Tests & Screenings

Understanding the source of your heart symptoms is one of the first steps toward good heart health. At MacNeal Hospital, we offer a wide range of heart tests and screenings all at one convenient location. Below is a list of common diagnostic tests and heart disease screenings you may receive at MacNeal.

  • 24-hour holter monitors

    24-hour holter monitors are battery operated ECG devices, which monitor and record the heart's electrical activity for 24 hours.
  • 3D Cardiac Mapping

    Electrophysiology experts at MacNeal use a 3-D cardiac mapping system that enables physicians to locate the precise location of arrhythmias. This imaging technology is “like a Global Positioning System for the heart.”
  • Angiography (Coronary Arteriography)

    Coronary angiography is an X-ray examination of the blood vessels or chambers of the heart, used to diagnose blockages and other problems in arteries and veins. MACNEAL HOSPITAL Cardiovascular specialists insert a very small tube (catheter) into a blood vessel in your upper thigh (groin area) or arm. The tip of the tube is positioned either in the heart or at the beginning of the arteries supplying the heart, and a special fluid (called a contrast medium or dye) is injected. This fluid is visible by X-ray, and the pictures that are obtained are called angiograms.
  • Ankle-Brachial Index (ABI)

    The ankle-brachial index uses blood pressure cuffs to provide a specific and sensitive test for diagnosing peripheral artery disease (PAD). ABI measures your systolic blood pressure at your ankle and divides it by the systolic blood pressure at your arm. It is recommended that every smoker or diabetic over 50 years of age, and all patients over 70 years of age have their ABI monitored.
  • Arterial Vascular Study Lower Extremity

    An arterial vascular study of the lower extremity typically involves inflating blood pressure cuffs on the legs while recording the pulse sounds through a Doppler transducer.
  • Blood and Urine Tests

    These are used to test levels of proteins and other specific things that should, or shouldn’t, be in your body.
  • Cardiac Catheterization (cath)

    Cardiac Catheterization is an invasive test that introduces a small catheter into the heart from the groin or arm, this allows measurement of various pressures inside the heart to aid in the diagnosis of heart failure. Biopsies of the heart tissue may be obtained in order to determine underlying causes of heart failure.
  • Chest X-ray

    A diagnostic test which uses invisible X-ray beams to produce images of internal tissues, bones, and organs onto film.
  • Coronary Calcification Scan

    A coronary calcification scan uses computed tomography (CT) technology to take multiple, clear pictures of the heart and calcium deposits in the coronary arteries. By measuring the calcium deposits in the coronary arteries, the physician gets a good idea of how much plaque has built up and "hardened" in the arteries. This calcification measurement is an excellent indicator of the patient's risk of a heart attack and other heart problems. A negative (or low calcium) score generally indicates a low risk for future coronary artery blockages and coronary events. The test is painless and takes about 10 minutes.
  • CT Angiography

    The 64-slice CT provides clear, non-invasive, 3D images of the coronary arteries with remarkable detail and speed. This sophisticated examination can discover signs of heart disease that may be invisible to stress testing and EKG and calcium scoring alone. Taking minutes to perform, Coronary CTA can provide important diagnostic information about the structure and function of the heart, such as the presence of calcium and/or fatty deposits (plaque) in coronary arteries.
  • Echocardiogram

    An echocardiogram, also known as an "echo", is an ultrasound of the heart. The test is non-invasive, painless and safe. High-frequency sound waves bounce off the structures of the heart and create a computerized, moving picture of the beating heart. Highly trained cardiac imaging specialists at CVI use these images to detect heart damage and disease.

    An echocardiogram is especially useful for detecting congenital heart disease and problems with the heart valves. The test is sometimes used in combination with a stress test to identify changes in the function of the heart muscle when exercise is performed. Some problems with the heart are easily missed when the heart is at rest and only become apparent under the stress of exercise.
  • Electrocardiogram (ECG)

    An electrocardiogram (ECG) records the electrical activity of the patient’s heart. During the test, ten electrodes are attached to the patient’s legs, arms and chest. The electrodes create a record of the heart’s rhythm, including any arrhythmias that occur during the test. Sometimes an ECG is performed while the patient exercises on a treadmill. This is called a Stress Test, which is designed to record electrical activity of the heart during physical exertion.
  • Electrophysiology (EP) Study

    Electrophysiology allows a cardiologist to accurately diagnose the precise cause of an arrhythmia and select the best possible treatment. During an EP study, a specially trained cardiologist may provoke arrhythmia events. As a result, EP studies can
    • Diagnose the source of arrhythmia symptoms
    • Evaluate the effectiveness of certain medications
    • Predict the risk of a future cardiac event, such as Sudden Cardiac Death
    • Assess the need for an implantable device (a pacemaker) or treatment procedure (radio frequency catheter ablation)
    An EP study is performed with the patient under local anesthesia and conscious sedation (twilight sleep). A narrow, flexible tube called a catheter is inserted into a blood vessel and the heart. Once the catheter reaches the heart, electrodes at its tip gather data.
  • Electroencephalogram (EEG)

    An electroencephalogram (EEG) is a test that uses electrodes placed on the scalp to detect the electrical activity of the brain.
  • Microvolt T-Wave Alternans Test

    The Microvolt T-Wave Alternans Test is a non-invasive test used to identify patients at risk of life threatening heart rhythm disturbances. Similar to a Stress Test, electrodes and sensors are applied and the patient is asked to exercise on a treadmill for the duration of the test. The Microvolt T-Wave Alternans test permits measurement of the heart’s T-waves at a microvolt level.
  • Monitoring Devices

    Monitoring devices are used to detect irregular heart rhythms over varying periods of time. 

