Cardiac imaging

An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a standard x-ray image. An echocardiogram does not expose you to radiation.

The most common type of echocardiogram we perform is a transthoracic echocardiogram (TTE).

During a TTE, we place an instrument (called a transducer) on your chest and upper abdomen and direct it towards the heart. This device releases high-frequency sound waves. The transducer picks up the echoes of sound waves and transmits them as electrical impulses. The echocardiography machine converts these impulses into moving pictures of the heart.

We also take still pictures during this process. In some cases, the lungs, ribs, or body tissue may prevent the sound waves and echoes from providing a clear picture of heart function. If this is a problem, the health care provider may inject a small amount of imaging enhancer through an IV to better see the inside of the heart.

Usually, a regular echocardiogram is performed with a bubble study done at the end of the exam. The sonographer or a RN place an IV line to perform the bubble study. A saltwater solution is mixed with a tiny amount of air to create small bubbles, which are injected through the IV. The fluid then circulates to the right side of your heart and shows up on the screen. Normally your lungs filter out the bubbles but if you have an opening between your heart's upper chambers, some bubbles will move across and appear on the left side of your heart. A hole in the upper chambers may be responsible for certain rare strokes when no other cause can be found.

No special steps are needed before a transthoracic echocardiogram (TTE) test.

If you are having a transesophageal echocardiogram (TEE), you will not be able to eat or drink for several hours before the test.

When a cardiologists needs more detailed images of the heart, an exam called a transesophageal echocardiogram (TEE) may be performed. With the patient under sedation and monitoring, the cardiologists will guide a small transducer down the throat. This allows more detailed images of cardiac structures and anomalies.

Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body. It is most often used to detect a decrease in blood flow to the heart from narrowing in the coronary arteries.

Prior to a stress test, a resting echocardiogram will be done first. For a resting echocardiogram, patients lie on their left side with their left arm out while a small device (called a transducer) is held against their chest. A special gel is used to help the ultrasound waves get to your heart.

During a stress test, most people walk on a treadmill or pedal an exercise bike. The amount of effort to expect is similar to walking quickly or jogging up a hill. The stress test usually takes between 5 and 15 minutes, depending on the person's level of fitness and age.

If someone is not able to exercise, we provide a medication that allows the heart to beat faster and harder. This medication simulates the heart's reaction to exercise.

We continuously monitor blood pressure and heart rhythm (ECG) throughout the procedure.

We take additional echocardiogram images while the heart rate is increasing or when it reaches its peak. The images will show whether any parts of the heart muscle do not work as well when your heart rate increases. This is a sign that part of the heart may not be getting enough blood or oxygen because of narrowed or blocked arteries.

Ask your provider if you should take any of your routine medicines on the day of the test. Some medicines may interfere with test results. Never stop taking any medicine without first talking to your doctor.

Do not eat or drink for at least three hours before the test.

Wear loose, comfortable clothing. You will be asked to sign a consent form before the test.

Computerized tomography, also known as CT scan, is a diagnostic procedure that takes images of blood vessels, bones, internal organs and structures. 

The scans from this procedure help diagnose a range of cardiovascular conditions such as coronary artery disease. It's a life-threatening condition caused by a buildup of fat, cholesterol, calcium and other substances in the arteries, which supply blood to the heart.

Most CT scans are painless procedures that take about 10 minutes. The patient’s heart rate is checked first to make sure it’s ideally less than 65 beats per minute. Anything above 65 beats per minute will make it difficult for the CT to capture images.

If the patient’s heart rate is too high, a beta blocker might be administered to slow it down. Once the patient’s heart rate is beating at 65 beats per minute or less, nitroglycerin is given beneath the tongue, which helps to dilate the arteries. Images are acquired during injection of intravenous contrast.

During image acquisition, the patient’s body will be moved inside the scanner. The head and neck usually remain outside of the scanner.

Your exam will be interpreted by one of our cardiologists. Results are typically available within 24 hours and will be sent directly to your referring provider and available in MyChart.

No special preparation is necessary in advance of a cardiac CT scan. You should continue to take your usual medications. Avoid caffeine and smoking for four hours prior to the exam.

Wear comfortable, loose-fitting clothing to your exam. You may need to change into a gown for the procedure.

Metal objects, including jewelry, eyeglasses, dentures and hairpins may affect the CT images. Leave them at home or remove them prior to your exam.

Some CT scans will require you to remove hearing aids and removable dental work. Women will need to remove bras containing metal underwire. You may need to remove any piercings, if possible.

Women should always inform their physician and the CT technologist if there is any possibility that they may be pregnant.

To schedule a cardiac imaging appointment — that has been ordered by your provider — call us at 503-814-5293.

If you have a MyChart account, you can schedule your exam via MyChart.