What is an Abdominal Aortic Duplex?

An Abdominal Aortic Duplex Study is an ultrasound image of the abdominal aorta, the main artery in the abdomen, as well as the iliac arteries. The abdominal aorta is the large blood vessel which travels from the back of the chest through the abdomen, providing blood to the lower part of the body. It branches out through the pelvis, via iliac arteries, to the legs. In addition to vessel blockage, the study is used to detect any enlargement which is the result of an abdominal aortic aneurysm. An aneurysm is a bulge in an artery caused by a weakening in the vessel wall.

Why is an Abdominal Aortic Duplex Done?

An Abdominal Aortic Ultrasound gives doctors information about the artery in the abdomen. Such as:

The blood flow through the artery extending into the pelvis towards the legs. The presence of plaque, a sticky substance that clings to the arterial wall that can cause narrowing within the artery. The presence of an aneurysm, a bulging in the artery. Evaluate previous surgeries including stents and bypass grafts.

WHAT CAN I EXPECT DURING THE ABDOMINAL AORTIC DUPLEX?

After fasting (nothing to eat or drink, except water) for approximately eight hours, a clear gel will be placed on your abdomen, and the technologist will scan your abdomen with a transducer (a microphone-like device) that will show pictures of the artery and listen to the blood flow within. Feel free to bring a snack for after your test, if necessary.

WHEN WILL I KNOW THE RESULTS OF THE ABDOMINAL AORTIC DUPLEX?

Your doctor will review the findings of the Abdominal Aortic Ultrasound with you on your next office visit. Make sure that you have a follow-up appointment scheduled, as the results of this test cannot be given over the telephone.

What is an Ankle Brachial Index (ABI)?

An Ankle Brachial Index, or ABI is non-invasive test that measures the blood pressure in your ankles and compares it to the blood pressure in your arms. This test is used for diagnosing or detecting poor circulation in the legs or the severity of Peripheral Artery Disease (PAD) which is indicated by lower blood pressure in the legs versus arms. The test can be done at rest or can provide more telling indications when the heart is stressed through exercise on a treadmill.

How is an ABI performed?

During the ABI, you will be asked to remove your clothing from the waist down, leaving your undergarments on, so the technician can place blood pressure cuffs on your arms and legs. The cuffs will be briefly inflated and an ultrasound doppler will be used to determine if there is sufficient blood flow to your legs. This test takes about 30 – 45 minutes.

What is a Stress ABI?

In some cases, a physician may order a Stress ABI. This is done like an ABI with the addition of walking on a treadmill. A Stress ABI is used to determine a decreased amount of blood flow with exercise. This test is also used to rule out other symptoms that may appear to be vascular in nature but are lumbar back pain, joint disease or nerve related.

When will I know the results of my test?

The results of this test will be given to you by your physician at your next follow-up appointment. You are required to wear undergarments for this test. Your test will be rescheduled, otherwise.

Please contact the testing department if you have any questions prior to your test.

What is an AV Optimization?

During an AV Optimization, an ultrasound technician will take pictures of your heart with ultrasound and Doppler. A technician from your device company will be present during the exam to adjust your device settings based on the information the ultrasound technician is finding. In some cases, these adjustments may improve your heart function and current symptoms.

What do I need to do for the AV Optimization?

You will need to lie on your left side with your left hand behind your head for the entire testing period. The testing usually lasts about 45 minutes to 1 hour. If you become uncomfortable at all, please inform the ultrasound technician so they may make adjustments for your comfort.

What will I wear for the AV Optimization?

Gentlemen are asked to remove their shirts and Ladies are asked to wear a gown on the upper half of their body. These requests allow easy access to your heart and device for the technicians.

When will I know the results of my AV Optimization test?

The results are given to you by your physician at your follow-up appointment.

What is a “Bubble Study”?

An ultrasound of the heart is called an “Echocardiogram. It is done to get pictures of the heart and the areas around the heart. Better pictures are sometimes seen if a material called “contrast” is used during the ultrasound. One type of contrast is saline (sterile salt water). When saline is used, it is called a “Bubble Study”.

During a Bubble Study, the nurse will agitate the salt water until it forms small bubbles. The bubbles are then injected into the vein through an intravenous line (IV). In a normal heart, the bubbles are filtered by the lungs and are seen only on the right side of the heart. If the bubbles are seen on the left side, it shows that there is an opening or hole between the two upper or lower chambers of the heart, which is abnormal. The Bubble Study helps to identify those abnormalities.

Why would a Bubble Study be done?

