Ankle Brachial Testing
The vast majority of patients with coronary artery disease also suffer from peripheral artery disease. Ankle Brachial Index Testing is another important screening test for patients with blockages in their legs, a condition that is particularly prevalent in patients with diabetes. The ABI test is a systolic blood pressure comparison between the ankles and the arms. In addition to diabetes, it is recommended for all patients with high blood pressure, high cholesterol, family history of heart attack or stroke, and for those that are overweight. Our Cardiovascular Technician uses a Doppler system to evaluate the peripheral blood flow parameters non-invasively, quickly and easily.
Complex Cardio-Pulmonary Stress Testing
We use the newest technology to measure exhaled CO2 and pulse oximetry to evaluate a patientís pulmonary and cardiac function. We can evaluate Chronotropic incompetence, which can assist in the adjustment of medications such as Beta Blockers. This equipment allows not only the evaluation of a patientís current status, including de-conditioning, but it can also identify the optimum aerobic heart rate for exercising to lose weight!
Complex Blood Work
We use state of the art complex blood work including lipid profile with lipid fragmentation. The test is sent to a partnering lab in California for analysis.
We monitor our patients taking blood thinners using a specialized, CLIA waived, finger stick method test. This allows us to provide our patients with instant results and quick corrections to their medication levels while a doctor is present in the office. This is particularly important for patients recently starting blood thinners and needing close monitoring to achieve stabilization.
All of our patients with pacemaker and Internal Cardiac Defibrillators require that their devices are checked on a regular basis. We provide the convenience of this service at our office. Skilled Technical Representatives of all the highest quality devices manufacturers monitor our patients to ensure the highest level of safety, verify the proper functioning of the device, look for indications for replacement or malfunction, and reprogramming as needed. Additionally, working closely with the manufacturerís Technical Representative, our office participates in the Home Monitoring program of the most advanced systems so that your device is being monitored on a 24 hour basis, with your cooperation.
The sophisticated implantable devices, including both pacemakers and implanted defibrillators, are designed to improve the quality of life of the patients that have them. Often times the programming is based on best practices and averages but most importantly, these values are done at rest. We can improve the performance of these devices by optimizing their performance by evaluating the programming during patient exercise. This can be done for basic devices and also bi-ventricular devices. This testing can help prevent iatrogenic mitral valve regurgitation. In the case of bi-ventricular devices, this involves walking 1 mile per hour on a treadmill and stepping up on a small step. In both cases, patients often experience an immediate change in their comfort and breathing.
Echocardiography & Bubble Studies
Southwest Cardiovascular is accredited by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories.
Also known as ultrasonic cardiography is an echocardiogram or Ďechoí is an ultrasound image of the heart. Our highly qualified Technician uses our state of the art machine to meticulously evaluate the structures inside the heart, the shape and measure of the chambers, the heart valves, the ejection fraction of the valves and the motion of the heart and valves. Any abnormalities are quantified and noted. The doctor uses this information to determine the proper function of the heart and the information can be used to evaluate which medications can be used most effectively to support the heart function best for the patient.
Bubble studies are a means of identifying an opening between in the septal wall, the heart structure between the atria. This opening, called a Patent Foramen Ovale or PFO, is quite common and about one in five people have this defect. This defect is most often treated medically but, in some cases, it may require other treatment as the blood that passes between the atrium in this way has bypassed the bodyís natural filtration system and so debris, such as small blood clots, can pass through the body and lodge causing Transient Ischemic Attacks, or TIAs. (this should have a link)
Holter & Event Monitoring
Holter and Event Monitoring are devices that provide important feedback for the doctor regarding the electrical functioning of the heart. The Holter monitor is worn for a twenty-four hour period of time and is used to detect frequently experienced, i.e. at least once a day, phenomena or irregularities.
Event monitors can be worn for up to thirty days. These monitors start recording at the patientís indication when the heartís patient experiences discomfort or some other irregularity. Event monitors are used when the doctor suspects an infrequently experienced arrhythmia.
Nuclear Stress Testing
Southwest Cardiovascular Associates is an American College of Radiology Accredited Facility. Sometimes, the effects of heart disease are not readily apparent when the patient is at rest. By putting stress on the heart and monitoring the heartís rhythms compared to the rhythms of the heart at rest, our doctors can better evaluate the patientís heart function. Stress tests provide a means to identify blockages caused by coronary artery disease, potentially deadly arrhythmias, or irregular heart rhythms that threaten a patient's health, and the functional capacity of the patient's heart.
Nuclear Medicine Tests provide our doctors with specific information regarding the blood supply to the heart at rest and under stress. We use a radioactive isotope to track the blood flow through the heart. This is one of the tests that provides insight into the extent or existence of coronary artery disease and helps the doctor to determine whether a patient requires a cardiac catheterization.
There are two parts to this test: a resting cycle and a stress cycle. The rest portion uses only the isotope. The second part can be done one of two ways: Exercising the patient on the Treadmill or, alternatively, using a pharmacological stress agent, Lexiscan, to stress the heart chemically, essentially a simulation of vigorous exercise.
Pulmonary Function Testing/Spirometry
Pulmonary Function tests are performed when a patient is experiencing shortness of breath. This test allows a qualitative measure of a patientís lung function. Patients with pulmonary issues can then be referred to a pulmonologist (or back to their primary care).
Pulse Oximetry is a measure of oxygen in the patient's blood. We can quickly measure the patientís oxygen saturation respond accordingly. We do this test at rest and during/after light exercise.
Testing for Cardiac Rehabilitation
Cardiac Rehabilitation is extremely important for management of Coronary Artery Disease. One method for assessing a patientís cardiovascular condition is to use a treadmill exercise test. The treadmill speed is constant but the slope of the increases at regular intervals. This is known as the Naughton Treadmill Exercise Protocol by following this well proven method; our doctors can send the patient to an appropriate cardiac rehabilitation facility with a careful measure of their capacity to exercise.
T-Wave Alternans is a measure of a thousandth of a volt in the T-wave portion of the heart rhythm. Most incidents of sudden cardiac death are related to irregularities in the ’T’ part of the heart wave. This is one of the tests that measure the electrical portion of the heart function and it is 98% accurate in predicting acute coronary syndrome (ACS) in the following 12 month period.
Vascular Ultrasound and Testing
Over 80% of patients with Coronary Artery Disease have Peripheral Vascular Disease, PAD, as well. Patients also have a higher risk of PAD if they have a history of stroke, smoking, diabetes, hypertension, or kidney disease. We have a registered Vascular Ultrasound Technician to perform Carotid Artery, Renal Artery and upper and lower extremity Venous and Arterial studies. We also screen for abdominal aneurisms, a serious and potentially life-threatening condition.