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Heart Disease Testing Overview:

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff.   Some of these are discussed in detail in the links in this section.

What to Expect on Your First Visit:

First office visits typically last 45-60 minutes.  Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.

First Visit: Blood Test

To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.

Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.

A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.

Containers should be clearly labeled with the patient’s names and brought to the clinic at the time of their appointment.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Specific Heart Disease Testing:

1. Doppler Echocardiography/ Doppler Ultrasound

What is the Doppler Echocardiograph/Doppler Ultrasound?

A special type of ultrasound scan, called a Doppler ultrasound, is used to detect the speed and direction of blood flow in certain regions of the body by using sound waves flowing through the blood vessels. This test is used to look at how blood flows through the heart chambers, heart valves, and blood vessels. The movement of the blood reflects sound waves to a transducer. The ultrasound computer then measures the direction and speed of the blood flowing through your heart and blood vessels

Indications and Contraindications

A Doppler ultrasound may help in diagnosing many conditions such as:

• Blood clots and narrowed or blocked blood vessels
• Blocked or narrowing artery
• Leg pain
• Evaluation of stroke
• Congenital heart disease
• Arterial plaque build up (coronary artery disease symptoms, e.g. angina)
• Abnormal veins
• Monitor blood flow on liver and kidney transplants and blood vessel surgeries

A Doppler ultrasound may not be performed on postoperative patients with wound dressings.

How do you prepare for a Doppler Echocardiograph?

An ultrasound scan doesn't require any special preparation beforehand. It may be necessary for you to avoid nicotine products for at least one hour before the test to prevent result inaccuracies. Items that may interfere during the ultrasound, such as jewelries and other metallic objects, must be removed before the test.

How does it feel? How long will it take?

An ultrasound scan usually takes around 15 to 20 minutes. This test is non-invasive, therefore it is painless. You will not feel anything at all, except for the cold feeling of the gel as soon as it is applied to your skin. You will feel very little to none discomfort during the test.

Expected effects after the test:

The ultrasound scan is a safe, non-invasive procedure that doesn't pose any known risks, side effects or complications.

Special instructions after the test:

After the procedure, you will be given paper towels (or something similar) to wipe off the gel. You can then get dressed. The scan itself is painless, drug-free and non-invasive, so there is no 'recovery time' needed. You can go about your normal business as soon as you've finished the scan.

Results:

Normal Findings:

• No findings of blood clots in the veins.
• No findings of narrowing and blockage of arteries
• Absence of abnormal growth
• Normal position, size and movement of the veins

Abnormal Findings

• Blockage and narrowing of arteries and blood vessels
• Presence of blood clots
• Aneurysm
• Abnormal veins
• Abnormal blood flow
• Coronary artery diseases (e.g. atherosclerosis)

Notes:

A lubricant is used for good transmission of sound waves to and from the body.

Other names for ultrasound scan include sonogram and ultrasonography.

This test requires you to remain still. If you have problems staying still, it might necessary for you to be sedated. Avoid driving after the procedure if you will be receiving sedatives during the test. Have a responsible adult drive you home afterwards.

It is difficult to perform this procedure on an obese patient due to altering effects of the fatty tissues.

2. Electrocardiography

What is an Electrocardiography (ECG)?

Electrocardiography is a procedure that records and evaluates the electrical activities of the heart. During an electrocardiogram, patches called electrodes are attached to the skin of your arms, leg and chest. These electrodes are connected to a machine that traces your heart activity onto a piece of paper that will be later used by your physician for evaluation.

Indications and Contraindications

An electrocardiogram is done to measure the electrical activities of the heart in order to gives vital information on the current condition of your heart. The readings from an electrocardiogram determine the causes of various cardiovascular problems that you may be experiencing such as palpitations, abnormal heart rhythms, chest pain, shortness of breath, stroke, enlargement of the heart, and heart attacks. It also checks for the effectiveness of heart therapies, medications and surgery. An electrocardiogram is also used to measure stress.

Patients with the following conditions are also at risk for cardiovascular disease and will benefit from electrocardiogram assessment:

• Diabetes
• Obesity
• Renal failure
• Electrolyte abnormalities

How do you prepare for an ECG test?

There is no special preparation needed prior to the electrocardiogram test. However, if you are taking medications, inform your physician of the medicines that you take as this may alter the results of the electrocardiogram.

You may be asked to wear a gown during the test. Remove all jewelries and metallic items from your body before the test.

How does it feel? How long will it take?

The electrocardiogram test is safe and painless. You may feel that the disks of the electrodes are cold as soon as they are being attached to your chest. After the test, you may feel a slight pull when the electrodes are being removed. This procedure will last for 10-15 minutes, including attachment of electrodes to the body.

Expected effects after the test:

An electrocardiogram is safe and simple. It poses no harmful risks and is considered to be a standard test that is part of a complete physical examination. Normally, there are no effects from the electrocardiogram procedure. Chest pain during the procedure may be related to an arrhythmia on the EKG.

Results:

Normal: 60-100 beats/minute, consistent and even rhythm, tracing normal, wave deflections

Abnormal: less than 60 beats/minute, greater than 100 beats/minute; Abnormal results also include abnormal ECG/EKG tracing, abnormal heart rhythm and heart murmur.

Abnormal ECG results may indicate:

• Arrhythmia, dysrhythmia
• Acute myocardial infarction
• Myocardial ischemia
• Ventricular hypertrophy
• Pericarditis
• Conduction system disease
• Pulmonary embolus
• Electrolyte imbalance

Notes:

• In order to properly diagnose cardiovascular disease, complete physical examination, electrocardiogram results, medical history and symptoms of heart disease must all be evaluated.
• Results may be altered by factors such as: talking and moving during the test, drinking cold water and exercising before the test and loose attachment of the electrodes.

The Right Diagnosis and Treatment for Heart Disease

Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical’s Personal Approach to Heart Disease

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer’s, Diabetes, Parkinson’s, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.