Your doctor may ask to have a Bubble Study when the Echocardiogram (“Echo”) test is ordered. It can be especially helpful if someone has had a stroke or what is called a “mini-stroke” which is also called a Transient Ischemic Attack (TIA).

How do I prepare for a Bubble Study?

No preparation is needed.

What can I expect during the Bubble Study?

• An intravenous line (IV) is placed in your arm or hand.
• Electrodes/patches and sensors are placed on your chest and trunk of your body.
• A complete ultrasound exam of the heart is performed.
• Sterile saline (salt water) is agitated in a syringe attached to the IV and then injected into the IV while the ultrasound is done.

Is a Bubble Study safe?

The bubble study is extremely safe. There is a small risk of bruising from the placement of the IV line.

How will I know the results of the test?

Final interpretation of the test results are completed by your cardiologist. You will obtain your results at your next follow-up visit with your cardiologist. Prior to leaving our office, please make sure you have a follow-up appointment for test results.

What is a Cardiac PET/CT?

A Cardiac PET/CT exam, also knowns as Cardiac Positron Emission Tomography / Computed Tomography, is a specialized imaging test used to evaluate the blood flow and function of  your heart.

Why you should get a Cardiac PET/CT exam:

• Evaluation of Coronary Artery Disease (CAD). Symptoms of CAD include chest pain (angina), shortness of breath, or unexplained fatigue. Cardiac PET/CT can detect areas of reduced blood flow or blockages, allowing your doctor to plan appropriate treatments.
• For Individuals with risk factors for heart disease, such as diabetes, hypertension, or a family history of heart problems.
• After a heart attack or other cardiac events, heart tissue may be damaged but still viable. A Cardiac PET/CT can assess whether damaged tissue can be recovered with treatment.
• If you have been diagnosed with CAD or other heart conditions, a Cardiac PET/CT exam can help your healthcare team to make informed decision about your treatment options.
• Cardiac PET/CT benefits patients with mobility issues who may struggle to move during a longer imaging session.
• If you have already undergone heart procedures or surgeries, such as angioplasty or coronary artery bypass grafting (CABG), this exam can help monitor the success of these interventions and identify any potential complications.

Advantages of Cardiac PET/CT:

• High diagnostic accuracy
• Consistent high-quality images
• Low radiation exposure
• Short acquisition protocols
• Quantification of myocardial blood flow
• Strong prognostic power

What to Expect During a Cardiac PET/CT Exam

A Patient Education Video >>

What is a Carotid Duplex Scan?

A Carotid Duplex Scan provides a two-dimensional ultrasound image of the carotid arteries in the neck. The study is referred to as duplex because it uses two types of ultrasound, Doppler and B-mode, to view the arteries as well as the speed and direction of the blood flow from the heart through the neck to the brain.

Why is a Carotid Duplex Ultrasound done?

A Carotid Ultrasound gives doctors information about the arteries in the neck:

• The blood flow through the arteries to the face and brain.
• The presence of plaque within the arteries.
• The cause of “bruits”, a blood flow murmur heard by the doctor.

What can I expect during my Carotid Duplex scan?

A clear gel will be placed on your neck, and the technologist will scan your arteries with a transducer (a microphone-like device) that will show pictures of the arteries and listen to the blood flow within them.

When will I know the results of my test carotid duplex ultrasound?

Your cardiologist will review the findings of the Carotid Ultrasound with you on your next office visit. Make sure that you have a follow-up appointment scheduled as the results of this test cannot be given over the telephone.

Schedule a Carotid Duplex Ultrasound Today!

If you are interested in learning more about our Carotid Duplex Scan or other Cardiology services, please call us at (480) 641-5400. CVAM’s four Arizona offices are located in Mesa, Queen Creek, Gilbert, and Chandler.

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Chemical Nuclear Stress Test (One Day)

Please allow 4 hours to complete this test.

Overview:
This procedure is used as a tool for the detection of coronary (heart) artery disease. In order to obtain the images for this procedure, a small gauge IV will be inserted into either arm or hand. This IV will be used for all medications and nuclear imaging tracers. You will be imaged twice; first is the rest phase of the procedure and then the stress phase. Imaging takes about 15-20 minutes for each set of images. The stress phase consists of an injection of a short acting drug that dilates the coronary (heart) arteries. The diagnostic data obtained is the same as if you were exercising on a treadmill. Occasionally, chest tightness, shortness of breath, head pressure and nausea are felt. However, this sensation should dissipate in a matter of minutes post injection. In most cases, patients are walked on a treadmill very slowly to help minimize the side effects.

