Imaging And Diagnostic Testing
The Alaska Heart & Vascular Institute offers advanced imaging and diagnostic testing in one location for patient convenience. Below are a list of the services we provide. Our experienced staff will help make your visit as comfortable as possible.
Perhaps the most common heart screen test performed at the Alaska Heart & Vascular Institute is the EKG. This test is used to determine heart rate, rhythm and if any heart damage has occurred. It produces a graph of the heart’s electrical pulse, which can be read by your cardiologist to decide what treatment or further testing may be needed.
Also known as ECHO, this is a non-invasive medical imaging technology that uses high frequency sound waves to form an image of your body tissues. Information obtained from these images can be utilized along with other data in order to assist your physician at arriving at the proper medical diagnosis. The echocardiogram is an extremely useful test for studying the heart’s anatomy. It is non-invasive and entirely safe, and when interpreted by well-trained cardiologists, is very accurate.
ETT/Cardiac Stress Test
This test involves walking on a treadmill or moving belt. During the test, you will be attached to an Electrocardiogram ( ECG). This will record the electrical activity of your heart. You will also have your blood pressure recorded at regular intervals. The test has many stages, each lasting three minutes. The speed and incline of the treadmill will increase at each stage. An Exercise Tolerance Test is performed on people who have chest pains or symptoms of angina. A positive result will confirm a diagnosis of coronary artery disease. If the test is positive your cardiologist will then choose the next intervention necessary to confirm the extent of the coronary artery disease.
Cardiac Computed Tomography or Coronary CT Angiography (MSCT, CT, Cardiac CT, coronary CTA or cardiac CAT scan)
Computed tomography (CT) combines the use of X-rays with the latest computer technology. Using a series of X-ray beams, the CT scanner creates cross-sectional images. A computer reconstructs the “slices” to produce the actual pictures. Considering that some slices are as thin as half a millimeter, a CT scan offers much more image detail than a traditional X-ray, which means your doctor gets the best information to make the most accurate diagnosis.
CT Calcium Scoring
Without the need for an IV or for an injection, this scanner quickly takes a picture of the heart and finds and measures the amount of calcium within the arteries. Calcium in the arteries reflects established atherosclerosis within the lining of the arteries, and the amount of calcium indicates the extent of this condition. Greater amounts of calcium indicate a greater likelihood of heart attack in the foreseeable future and is of assistance in deciding whether further testing or prevention is necessary. As a service to the community, this testing is available for only $99.00 but requires the order of a physician.
Cardiac Nuclear Medicine
May also be referred to as “Cardiolite.”
By producing an image of the heart, radioactive “tracers” such as a Cardiolite can increase the accuracy of a traditional stress test. Nuclear scanning of the heart shows how well blood flows to the heart muscle. It is done in conjunction with an exercise stress test on a treadmill, but can also be performed using medicines such as adenosine and Lexiscan that simulate the effects of exercise on the heart. Cardiac Nuclear Stress Imaging helps determine whether coronary artery stenosis (blockages) are so severe as to limit blood flow to the heart muscle when it needs it most, during physical activity. Also, nuclear imaging allows a determination of the heart’s pumping function (ejection fraction).
At the Alaska Heart & Vascular Institute, resting pictures are first obtained using a “tracer” agent. Next, stress is performed using treadmill exercise or medications. When a patient reaches his or her maximum level of exercise, or after simulating exercise with medications, a small amount of tracer is injected into a vein. The patient then lies down on a table under a camera that detects the energy emitted from the radioactive tracer and generates pictures (or scans) that reflect the heart’s blood flow both at rest and following stress. If a portion of the heart muscle is under-perfused (doesn’t receive a normal blood supply), a deficiency of tracer activity in that area will appear on the finished images as a “defect.” Some patients require this test be done over two days.
Cardiac PET CT is another similar method of nuclear testing. A baseline scan of your chest is obtained, followed by the “stress Medication” which takes the place of exercise. The second set of images are obtained, and the reading cardiologist can determine your heart function from the comparison of images. This entire test is performed on the PET CT table with no waiting between images.
Our “tracers” and methods are both widely used and quite safe. These tests take from 1-3 hours, and you may resume normal activity and diet immediately after. Cardiologist, nurses, exercise physiologists, and technologists with expertise in nuclear cardiology supervise and analyze these test results.
MRI of the Heart, Great Vessels and Adjacent Structures
MRI (magnetic resonance imaging) uses radiofrequency waves and a strong magnetic field rather than X-rays to provide remarkably clear and detailed pictures of internal organs and tissues. The procedure is valuable in diagnosing a broad range of conditions in all parts of the body, including heart and vascular disease, stroke, cancer and joint and musculoskeletal disorders. MRI is unique in that it can also create detailed images of blood vessels without the use of contrast material, although there is a trend toward the use of special non-iodinated MRI contrast material- for example, gadolinium. MRI requires specialized equipment and expertise and allows evaluation of particular body structures that may not be as visible with other imaging methods.
Magnetic resonance imaging is becoming very important in the initial diagnosis and subsequent management of coronary heart disease. MRI can help physicians to look closely at the structures and function of the heart and major vessels quickly and thoroughly, without the risks associated with traditional, more invasive procedures. Using MRI, physicians can examine the size and thickness of the chambers of the heart, and determine the extent of damage caused by a heart attack or progressive heart disease.
After a heart attack, for example, an MRI examination can help the cardiologist understand how well the heart is pumping, whether the flow of blood is blocked in any chamber or major vessel, whether the heart muscles are damaged or whether the lining of the heart is swelling. This is critical knowledge needed to administer prompt and effective treatment. MRI can also detect the buildup of plaque and blockages in the blood vessels, making it an invaluable tool for detecting and evaluating coronary artery disease. Recently, specialists in MRI have demonstrated its potential for showing not only the structure, but also the function of the heart muscles, valves and vessels. Using MRI, they have created movie-like images of the beating heart that doctors can use to diagnose a variety of cardiovascular problems. More and more, MRI is being used as part of the traditional cardiac stress test to help physicians with earlier diagnosis and treatment of heart disease and to assess the patient’s recovery after treatment.
Cardiac Catheterization is a procedure to evaluate blood flow to the heart, test the pumping ability of the heart and study various heart structures. Cardiac catheterization can be done to confirm the presence of coronary artery disease and valve disease. It can also help determine the need for further treatment such as coronary stent, bypass, surgery or valve replacement.
During this procedure, a short tube called a sheath is placed into your leg or arm artery. A long, thin tube called a catheter is passed through the sheath and guided to the heart arteries while the physician watches on a video screen. X-ray dye is then injected through the catheter and into the heart arteries, and x-ray movies are created as the dye flows through the arteries. A different catheter may be guided to the heart to determine pressures within the chambers and to study the valves. You can expect to spend 3-6 hours recovering in our observation area after a heart catheterization procedure.
The “Alaska Heart Beat Blog” is dedicated to informing patients about numerous areas of cardiovascular health and prevention. It primarily focuses on the importance of being screened for cardiovascular disease and the risk factors associated with it, as well as information about varicose veins and venous insufficiencies. Click here to learn more.
If you have more detailed questions about the Alaska Heart & Vascular Institute, its Vein Clinic, or imaging and diagnostic testing services, please call 907-561-3211 for information or to book an appointment.