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Diagnostic Testing

TYPE

WHAT IS THE PROCEDURE?

HOW YOU SHOULD PREPARE

Cardiac Catheterization

This is a special x-ray study of the heart. A soft, narrow plastic tube called a catheter is placed into a vein or an artery in your upper leg (groin). The catheter is then passed through your blood vessel into a chamber or a coronary artery. Special x-ray fluid called dye allows your doctor to see the chambers, valves or coronary arteries in your heart on an x-ray screen. If you know that you are allergic or have had a reaction to x-ray dye, iodine or shellfish, please tell your doctor and nurse. A special medication may be given to reduce or prevent a reaction.

You must have nothing to eat after midnight. You may drink clear fluids such as tea, coffee, juice or water up until three hours before your procedure. This will reduce the possibility of nausea or vomiting during the test. You may take your regular medications with a sip of water. You will wear a hospital gown for the test. Before leaving your room you will be asked to empty your bladder and remove jewelry. You do not have to remove your glasses or dentures for this test.

Cardiac MRI

Magnetic waves are beamed towards the heart which produces an image. This procedure is used to obtain detailed information about congenital heart disease, cardiac masses, and lesions of large blood vessels prior to surgery.

See Stephenson MR Centre for more details

Echocardiogram

A small ultrasound probe will be placed on your chest. Moving pictures of the heart muscle, valves, chambers and blood flow will be recorded on a videotape. Allow 90 min for this test.

No special preparation.

Event Recorder

Long term ambulatory event monitoring is useful in obtaining ECG recordings over a longer period of time (weeks or months). You must start the recorder when you are having symptoms. For people who do not faint often, this may be the only way to obtain an ECG recording during an event. The recorder can record ECG's for a varying time period before and after it is started. The event monitor is especially usefully if you have warning signs before fainting. The monitor is small, lightweight , and simple to use by either the affected person or a witness to the event. If there is an activity that causes you to faint, your doctor may encourage this activity in an effort to more quickly identify the problem.
Make sure you have a family member or friend present to protect you from possible harm and to ensure that the event recorder is activated.

Exercise Stress Test

Ten leads will be placed on your chest. These leads are attached to a machine which will record the electrical activity of your heart while you are walking on a moving belt (treadmill). Allow 45 minutes for this test.

No solid food or caffeine (coffee, tea, chocolate, coke, cold medicines) for four hours prior to the test. Juice and water area allowed until 30 minutes before the test. Diabetics may follow their routine meal plan. Take regular medications unless your doctor gives you other instructions. Wear or bring exercise clothing, running shoes or flat walking shoes.

Holter Monitor (24HR & 48HR)

Five leads will be placed on your chest. These leads are attached to a small portable recorder which will record the electrical activity of your heart. Depending on whether you have a 24-hour or 48-hour Holter you will be instructed to remove the Holter and return it to the CV Labs at approximately the same time of day on the appointed date.

No special preparation. Please wear a blouse or shift with buttons in the front. Do not bathe or shower while connected to the Holter.

MUGA Scan

A radioisotope will be injected through a vein in your arm. Pictures of your heart will be taken during rest. Allow 90 minutes for the resting MUGA Scan.

No caffeine 24 hours prior to this test. Nothing to eat or drink after midnight. If you are on medications, please ask your doctor if it should be taken before this test. Please bring or wear comfortable flat shoes and clothing suitable for exercising.

Thallium Stress Test

An intravenous will be started in your arm. You will be asked to walk or run on a treadmill to "stress" your heart. If you are unable to exercise, the drug Dipyridamole will be given to simulate exercise and "stress" your heart. Near the end of the stress part of the test, Thallium will be injected into the intravenous. Following the injection, images will be taken of your heart. You will lie beneath a special camera for 20 minutes. When this is complete you will be allowed to leave the department, but you must return for a second set of images in a few hours. The technologist will give you an exact time to return. While you are on your break, you may have clear fluids such as black coffee, clear tea, diet pop or water. The second set of images will take about 15 minutes. Note: Thallium is a radioactive material which will collect in the muscle of the heart allowing images of the blood flow in the heart. Thallium will not cause you to be sick in any way.

No caffeine 24 hours prior to this test. Nothing to eat or drink after midnight. If you are on medications, please ask your doctor if it should be taken before this test. Please bring or wear comfortable flat shoes and clothing suitable for exercising.

Tilt Table Test

This test is done if you are prone to an exaggerated drop in your blood pressure or to an abnormal sudden slowing of heart rhythm. This tilt test can bring out an abnormal slowing of the heart rhythm and low blood pressure in a susceptible person. It gets ins name from the bed that is used during the study. This bed can be tilted to an upright position from a lying position and vice versa, in a matter of seconds. This tilting is similar to standing except less muscle contraction is needed to maintain an upright position. This results in more blood pooling in the legs. Tilt testing is a safe, simple and useful way for your doctor to identify whether you suffer from neuromediated syncope. It attempts to copy the conditions that cause you to faint. A negative tilt table test does not rule out reflex fainting. Tilt testing may be helpful in learning whether reflex fainting plays a role in your syncopal episodes and may be used to assess the benefits of treatment.

Do not eat or drink anything for at least four hours prior to the test. You will usually be able to take any medications you have been prescribed for other conditions. Check with your doctor to see if or when you should stop taking any medications that you have been prescribed for your syncopal episodes. These may need to be stopped before the tilt test.

Transesophageal Echocardiogram

Pictures of the heart are taken by scanning from within your esophagus (or swallowing tube). A narrow bendable scope with a special tip is inserted in your mouth and down the esophagus. This test will help your physician obtain very detailed pictures about your heart and its blood flow patterns.

Do not eat or drink anything for six hours prior to the test. You may take regular medications with a small amount of water. If you have diabetes, do not take your diabetic medication the morning of the test. Bring your medication with you to the hospital, you can take it following the procedure. Make arrangements for transportation home. You will not be able to drive yourself, please have a responsible adult accompany you to take you home either by car or taxi.

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