Preparation: PLEASE FOLLOW THESE INSTRUCTIONS OR YOUR TEST MAY BE RESCHEDULED

• Do not eat for four hours prior to the test.
• If you are scheduled after 12:00 p.m., please eat a fatty meal 4 hours before your scheduled test.
• If you are diabetic and/or on insulin: Eat, take ½ your insulin dose and bring a
  snack.
• Do not eat or drink anything caffeinated or de-caffeinated for 12 hours prior to your study. This includes coffee, decaf coffee, tea, decaf tea, sodas, and chocolate.
• Do not take any medications that have caffeine including Excedrin, Anacin, Darvon, etc.
• Do not drink any fluids one hour prior to the test.
• Take your medications as you normally do except Theophylline, Persantine, Aggrenox as these should be avoided 48 hours prior to testing.
• Drink as much water as you can the day prior to hydrate your system.

What to wear: Please wear a loose, comfortable, cotton t-shirt. Please do not wear nylon shirts or undershirts. Please no metal buttons, no jewelry, perfume or lotions. Please wear comfortable walking shoes and no flip-flops or open-toed shoes.

What to bring: Please bring a fatty snack, such as chips, cookies, etc. and your preferred choice of caffeinated soda. You will need to have your snack and soda after the stress portion of the test.
Please bring a sweater as our rooms tend to be cool and books or magazines to keep you busy during the 4 hours.

Please arrive 30 minutes prior to your scheduled time; this is especially important as the nuclear medication can decay over time. If you are scheduled at 7:00 a.m., arrive 15 minutes early only.

** Please call our office if you have any questions regarding your test preparation**

Insurance co-payments: All patients except those with Medicare only, please verify your co-payment for this test with your insurance company prior to your appointment. Call member services (the phone number is on your insurance card) and verify the dollar amount of your co-payment required. Co-payments for diagnostic test may differ from office visit co-payments. This amount can vary from $0-$200 per test or may be a percentage of the actual cost of the test. The contract that you have with your insurance carrier determines this amount. Our office has no influence on the amount owed at the time of service.

**Please call the office with any insurance questions**

PLEASE NOTE: Failure to show or cancel this test with a 24- Hour or more notice may result in a $100 fee.

What is a Chemical Stress Echocardiogram?

A Chemical Stress Echocardiogram is a special type of echocardiogram, or ultrasound of the heart, which examines the heart at rest and then after stress triggered by a medication (Dobutamine or Adenosine) that causes the heart to beat as if exercising. This test is for patients who are unable to exercise on a treadmill.

What is ECG Stress Testing?

ECG Stress Testing uses basic ECG monitoring to determine any potential risk for a heart attack or arrhythmia. This test is usually done prior to more extensive stress testing.

What is an Event Monitor?

Event Monitoring is a recording of your heart rhythm when you are having symptoms, or an “event.” You carry a small, lightweight recorder over a period of days or weeks. When you feel symptoms, such as dizziness, palpitations, fainting spells, or chest pain, you press a button to record your heart’s electrical activity. The recording is then sent over the telephone to a receiving center, where it is printed and reviewed by a team of nurses and/or EKG technicians. The report is then faxed to your doctor. This allows your doctor to make an accurate diagnosis and develop a treatment plan that is best for you. The test helps your doctor determine whether your symptoms are caused by a heart problem.

What Results does Event Monitoring show?

An abnormal heart rhythm, called an arrhythmia, is a change in either the speed or pattern of the heartbeat. During an arrhythmia, the heart may beat too fast, too slowly, or irregularly. Doctors can diagnose an arrhythmia, that does not occur frequently, by ordering an event monitor.

Benefits of Event Monitoring

• To determine whether symptoms such as dizziness, palpitations, fainting spells, or chest pain are caused by heart disease
• To detect heart rhythm problems that occur irregularly or infrequently
• To see how heart rhythm treatments (pacemaker, medication) are working
• To detect poor blood flow to the heart muscle.

When will I know the results of my Event Monitoring test?

The results will be given to you by your physician at your next follow-up appointment.

Patient Information – Exercise One Day

Exercise Nuclear Stress (One Day)

Please allow 4 hours to complete this test

Overview:

This procedure is used as a tool for the detection of coronary (heart) artery disease. In order to obtain the images for this procedure, a small gauge IV will be inserted into either arm or hand. This IV will be used for all medications and nuclear imaging tracers. You will be imaged twice, first is the rest phase of the procedure and then the stress phase.

