The Heart Institute of Northwest Ohio offers comprehenssive testing and treatment services to ensure the highest quality health care for our patients. Our attention to the individual unique needs of each patient ensures that every patient receives the best possible care for their own private needs.

Below is a listing of the services offered at the Heart Institute of Nortwest Ohio.

Echocardiogram - Echocardiogram is a non-invasive ultrasound exam helpful in the diagnosis of multiple forms of heart disease. Two-dimensional images allow evaluation of the severity of valve disease, chamber size measurement, and calculation of ejection fraction.

The exam takes approximately one hour and requires no special preparation by the patient.  Patients should wear loose, comfortable clothing

Stress Echocardiogram - Stress Echocardiogram is a non-invasive ultrasound combined with exercise treadmill examination, used to diagnose wall motion abnormalities resulting from ischemic disease.  In addition, viability of damaged heart muscle, regurgitant lesions, and intracardiac pressures can be evaluated. 

Stress Echo takes 1-1 ½ hours.  Heart rate, blood pressure, and ECG are closely monitored throughout the exam.  Nothing orally, except water, 4 hours prior to test.  Beta blockers and other medications, as instructed, should be withheld for 24 hours prior to test.  Patients are advised to wear loose fitting clothing and comfortable walking shoes. 

Cartiod Duplex Exam - This exam evaluates carotid blood flow and possible causes of stroke or transient ischemic attack.

The exam takes about 1-1½ hours.  It requires no specific prep and no special clothing.

Abdominal Renal Exam - The abdominal vascular exam is a non-invasive exam helpful in diagnosis of abdominal aortic aneurysm and evaluation of abdominal bruits.

The exam takes 1-2 hours.  Patients must fast for an 8-hour period prior to testing.  Loose fitting, comfortable clothing is suggested. 

Ankle Brachial Index - This arterial exam is a non-invasive exam helpful in evaluation of arterial insufficiency.  At-rest ankle brachial pressures are obtained, as well as post exercise, to evaluate physiologic changes in pressure. 

The exam takes 30 minutes.  No special preparation is required, although it is helpful for patients to wear shorts. 

Lower Extremity Exam - This arterial exam is a non-invasive exam helpful in evaluation of arterial insufficiency.  Ultrasound is used to determine the location and severity of disease.  At-rest ankle brachial pressures are obtained, as well as post exercise, to evaluate physiologic changes in pressure.

The exam takes 1½-2 hours.  Patients may have a light meal prior to testing.  Loose fitting, comfortable clothing is suggested. 

Venous Study (Leg) - Venous study is helpful in locating deep venous thrombosis
(vein clot)

This exam takes 1-1½ hours and requires no special preparation. 

Exercise Treadmill Testing - Exercise Treadmill is useful in the  diagnosis of exercise induced   cardiac ischemia and aids in   evaluating therapy.  Patients are   exercised on an incline treadmill   to reach peak tolerance.  Vital   signs and EKG are closely   monitored during this test.

Exercise Treadmill Testing takes 1 hour.  Heart rate, blood pressure, and ECG are closely monitored throughout the exam.  Nothing orally, except water, 4 hours prior to test.  Beta blockers and other medications, as instructed, should be withheld for 24 hours prior to test.  Patients are advised to wear loose fitting clothing and comfortable walking shoes. 

Nuclear Testing - This test can detect cardiac muscle damage or conditions that may lead to damage through injection of a small amount of heart-sensitive radioisotope.  The heart is subsequently imaged with a special camera.  Images are obtained at rest and after treadmill exercise stress testing.  For those patients unable to exercise, the drug Persantine can simulate exercise by increasing the patient heart rate and blood pressure. 

The test takes approximately two hours.  Preparation for the exam requires that beta blockers, Viagra, and other medications, as instructed, be withheld for 24 hours prior to exam.  Patients must avoid caffeine and decaf products for 24 hours prior to testing.  Nothing orally, except water, 4 hours prior to test. 

Holter Monitor - This monitor provides continuous tracking of cardiac rhythm for changes correlating with patient symptoms.  Worn for 24 hours, the Holter Monitor is the best choice for symptoms that occur frequently. 

