Frequently Asked Questions

We strive to make your patient experience as pleasant as possible. To help you know what to expect, we have provided answers to frequently asked questions about our non-invasive tests.

Please select the test you would like to learn more about.

Non-Invasive Testing Patient Information
Carotid Doppler Study
Nuclear Stress Test
Transesophageal Echocardiogram (TEE)

Non-Invasive Testing Patient Information

Can my coronary arteries be blocked and I have no symptoms?
Even if an artery is completely obstructed, there may be a vast network of tiny, collateral vessels through which blood can flow. Therefore, the same patients do not experience any symptoms.

How accurate is non-invasive testing?
Each test has different accuracy rates for detecting various problems.

Where can I have non-invasive testing done?
Several forms of non-invasive testing can be performed at our cardiology office, or you can have non-invasive testing done at one of our hospitals or ambulatory locations.

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Carotid Doppler Study

What is a Carotid Doppler Study?
A carotid doppler study is a test that uses sound waves to create pictures of the blood flow in the two large arteries in your neck. These arteries are called the carotid arteries. They supply your brain with blood. You have one carotid artery on each side of your neck. The study will look at the size of the arteries and the blood flow. Other names for this test are Carotid Duplex Ultrasound and Carotid Doppler Ultrasound. It is not a painful study and takes about 30 - 45 minutes.

Why am I having a carotid doppler study?
Your doctor may order this test to check for plaque buildup in the carotid arteries. This buildup can narrow or block your carotid arteries.

Do I need to follow special instructions before the test?
You are not given contrast dye and no x-rays are used.

What can I expect during the test?
You will lie on your back on a soft cushioned table. The room will be a little dark. The sonographer, or ultrasound technician, places clear gel on one side of you neck. A microphone-like device called a transducer is moved back and forth on different spots of your neck. It sends and receives sound waves to an ultrasound machine and monitor. Moving pictures of the arteries are created and recorded. You may hear a swishing sound at times. This is the "Doppler" sound of blood moving in the artery. It will show color on the monitor. The clear gel is then placed on the other side of the neck, and the test is repeated.

What can I expect after the test?

There are no special instructions after the test. The gel is easily wiped from the neck. Your doctor will discuss with you the test results and your plan of care.

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Nuclear Stress Test

What is a nuclear stress test?

A nuclear stress test is a test used to detect heart disease. You will receive a small amount of radioactive isotope through an intravenous (IV) line that acts as an “imaging agent.” A special gamma camera takes views of your heart at rest and after stress. You may walk or exercise on a treadmill for the “stress” part of this test, or you may receive medicine through your IV. This is a two part test that takes 2-4 hours.

Why has my doctor ordered a nuclear stress test?

A nuclear stress test can give your doctor information about the cause of your chest pain or other symptoms that may be related to your heart. It is done so your doctor can look at the blood supply to your heart muscle, and see the areas with less or no blood flow.

What do I need to do before the test?

For 24 hours before the test:

  • Do not have any food, drinks, or medicines with caffeine. This also includes decaffeinated beverages, chocolate and tea, including green tea.
  • Do not smoke.

For 6 hours before the test: do not eat or drink any food or liquids. If you have:

  • a morning appointment (before 12:00 noon) please do not have breakfast.
  • an afternoon appointment (after 12:00 noon) you may have a light, caffeine-free breakfast, such as cereal, oatmeal, milk, toast, or choice.

Please, contact your doctor at least 24 hours before your test to discuss your medicines.

Ask your doctor if you should stop any of your heart medicines on the day of the test. You can take your medicine on the day of the test with a sip of water. Please bring with you, any medicines your doctor told you not to take on the day of the test. You will be able to take them once your test is complete.

If you have diabetes and are taking medicine for it, speak with your doctor at least 24 hours before your appointment to see if any of your diabetes medicines need to be changed.

Wear loose fitting clothes and rubber soled shoes or sneakers for the test.

Pregnant or possibly pregnant women and women who are breastfeeding must tell their doctor and the stress lab staff.

What happens during the “resting” part of the test?

  • A small amount of radioactive isotope or “tracer” will be given through an intravenous (IV) line.
  • About 10 - 30 minutes later, scans will be taken of your heart. It is important that you lie as still as possible during the scan.
     

What happens during the “exercise” part of the test?