Each set of images takes 15-20 minutes. The stress phase consists of exercising on a treadmill, with the treadmill increasing in elevation and speed every three minutes. This is a maximal stress test so you will exercise until you are unable to continue. Your electrocardiogram, blood pressure and heart rate will be monitored during and after the exercise.

Preparation: PLEASE FOLLOW THESE INSTRUCTIONS OR YOUR TEST MAY BE RESCHEDULED

• Do not eat for four hours prior to the test.
• If you are scheduled after 12:00 p.m., please eat a fatty meal 4 hours before your scheduled test.
• If you are diabetic and/or on insulin: Eat, take ½ your insulin dose and bring a snack.
• Do not eat or drink anything caffeinated or de-caffeinated for 12 hours prior to your study. This includes coffee, decaf coffee, tea, decaf tea, sodas, and chocolate.
• Do not take any medications that have caffeine including Excedrin, Anacin, Darvon, etc.
• Do not drink any fluid one hour prior to the test.
• Drink as much water as you can the day prior to hydrate your system
• Theophylline, Persantinen and Aggrenox should be avoided 48 hours prior to testing.
• Take your daily medications except for the below list of Beta Blockers.
• Avoid the following BETA BLOCKERS for 48 hours prior to testing:
  • Atenolol/Tenormin/Tenoretic
  • Toprol/Metoprolol/Lopressor
  • Carvedilol/Coreg
  • Propanolol/Inderal
  • Sotalol/Betapace/Labatolol
  • Timolol/Blocadren
  • Bisoprolol/Zebeta/Ziac
  • Nadolol/Corgard/Corzide
  • Bystolic/ Nebivolol/Timolide

What to wear:

Please wear a loose, comfortable, cotton t-shirt. Please do not wear nylon shirts or undershirts. Please no metal buttons, no jewelry and perfumes or lotions. Please wear comfortable walking shoes and no flip-flops or open toed shoes.

Women Only

No dresses please.

What to bring:

Please bring a fatty snack, such as chips, cookies, etc. and your preferred choice of caffeinated soda. You will need to have your snack and soda after the stress portion of the test.

Please bring a sweater as our rooms tend to be cool and books or magazines to keep you busy during the 4 hours.

Please arrive 30 minutes prior to your scheduled time; this is especially important as the nuclear medication can decay over time. If you are scheduled at 7:00 a.m. arrive 15 minutes early only.

** Please call our office if you have any questions regarding your test preparation**

Insurance Co-Payments:

All patients, except those with Medicare only, please verify your co-payment for this test with your insurance company prior to your appointment. Call member services (the phone number is on your insurance card) and verify the dollar amount of your co-payment required. Co-payments for a diagnostic test may differ from office visit co-payments. This amount can vary from $0-$200 per test or may be a percentage of the actual cost of the test. The contract that you have with your insurance carrier determines this amount. Our office has no influence on the amount owed at the time of service.

**Please call the office with any insurance questions**

PLEASE NOTE: Failure to show or cancel this test with a 24-hour or more notice may result in a $100 fee.

What is a Holter Monitor?

The Holter Monitor is a 24-hour continuous recording of the rhythm of your heart. This test will be useful in diagnosing any abnormal heart rhythms, or arrhythmias, that you may have while doing your usual daily activities.

What are the benefits of this test?

Wearing a Holter Monitor can indicate to the physician whether you have abnormal heart beats, poor circulation to the heart muscle (ischemia), or help show whether or not any symptoms, such as dizziness or chest pain, correlate with changes on your ECG (known as an electrocardiogram).

What do I need to do while wearing the monitor?

The cardiovascular technician will place electrodes on your chest that need to stay there for 24 hours. You may want to shower or bathe before your test date because the monitor and electrodes cannot get wet. Here are some helpful hints for us get the most diagnostic test possible:

• Wear a loose-fitting shirt or blouse.
• Do NOT shower, bathe or get the unit wet during the 24-hour period.
• Return the next day at your scheduled Holter Removal Appointment. It is extremely important to keep this appointment to ensure you receive your results in a timely manner.

Why is it important that I keep a diary?

You will be given a special diary for the recording of any events that may occur. The diary is extremely important. You will be asked to record any symptoms that you may experience during the test, along with the time and activity you were doing. This helps us evaluate whether your symptoms correlate with any changes in your heart rate or rhythm.

When will I know the results of my test?

The results will be given to you by your physician at your next follow-up appointment.

What is a Lower Extremity Arterial Duplex?