    Event Recorder
    An event recorder is a pager-sized box that can create a 1 to 2 minute recording of the heart rhythm. When you experience symptoms, you press a button to record the heart rhythm.

    Holter Monitoring
    Holter monitoring devices are portable ECG recorders that you wear during normal activity for 24 to 48 hours. During this time, the device makes a detailed record of the heart’s activity.

    Insertable Loop Recorder (ILR)
    For occasional arrhythmias, an insertable loop recorder may be implanted under you skin 12 to 18 months. The device creates a long-term record of your heart’s rhythm.
  • MRI

    MRI (magnetic resonance imaging) uses radio waves and a magnetic field to provide clear and detailed pictures of the heart and blood vessels. A non-invasive tool, MRI is becoming very important in the diagnosis and management of heart failure.
  • Positron Emission Tomography Scans (PET)

    PET scans are non-invasive, providing detailed information about the blood supply and metabolic activity of the heart. By revealing cardiac metabolism rates and other information, PET studies help physicians identify the best therapies for patients. They are particularly helpful in treating high-risk patients with coronary disease and heart failure. These studies can not only show heart muscle with inadequate blood flow due to blockages, PET studies can also identify heart muscle that has been damaged from past heart attacks. 

    Taking it a step further, PET studies can even distinguish between irreversibly damaged heart muscle and damaged heart muscle that has the potential to recover after bypass surgery or stent placement.

    Another advantage: PET studies can be completed in about 45 minutes while a traditional nuclear cardiac imaging study takes from 4 to 5 hours. Plus, PET studies provide greater scan clarity than traditional nuclear studies. This clarity provides more accurate interpretation.
  • Stress Testing

    Stress tests are a noninvasive technique commonly used to evaluate the flow of blood to your heart muscle. They can identify areas of the heart muscle that have an inadequate blood supply as well as the areas of heart muscle that are scarred from a previous heart attack.

    The tests also can evaluate the pumping function of the heart. Some patients may need an additional level of testing using an imaging agent. These tests are often called nuclear cardiology tests.

    Nuclear medicine tests help identify patients at increased risk for a heart attack and those who may be candidates for procedures such as coronary angiography, angioplasty and heart surgery. While tests are usually done while the patient is exercising on a treadmill or stationery bike, some patients who can’t exercise may be given a "chemical" stress test using a drug that simulates exercise.

    Before the test, the patient is connected to equipment which will monitor the heart. The patient then walks slowly on a motorized treadmill. The speed is slowly increased and the treadmill is tilted to produce the effect of going uphill. Patients can stop the test at any time if needed. Medical professionals are present throughout the test.
     
    At MacNeal, several types of stress tests and nuclear cardiology tests are performed:
    Exercise Stress Test (GXT): The patient is monitored by EKG and blood pressures are taken before, during and after the test. The test is symptom limited. Average time on the treadmill is six to 12 minutes. The entire test takes 30 minutes.

    Exercise Stress Echocardiogram: Before and after the treadmill test, echocardiogram pictures are taken. This compares the wall motion of the heart at rest and when it becomes stressed. Average time on the treadmill is six to 12 minutes. The entire test takes 45 minutes.

    Dobutamine Stress Echocardiogram: During the treadmill test, the patient is given the medication Dobutamine intravenously. The medication slowly increases the heart rate and contractility until the desired heart rate is obtained or the patient’s symptoms limit the study. Echocardiograms are taken before, during and after the Dobutamine infusion. The test takes approximately one hour.

    Exercise Sestamibi (Stress Cardiolite): Prior to exercise, a Cardiolite injection is given and resting images taken of the cardiac structure. When a predetermined heart rate has been achieved during the stress test, a second injection of Cardiolite is given. After a rest period, a set of images of the heart is taken. The entire test lasts approximately three hours.

    Persantine Sestamibi (Persantine Cardiolite): Prior to exercise, a Cardiolite injection is given and resting images taken of the cardiac structure. The patient also receives Persantine intravenously, then a second injection of Cardiolite. After a rest period, a set of images of the heart is taken. The entire test lasts approximately three hours.

    Dobutamine Sestamibi (Dobutamine Cardiolite): Prior to exercise, a Cardiolite injection is given and resting images taken of the cardiac structure. During the treadmill test, the patient is given the medication Dobutamine intravenously. The medication will slowly increase the heart rate and contractility until the desired heart rate is obtained or the patient’s symptoms limit the study. A second injection of Cardiolite is administered. Echocardiograms are taken before, during and after the test. The test takes approximately three and a half hours.
  • Thallium and Dobutamine Testing

    Thallium and dobutamine are two medications that are used to facilitate cardiac testing. Thallium is a radioactive substance that travels through the vessels and helps make the path the blood has traveled visible while dobutamine chemically increases the heart rate for those who are unable to walk on a treadmill.
  • Tilt Table Test

    The tilt table test is used to evaluate the causes of fainting. The test checks how changes in body position can affect blood pressure. The patient lies on a special table and heart rhythm and blood pressure are monitored as the table tilts the patient to a 70- to 80-degree angle.

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