded over the wire and pushed into the artery (Seldinger technique). The wire is then removed and the side-port of the sheath is aspirated to ensure arterial blood flows back. It is then flushed with saline. Catheters are inserted using a long guidewire and moved towards the heart. Once in position above the aortic valve the guidewire is then removed. The catheter is then engaged with the origin of the coronary artery (either left main stem or right coronary artery) and x-ray opaque iodine-based contrast is injected to make the coronary vessels show up on the x-ray fluoroscopy image. 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 and plug. 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, as well as left ventrical angiography. Once the catheter is in place, it can be used to perform a number of procedures including angioplasty, angiography, balloon septostomy, and an Electrophysiology study.
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