General Physical Exams
Cardiovascular & General Physical Exams
In addition to checking your vital signs (blood pressure, heart rate, respiration rate and temperature), the doctor listens to your heart with a stethoscope and checks for an irregular heartbeat, a heart murmur or other clues indicating heart disease. The doctor also listens to your lungs checking for crackles, wheezes or decreased breath sounds which may signal heart disease. He may examine your head and neck evaluating your neck vessels, carotid artery and jugular veins. Assessment of the pulses of these vessels reflects the integrity of your heart muscle. The doctor may perform additional physical exams as necessary.
Blood tests may be ordered to check the levels of cholesterol, certain fats, sugars and proteins in the blood stream. Abnormal levels may indicate coronary heart disease or even a heart attack.
This test records the electrical activity of the heart, shows abnormal rhythms (arrhythmias), and can sometimes detect heart muscle damage. You may have an ECG while you are at rest or while exercising. An EKG is non-invasive, quick and painless. The entire procedure takes about 10 minutes. During this test, a technician attaches a number of soft electrodes with a gel to your chest, arms and legs. You lie still on a table while the machine records your heart's electrical activity and generates a graph.
Holter monitor, also known as ambulatory ECG or EKG monitor is a portable device that records your heart's activity for over 24 to 48 hours. Electrodes are attached to your skin over your chest and record information on a battery-operated, portable monitor that you carry with you while keeping a diary of your activities. After the monitor is removed, the heart's beats are counted and analyzed by a technician with the aid of a computer. This helps your physician identify the cause of your symptoms. The doctor may order this test if he suspects an abnormal heart rhythm, palpitations or insufficient blood flow to your heart muscle.
Event monitoring which uses EKG is very similar to Holter monitoring and is used to evaluate symptoms that may be heart related such as chest pain, fatigue, shortness of breath, dizziness or fainting. This test may also be used to assess the function of an implanted pacemaker or the effectiveness of therapy for complex arrhythmias. During this test, EKG electrodes are attached to your chest and they are connected by wire leads to a recording device. Event monitors are slightly smaller than Holter monitors and can be worn for several weeks. They can be auto-triggered to record faster or slower than normal rhythms when symptoms are rare or occur during sleep. They can also be activated manually by pressing a button if you experience symptoms. After you experience symptoms and record them, you will send the data to your doctor. based on the transmission Instructions that will be provided. You will also need to keep a diary of your symptoms and activities which will be analyzed by your physician.
An implantable loop recorder is a small, subcutaneous, single-lead ECG monitor used to diagnose unexplained recurrent symptoms that may be associated with heart disease. This device which is inserted just below the skin of the chest is capable of continuously recording your heart rhythm for up to three years. It can capture information which a standard electrocardiogram or Holter monitor misses because some heart rhythm abnormalities do not occur frequently. The device records the electrical impulses of your heart and automatically transmits them to your physician via the internet and wireless technology. Implanting the recorder which is typically smaller than a USB thumb drive, requires a tiny incision which is usually done at the doctor's office using local anesthesia.
Stress ECG Test
During this test, an ECG monitors your heart's electrical rhythms while you use a stationary bike or a treadmill that makes your heart work progressively harder. Abnormalities in blood pressure, heart rate or ECG or worsening physical symptoms may indicate coronary heart disease or plaque that lower the flow of oxygen-rich blood to the heart muscle. This test may also guide treatment decisions, diagnose arrhythmias, measure the effectiveness of treatment or determine the severity of your heart condition. If an exercise stress test doesn't pinpoint the cause of your symptoms, the doctor may recommend an imaging test such as a nuclear stress test or an echocardiographic stress test.
Tilt Table Test
Also called an upright tilt test, this procedure is used to determine the cause of frequent, unexplained syncope (fainting) spells, light-headedness or dizziness. The test results will also help in planning a course of treatment. The idea is to trigger your signs and symptoms while monitoring your heart rate and blood pressure. You will lie flat on a table or special bed that is equipped with special safety belts and a footrest. ECG electrodes will be attached to your chest, legs and arms to monitor the electrical impulses in your heart while a blood pressure monitor/cuff will be placed on your arm, finger or both. An oximeter will be connected to your finger to measure the oxygen level in your blood and an intravenous (IV) line placed in your arm will deliver medications and/or fluids as needed. The bed or table is then tilted at various angles (from 30 to 60 degrees) and your heart rate, blood pressure and symptoms (fainting, dizziness, headache, nausea or palpitations) are recorded and examined.