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Cardiology Associates Procedure Explanations

ABI – Short for Ankle Brachial Index, the ABI is a quick, non-invasive way to assess risk for peripheral artery disease, a condition in which the arteries in the legs and ankles are narrowed, causing a higher risk of heart attack, stroke and poor circulation. The ankle-brachial index test compares the blood pressure measured at the ankle with the blood pressure measured at the arm. A low ankle-brachial index number can indicate narrowing or blockage of the arteries in the legs, leading to circulatory problems, heart disease or stroke. This test may also be performed to evaluate how well a patient is responding to a treatment.

AFRO – An abbreviation for arterial femoral runoff, an AFRO is an arteriogram of the lower aorta and the arterial flow down both legs. An arteriogram is an x-ray of the blood vessels called arteries. It is performed to evaluate various vascular conditions, such as an aneurysm (a bulging, weakened area in the wall of a blood vessel), stenosis (narrowing of a blood vessel), or blockages. During an AFRO, a dye is injected into an artery making the arteries visible on x-ray. Generally, an arteriogram is performed under local anesthesia (numbing the site where the catheter is to be inserted), often accompanied by light sedation.

Angiogram – An angiogram is an imaging test that uses x-rays to view your body’s blood vessels. Physicians often use this test to study narrow, blocked, enlarged, or malformed arteries or veins in many parts of your body, including your brain, heart, abdomen, and legs. To create the x-ray images, the physician will inject a contrast liquid, sometimes called “dye”, through a thin, flexible tube, called a catheter. The physician threads the catheter into the desired artery or vein from an access point. The access point is usually in your groin but it can also be in your arm or, less commonly, a blood vessel in another location. This “dye” makes the blood flowing inside the blood vessels visible on an x-ray. The contrast is later eliminated from your body through your kidneys and your urine. Your physician may recommend an angiogram to diagnose a variety of vascular conditions, including peripheral artery disease, aneurysms, kidney artery conditions, aortic arch conditions, vascular malformations, or problems with veins such as deep venous thrombosis (DVT) or pulmonary emboli (blood clots in the lungs).

The physician can also treat a problem during an angiogram. For instance, your physician may be able to dissolve a clot that he or she discovers during the test. A physician may also perform an angioplasty and stenting procedure to clear blocked arteries during an angiogram, depending on the location and extent of the blockage. An angiogram can also help your physician plan operations to repair the arteries for more extensive problems.

Angioplasty – Coronary angioplasty is used to open blocked or narrowed coronary (heart) arteries. The procedure improves blood flow to the heart muscle. Over time, a fatty substance called plaque can build up in your arteries, causing them to harden and narrow, a condition called atherosclerosis. Atherosclerosis can affect any artery in the body, but when it affects the coronary arteries, the condition is called coronary artery disease or coronary heart disease (CHD). During the procedure, an inflatable balloon mounted at the tip of a catheter is inserted through the skin into an artery and advanced to the site of an arterial blockage where the balloon is inflated and deflated. In this process, the balloon expands the artery wall, increasing blood flow through the artery. A stent may be placed at the treatment site to hold the artery open. Angioplasty can restore blood flow to the heart if the coronary arteries have become narrowed or blocked because of CHD. Angioplasty is a common medical procedure. It may be used to improve CHD symptoms such as angina (chest pain/discomfort) and shortness of breath, reduce damage done to the heart from a heart attack, or reduce the risk of future heart complications.

Arterial Doppler – The Arterial Doppler test is a blood pressure test for the arteries in the legs. It is usually ordered to determine if there is a lack of blood flow in the legs, possibly caused by a blockage in the arteries. The blockage may be a result of plaque or cholesterol that has built up in the arterial wall. During an arterial Doppler, the patient will be asked to lie flat on the back. Blood pressure cuffs are applies to both the legs and arms. A “Doppler probe” is used to listen to the blood flow in the arteries and tests the blood pressure. The patient may also be asked to walk on the treadmill to test the blood pressure at the ankles.

Carotid Doppler – This diagnostic imaging procedure uses an ultrasound device to measure blood flow velocities within the carotid arteries. The Carotid Doppler exam uses sound frequency to produce images of the carotid arteries in the neck on a viewing screen. Carotid Doppler studies are used to demonstrate blocked or reduced blood flow in the arteries of the neck that could cause stroke. This test is also used to evaluate symptoms of dizziness, vision changes and loss of balance that may be caused by impeded or restricted blood flow through these vessels. During a carotid Doppler exam, the room is usually darkened. A gel is applied to the neck area to provide good contact for the handheld transducer. The transducer is placed on the neck and sound is sent into the body and is reflected off arteries and returned to the transducer. The echoes are converted electronically into images of the arteries that can be seen on a monitor. These images are recorded on paper or film.

