State of the Art Diagnostic Testing
Angiography is an X-ray test that uses fluoroscopy to take pictures of the blood flow within an artery (such as the aorta) or a vein (such as the vena cava).
Ankle-brachial index (ABI) - This test is done by measuring blood pressure at the ankle and in the arm while a person is at rest. Measurements are then repeated at both sites after 5 minutes of walking on a treadmill. By dividing the highest blood pressure at the ankle by the highest recorded pressure in either arm, the ankle-brachial index (ABI) can be calculated. The ABI result is used to predict the severity of peripheral arterial disease (PAD) that may be present. A decrease in the ABI result with exercise is a sensitive indicator that significant PAD is probably present.
Hs C-Reactive protein – helps to predict cardiovascular risk. An hs-CRP of more than .20mg/dL predicts high risk for stroke and heart attack. C-reactive protein is a substance found in the blood that occurs when inflammation occurs. Physicians have found that atherosclerosis (fatty buildup in artery walls) also produces an inflammatory process, so it registers on this test
Blood sugar (glucose) – detects diabetes and glucose intolerance (pre-diabetes). Both are vascular disease risk factors.
Lipid profile – measures your LDL (bad) and HDL (good) cholesterol and triglycerides
Carotid Ultrasound - This procedure uses sound waves to obtain color images of the arteries in your neck. Your physician will evaluate the images to determine the extent these arteries are blocked and how much blood is flowing to your brain and eyes.
CT Scan - A computed tomography (CT) scan uses X-rays to produce detailed pictures of structures inside the body. A CT scan is also called a computerized axial tomography (CAT) scan. A CT scanner directs a series of X-ray pulses through the body. Each X-ray pulse lasts only a fraction of a second and represents a “slice” of the organ or area being studied. The slices or pictures are recorded on a computer and can be saved for further study or printed out as photographs.
Duplex/Doppler Ultrasound - The system employs ultrasound imaging allowing the technologist to view the flow of the blood vessels in color while simultaneously providing a sound waveform analysis. This assists with detection of narrowing of blood vessels and abnormalities restricting blood flow. The technologist will apply a gel over the area of interest. A probe will then be placed over the vessel which will allow viewing of the image on a video screen. A series of photos and velocity measurements will be taken and provided to your doctor for interpretation.
Echocardiogram (Cardiac Ultrasound) - An echocardiogram is a non-invasive, painless test that uses high-frequency sound waves (ultrasound) to get a picture of the heart. From this echocardiogram, your doctor can evaluate your heart valves, the strength and thickness of your heart muscle and the size of the four chambers in your heart.
EKG/ECG - Electrocardiography (EKG/ECG) is a test that measures the electrical signals that control the rhythm of your heartbeat. The graph that shows the results is called an electrocardiogram.
MRI/MRA - Magnetic resonance angiography (MRA) is a type of magnetic resonance imaging (MRI) scan. It uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body. In many cases, MRA can provide information that cannot be obtained from an X-ray, ultrasound, or CT scan. MRA can detect problems with the blood vessels that may be causing reduced blood flow.
Peripheral vascular treadmill test - A vascular treadmill test is an ambulation exercise device administered to patients with a complaint of intermittent claudication. You will walk on a treadmill at a slow speed for up to 5 minutes. During the test, immediately notify the technician of the onset of pain and if you are unable to continue. At the end of the exercise, you will return immediately to an exam table. While on the table, bilateral ankle pressures will be taken. The numbers are all recorded and will be given to your doctor for interpretation.
Peripheral vascular ultrasound - This procedure uses sound waves to obtain images and measure speed of blood flow in carotids (neck) , arms, legs, abdominal aorta, and renal (kidney) blood vessels. These images are analyzed to determine whether or not you have blockages in your arteries, blood clots in your veins, or if an abdominal aortic aneurysm is present.
Renal (kidney) duplex imaging - This ultrasound test determines if blockages are present in the renal (kidney) arteries, which interfer with the supply of blood to the kidneys.
Segmental pressures – This test measures leg pressures with blood pressure cuffs and a doppler probe ultrasound detector. It assists your doctor in identifying the degree and location of narrowing and/or blockage of the arteries in the legs.
Stress test –A stress test compares your EKG while you are at rest to your EKG after your heart has been stressed, either through physical exercise (treadmill or bike) or by using a medication. This comparison can often reveal problems with your heart that show up only when your heart has to work very hard.
Exercise stress test – monitor your heart while you walk on a treadmill. Your blood pressure, EKG, and any problems you might experience are recorded and observed during the test .
Pharmacologic stress test – uses a drug, such as adenosine, to reproduce the effects of exercise. This is for individuals who are unable to perform the required level of exercise due to factors such as older age, arthritis, or excess weight.
Ultrasound - is a diagnostic procedure that uses high frequency sound waves to observe your heart beating or blood flowing through arteries and veins. The procedure is simple and painless. The ultrasound technologist applies gel to the tip of a probe. The probe is gently placed on your skin. The gel allows the passage of high frequency sound waves from the probe to the tissue underneath. Sound waves reflect off the tissue sending information back to the probe. This information is converted into electrical energy creating moving images on a TV screen. The images are recorded on videotape for the physician to review and interpret.