  • Your EKG and blood pressure are watched by a nurse and a doctor during the test. Electrodes will be placed on your chest and a blood pressure cuff will be placed on your arm.
  • You will walk on a treadmill. The speed and incline will slowly increase. You will be encouraged to exercise for as long as possible.
  • About one minute before the end of the test, the isotope will be injected again through your IV line. About 1 minute later, the treadmill will slow down, and you will walk slower.
  • You will have a recovery period once the exercise is finished.
  • After about 10 - 30 minutes, a second set of pictures will be taken.
     

What if I cannot walk or exercise?

If you cannot walk or exercise on the treadmill, you may have a chemical stress test where you will receive medicine through the IV. You will still be monitored and receive the isotope, and then have the 2nd set of pictures taken in about 60 minutes.

Your doctor will speak with you before the test to decide if this test is better for you.

How will I feel during the test?

There may be a slight metallic taste for a few seconds after the isotope is given.

You may notice things that you feel when you do tough exercises, such as fatigue, muscle cramps in your legs or feet, or some shortness of breath.

Tell the doctor or nurse right away if you have any unusual symptoms such as lightheadedness or chest pain at any time.

If you are having a chemical stress test, you may have minor side effects from the medicines that are given. Your doctor will discuss this with you.

What happens after the test?

You may eat and drink unless your doctor tells you otherwise.  Nuclear cardiology tests generally involve the use of very small amounts of radioactive tracers.  The radioactive exposure is very small, somewhat like that of a chest x-ray.  The isotope leaves your body through its natural processes and is not a dye and has no effect on your kidneys.   

State-of-the-art imaging techniques are used to increase test accuracy.  Your test will be read by one of our cardiologists who are considered leaders in the field of nuclear cardiology.  The information from the test allows your doctor to determine if you have coronary artery disease and assess your risk of heart attack.   It also assess the size of the pumping chamber and the strength of the heart beat, also called the ejection fraction.  In addition to determining the presence of coronary artery disease, the test also assesses the presence of a weak heart, called a cardiomyopathy.  

The results of your test will be shared with your doctor within 24 hours of your test.  If the results of the test are mildly abnormal, the appropriate treatment is generally aggressive reduction of risk factors and medical therapy for mild blockage of coronary arteries.  However, if the abnormalities are large, you may be referred for a catheterizationfor angioplasty or placement of a coronary stent.   With very severe artery disease, you may be a candidate for coronary bypass surgery.  Your doctor will speak with you about your results and determine your plan of care.

References:

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Transesophageal Echocardiogram (TEE)

What is a transesophageal echocardiogram (TEE)?

A Transesophageal Echocardiogram (“TEE”) is a test that uses sound waves to make moving pictures of your heart from inside of your food tube, or esophagus. A flexible tube with a probe at the end is guided down your throat and into your esophagus. This procedure allows for more detailed pictures of your heart than the standard transthoracic echocardiogram (which takes pictures from outside the chest.)

Who does the TEE?  

The test is done by a heart doctor who is a specialist in echocardiology.

Where is the TEE done? 

It is done in the Echocardiology Lab (echo lab).

How long will the test take?   

  • The test can take up to 40 minutes.
  • You will be in the echo lab for 2 - 3 hours.

Will I be awake during the test?

  • You will be awake but will be given medicine to make you sleepy.

What happens before the procedure?

  • Your doctor will discuss the risks, benefits, and choices with you and ask you to sign an informed consent giving permission to perform the procedure.
  • Do not eat or drink anything after midnight the night before the test.
  • You will receive special instructions about your medications.
  • You need to have someone drive you home the day of the test.

What happens during the procedure?

  • You will be asked to lie on a cushioned table.
  • The room will be a little dark.
  • If you wear dentures, you will be asked to remove them.
  • A registered nurse will monitor you during the test.
  • You will be attached to monitors that check your heart, blood pressure, and oxygen level during the procedure.
  • You will receive oxygen through your nose.
  • An intravenous line will be started.
  • You will be given medication to make you drowsy and to numb your throat.
  • The tube will be guided into your food pipe and will stay for 20-40 minutes.
  • Your doctor then takes several pictures and recordings of your heart.

What happens after the procedure?

  • You will be observed in the recovery room.
  • You will begin to feel less drowsy.
  • When you feel comfortable, you will be able to sit up.
  • You will be able to eat or drink 2 hours after the test
  • or when your throat is no longer numb.

What are my discharge instructions?

  • Your doctor will discuss the results and your plan of care.
  • You may have a sore throat for 1-2 days.
  • You may not drive the day of the test.
  • Call your doctor if you have:
  • chest or abdominal pain
  • persistent or severe sore throat
  • fever
  • vomiting
  • bleeding
     


References:
American Society of Echocardiography
Medline Plus  

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