A Lower Extremity Arterial Duplex Study is an ultrasound image of the arteries or arterial bypass grafts in the lower portion of the body from the distal abdominal aorta to the tibial arteries (ankle level). In addition to vessel blockage, the upper and lower extremity arterial duplex studies are used to detect any enlargement which is the result of an aneurysm. An aneurysm is a bulge in an artery caused by a weakening in the vessel wall.

Why is a Lower Extremity Arterial Duplex done?

A Lower Extremity Arterial Ultrasound gives doctors information about the arteries in the
legs, such as:

• The blood flow through the arteries
• The presence of plaque, a sticky substance that clings to the arterial wall that can cause narrowing within the arteries
• The presence of an aneurysm, a bulging of the artery
• Evaluate previous surgeries including stents and bypass grafts.

What can I expect during the Lower Arterial Duplex?

You will be asked to remove your shoes, socks and pants. A gown will be placed across your lower body. A clear gel will be placed on your legs and the technologist will scan your legs with a transducer (a microphone-like device) that will show a moving picture of the arteries and listen to the blood flow within.

When will I know the results of my test?

Your cardiologist will review the findings of the Lower Extremity Arterial Ultrasound with you at your next office visit. Make sure you have a follow-up appointment scheduled as the results of this test cannot be given over the telephone.

What is a Lower Extremity Venous Duplex?

A Lower Extremity Venous Duplex is an ultrasound image of the veins in the legs. The lower extremity venous study is designed to assess the deep and superficial leg veins for blood clots – DVT (deep vein thrombosis) and venous insufficiency. We also use venous extremity studies to measure size and structure of the superficial veins for possible use as bypass grafts.

Why is a Lower Extremity Venous Duplex done?

A Lower Extremity Venous Ultrasound gives doctors information about the veins in the
legs, such as:

• The blood flow through the veins
• The presence of blood clots within the veins.

What can I expect during the Lower Extremity Venous Duplex?

A clear gel will be placed on your legs and the technologist will scan your legs with a transducer (a microphone-like device) that will show a moving picture of the veins and listen to the blood flow within. Some slight pushing on the legs is required to evaluate for blood clots within the vein.

When will I know the results of my test?

Your cardiologist will review the findings of the Lower Extremity Venous Ultrasound with you at your next office visit. Make sure you have a follow-up appointment scheduled as the results of this test cannot be given over the telephone.

What is a Mesenteric Artery Duplex Scan?

A Mesenteric Artery Duplex scan is an ultrasound test. The superior and inferior mesenteric arteries branch out from the abdominal aorta. They supply the intestine with blood. In addition to vessel blockage, the study is used to detect any enlargement which is the result of an abdominal aortic aneurysm. An aneurysm is a bulge in an artery caused by a weakening in the vessel wall.

What is a Nuclear Perfusion Stress Test?

Nuclear Perfusion Stress Testing, uses a special type of radioactive contrast material that is injected to help create more detailed images of your heart. Our Nuclear Cardiology Laboratory is accredited by ICANL.

What is a Renal Artery Duplex?

A Renal Artery Duplex Scan is an ultrasound image of the abdominal aorta and renal arteries which service the kidneys. This study looks for significant plaque within the renal arteries which can cause uncontrollable hypertension or renal failure. We also look at the kidney size and function for the possibility of renal cysts or other kidney abnormalities.

Why is a Renal Artery Ultrasound Performed?

A Renal Artery Ultrasound gives doctors information about the arteries to the kidneys such as:

• The blood flow through the arteries
• The presence of plaque, a sticky substance that clings to the arterial wall that can cause narrowing within the artery, which can cause hypertension, if the narrowing is significant
• The presence of an aneurysm, a bulging of the artery.

Renal Artery Duplex Procedure

After fasting (nothing to eat or drink, except water) for approximately 8-hours, a clear gel will be placed on your abdomen and the technologist will scan your arteries to the kidneys with a transducer (a microphone-like device) that will show pictures of the arteries and listen to the blood flow within. Feel free to bring a snack for after your test, if necessary.

When will I know the results of the Renal Artery Ultrasound?

Your doctor will review the findings of the Renal Artery Ultrasound with you at your next office visit. Make sure you have a follow-up appointment scheduled, as the results of this test cannot be given over the telephone.

What is a Stress Echocardiogram?

A Stress Echocardiogram, or Stress Echo, is a special type of Echocardiogram, or ultrasound of the heart, which produces images of the heart, at rest as well as after stress, triggered by exercise on a treadmill or a medication that causes the heart to beat as if exercising. The study uses ECG monitoring, along with ultrasound, to see changes in the wall motion of the heart and show how effectively the heart is pumping, especially under stress, and if there is a lack of blood flow.