Echo – Short for echocardiogram, the echo is a test in which ultrasound is used to examine the heart. A colorless gel is applied to the chest and an echo transducer is placed on top of it. The physician or medical professional performing the echo will make recordings from different parts of the chest to obtain several views of the heart. The patient may be asked to change positions and to breathe slowly or hold his or her breath in an effort to obtain higher quality pictures. The images are constantly viewed on the monitor and recorded on photographic paper and on video. The doctor may suggest an echocardiogram if he or she suspects problems with the valves or chambers of your heart or your heart’s ability to pump.

EKG – An abbreviation for electrocardiogram, an EKG records the electrical activity of the heart over time. It is a noninvasive test that is used to record underlying heart conditions. During an EKG, electrical sensing devices (also called leads) are positioned on the body in standardized locations. A small amount of gel is applied to the skin to allow the electrical impulses to be easily transmitted to the EKG leads. The test is painless and only takes a few minutes, but it can detect evidence of heart muscle damage, patterns of abnormal electric activity which may indicate abnormal cardiac rhythm disturbances, impaired blood flow to the heart muscle, increased thickness (hypertrophy) of the heart muscle, and more generally, the rate, rhythm and placement of the heart in the chest cavity.

ICD Placement – An implantable cardioverter defibrillator (ICD) is a small, battery-powered electric pulse generator that monitors the heart rate and heart rhythm and delivers a small electric shock to the heart muscle when it detects an abnormal rhythm. ICDs are typically implanted in patients who are at risk of sudden cardiac death due to ventricular fibrillation. The process of ICD implantation is similar to the placement of a pacemaker. Both devices typically include electrode wires which pass through a vein to the right chambers of the heart. The difference is that pacemakers are more often temporary and generally designed to correct bradycardia, while ICDs are often permanent safeguards against sudden abnormalities.

Nuclear stress test – A nuclear stress test measures the flow of blood to the heart muscle both at rest and during stress. It is performed similarly to a routine exercise stress test, but provides images that can show areas of low blood flow through the heart and areas of damaged heart muscle.

A nuclear stress test involves taking two sets of images of the heart. One set is taken during an exercise stress test while exercising on a treadmill or stationary bike, or with medication that stresses your heart, and another while at rest. A nuclear stress test is used to gather information about how well the heart works during physical activity and at rest.

A nuclear stress test may be given if your doctor suspects that you have coronary artery disease or another heart problem, or if an exercise stress test did not pinpoint the cause of symptoms like chest pain or shortness of breath. A nuclear stress test may also be recommended in order to guide your treatment if you’ve already been diagnosed with a heart condition.


Pacemaker placement – Pacemakers are inserted to treat bradycardia, which occurs when the heart beats so slowly that it does not pump enough blood to meet the body’s needs.

A pacemaker is a small, battery-powered device that sends out weak electrical impulses to cause the heart muscle to contract. The pacemaker itself is a waterproof object about the size of a silver dollar. The battery in a permanent pacemaker usually lasts 5 to 15 years. Your doctor will monitor your pacemaker regularly to decide when the battery should be changed.

The surgery needed to implant a permanent pacemaker is considered a minor surgical procedure. It can usually be done using local anesthesia, which means part of your body is numbed, but you stay awake.

A small incision is made in the chest wall. The pacemaker leads are threaded through the incision into a large blood vessel in the upper chest and into the heart. Using the same incision, a small pocket is created under the skin to hold the pulse generator. The leads are then connected to the pulse generator.

Following pacemaker placement, most patients stay overnight in the hospital then go home the next day. Sometimes, however, the surgery is done as an outpatient procedure.

Within a few weeks, patients with newly placed pacemakers can return to normal activity. For several weeks after having a pacemaker implanted, you may be asked not to lift more than 5lb or raise the affected arm over your shoulder.

Treadmill stress test – A treadmill, or exercise stress test helps a physician evaluate how well your heart handles work, or stress. During the test, the patient wears leads that monitor the heart. The test begins with slow walking on the treadmill. The speed and incline of the treadmill are then increased with time. As the body works harder it requires more oxygen, making the heart pump more blood. The test can be stopped at any time. After the treadmill portion of the test, the patient’s blood pressure is checked. The test can show if the blood supply is reduced in the arteries that supply the heart and what type of exercise is most appropriate for a patient. A treadmill stress test may be ordered to diagnose coronary artery disease or a possible heart-related cause of symptoms such as chest pain, shortness of breath or lightheadedness. It may also be used to determine a safe level of exercise, check the effectiveness of procedures, or predict risk of dangerous heart conditions.

Venous Doppler – A Venous Doppler exam is an ultrasound test for the veins. It is performed to evaluate varicose veins or look for a blood clot in the veins, usually in the arms or legs. During the test, the patient lies flat on the back with the head elevated. An ultrasound transducer with large amounts of ultrasound gel is used. The transducer is moved around on the extremity being examined to look at your veins. Pictures are taken of the blood vessels and recorded for the physician to interpret. Transducer pressure will be used to see if your veins are compressible.