Testing for Heart Disease
by Rashmi Gulati, MD
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 not commonly performed in traditional medical clinics. 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.
What to Expect on Your First Visit
The first office visit typically lasts 45 to 60 minutes. Your physician 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 physicians. Specialty laboratory testing may be recommended.
Most patients are offered an initial protocol consisting of nutritional supplementation, and
dietary and life style recommendations.
Blood Test
To assess and identify kidney and liver function, blood sugar levels, and other key factors such as
blood cholesterols we will run a blood test during the first visit. 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 8:00 p.m. the previous evening.
On the day of the appointment any prescribed medication should be taken with water
as normal.
We recommend that patients bring food to eat after the blood sample has been taken.
Diabetics should advise the clinic of their condition and separate arrangements will be made.
Urine Analysis
To evaluate kidney function a urine analysis will be done on the first visit. 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-hour fasting period prior to the appointment.
The first urine of the day should be excluded. All subsequent urine for the next 24 hours should be collected in clean plastic containers.
If collection starts at 8:00 a.m. this process must be followed until 8:00 a.m. the following
day. For example, the appointment is at 10:00 a.m. on Friday. Fasting commences at 8:00 p.m. on Thursday for the blood test. Urine collection therefore needs to
start on Wednesday at 8:00 a.m. and go until Thursday at 8:00 a.m.
Containers should be clearly labeled with the patient’s names and brought to the
clinic at the time of their appointment.
Resting ECG
The electrocardiograph (ECG) determines the condition of the heart and measures
its actions and pulse. This will be done during the first visit as part of the patient's evaluation.
Specific Heart Disease Testing
Doppler Echocardiography/Doppler Ultrasound
A special type of ultrasound scan, called a Doppler ultrasound, sends sound waves through the blood vessels. The movement of the blood reflects the sound waves back to a transducer. Using the information provided by the sound waves the computer is able to measure the speed and direction of blood flow through the heart chambers, heart valves, and blood vessels. Other names for an ultrasound scan include sonogram and ultrasonography.
Indications and Contraindications
A Doppler ultrasound may help in diagnosing and explaining many conditions such as:
- Blood clots
- Blocked or narrowing arteries
- Leg pain
- The possibility of a stroke
- Congenital heart disease
- Plaque build-up
- Coronary artery disease symptoms such as angina
- Abnormal veins
- Monitor blood flow for liver and kidney transplants, and blood vessel surgeries
A Doppler ultrasound may not be performed on postoperative patients with wound dressings.
Preparation 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 inaccurate results. Items that may interfere during the ultrasound,
such as jewelry and other metallic objects, must be removed before the test.
Timeframe
An ultrasound scan usually takes around 15 to 20 minutes. This test is non-invasive and painless. You will feel the cold
gel as it is applied to your skin. The gel helps in the transmission of the sound waves. You will feel very little
to no discomfort during the test.
Expected After Effects
The ultrasound scan is a safe, non-invasive procedure that doesn't pose any known
risks, side effects, or complications. Because it is drug-free and
non-invasive no recovery time is 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 blood vessels
- No findings of narrowed or blocked arteries
- Absence of abnormal growths
- Normal position, size, and movement of the blood vessels
Abnormal Findings
- Blocked and/or narrowed blood vessels
- Presence of blood clots
- Aneurysm
- Abnormal veins
- Abnormal blood flow
- Coronary artery diseases (e.g. atherosclerosis)
This test requires you to remain still. If you have problems staying still, it might
be necessary for you to be sedated. Avoid driving after the procedure if you receive sedatives. Have a responsible adult drive you home.
Electrocardiogram (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, legs, and chest. These electrodes are connected to a machine
that traces your heart activity onto a piece of paper that will be used by
your physician for evaluation.
Indications and Contraindications
An electrocardiogram measures the electrical activities of the heart and provides vital information on the current condition of your heart. The readings
from an electrocardiogram determine the causes of various cardiovascular problems such as palpitations, abnormal heart rhythms, chest
pains, 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 also measures stress.
Patients with the following conditions are at risk for cardiovascular disease
and will benefit from an electrocardiogram assessment:
- Diabetes
- Obesity
- Renal failure
- Electrolyte abnormalities
Preparation for an ECG
No special preparation is needed prior to the electrocardiogram. If you take any medications inform your physician
as this may alter the results of the electrocardiogram.
You may be asked to wear a gown during the test. Remove all jewelry and metallic
items from your body before the test.
Timeframe
The electrocardiogram test is safe and painless. You may feel the coolness of
the electrode patches as they are placed on your skin. After
the test, you may feel a slight pull when the electrodes are being removed. This
procedure will last for 10 to 15 minutes, including attachment of electrodes.
Expected After Effects
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.
Results
Normal
- 60-100 beats/minute
- Consistent and even rhythm
- Normal tracing and wave deflections
Abnormal
- Less than 60 beats/minute
- Greater than 100 beats/minute
- Abnormal ECG/EKG tracing
- Abnormal heart rhythm
- 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 a 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 physicians and our
team of medical professionals will evaluate your diagnosis. At this point, the physicians
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
physicians will prescribe a preventative and comprehensive treatment plan that is tailored
to your needs and fits into your lifestyle.
Patients Medical Personal Approach to Heart Disease
Our physicians 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 physicians. 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.
Begin Your Journey to Wellness with Patients Medical
Our first job at Patients Medical is to listen, to connect the dots between a patient's medical history, their symptoms, and the underlying causes of their cardiovascular concerns. Patients Medical is a superb place for men and women to secure integrative and holistic cardiology health care from providers who provide personalized care, partnering with the patient to support their health.
For those that can make the journey, we are happy to welcome new patients to our medical center
in New York City. Call us at
1-212-661-4441.
We are here to listen and to help.
We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, New York, NY 10017.
Date of Publication: 09/05/2005
Article Last Updated: 06/17/2010