Pacemake & DifibrillatorChecks - Prescribed for follow-up of pacemaker and defibrillator function.  A transmitter is supplied to the patient, who is contacted on a regular basis for pacemaker checks. 

INVASIVE CATHETERIZATION EVALUATION 

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The following services are performed in a hospital by our surgical staff:

Cardiac Catheterization - Cardiac Catheterization is an invasive examination where after appropriate sedation and local anesthesia, catheters are threaded from an arm, neck, or leg artery and/or vein into the heart and great vessels to measure pressures and/or oxygen content within that cardiac chamber or vessel.  This examination usually requires approximately 30 minutes.  It requires arrival at the appropriate facility approximately 90 minutes before the scheduled exam with the patient fasting for 4-6 hours prior to the test.  Aspirin and other platelet inhibitors are not normally restricted prior to the exam, but other forms of anticoagulation may be restricted and the patient must check with the physician prior to the test for specific instructions.  Appropriate gowns and clothing will be provided during the test.  Iodine or shellfish sensitivity should be brought to the attention of the healthcare providers before the test is performed.

Angiography –coronary, aortic, peripheral, e.g., carotid, renal, iliofemoral - This invasive examination occurs with the injection of iodine-based contrast dye into the artery to further outline and detect vascular abnormalities in that vessel. Angiography is performed as part of cardiac catheterization when appropriate.  No other special preparation beyond that described for cardiac catheterization is needed.

Initial Electro-physiologic Cardiac Conduction System Mapping - This invasive examination involves placement of catheters within the heart to assess the electrical system function of the heart.  Attempts to provoke an abnormal cardiac rhythm with pacing, intravenous medication, etc. may be attempted concomitantly.  This examination normally requires approximately 60-120 minutes.  It must be done in an approved facility with specialized technician training and equipment.  Patient preparation is similar to that for cardiac catheterization (refer to Cardiac Catheterization Preparation above)

Transesophageal Echocardiography - This examination involves placement of a scope through the pharynx after appropriate sedation and anesthesia to then image the heart and great vessels with the use of ultrasound.  It is done to assess valve function, cardiac muscle function, possible cardiac tumors or masses, etc.  This test can be performed on an in or outpatient basis.  It requires arrival approximately 60 minutes prior to the test in an outpatient facility.  The patient must be fasting for at least 8 hours prior to the test.  No other special preparation or clothing is required.  No medications need be held prior to the examination.

Percutaneous Intervention – coronary, peripheral artery - These therapeutic procedures, in general, involve reestablishment of improved blood flow to the downstream organ by placement of a stent, balloon inflation, or atherectomy procedure.  They are performed after angiography has documented that percutaneous intervention is appropriate and technically possible.  Preparation for these tests is similar to that for cardiac catheterization (refer to Cardiac Catheterization Preparation above).  These procedures must be done in an approved specialized facility.

Therapeutic Electrophysiology – permanent pace-maker insertion, defibrillator placement - Pacemakers or defibrillators are implanted to provide improved control on individual patients with rhythm disorders.  Pacemaker implantation can be used to improve slow or absent cardiac rhythms or improve cardiac muscle performance.  Defibrillators are used to convert rapid, possibly lethal cardiac rhythms back to normal rhythm by the process of shocking the heart back to an electrically normal rhythm.  These procedures must be done in an approved facility, usually on an inpatient basis.  Preparation is similar to that for cardiac catheterization (refer to Cardiac Catheterization Preparation above).  

The American Heart Association
The official web site of the American Heart Association is an excellent resource for the public and healthcare professionals. It contains practical information about the prevention and treatment of heart disease and stroke including the most up-to-date research on a whole host of heart and vascular related conditions.

www.americanheart.org

Mended Hearts, Inc.
Mended Hearts is a national nonprofit organization that is affiliated with the American Heart Association. Partnering with hospitals and rehabilitation clinics, this organization offers services to heart patients such as support group meetings, visiting programs and educational forums.

www.mendedhearts.org

HeartInfo.org
HeartInfo.org is an independent, educational Web site that provides consumers with instructional information and services for the prevention, diagnosis and treatment of cardiovascular disease.

www.heartinfo.org