Our Services

Office Consultation

Our cardiologists and nurse practitioners are available to evaluate your heart related symptoms. These may include chest pain, shortness of breath or congestive heart failure.

Stress Echocardiogram

A stress echocardiogram or a stress echo is a noninvasive procedure that combines a stress test with an ultrasound of your heart. It allows your cardiologist or healthcare provider to assess your heart’s structure, function and response to exercise, usually on a treadmill. A stress echocardiogram is used to detect the presence of coronary artery disease (cholesterol buildup), valvular heart disease and many other conditions that can be present while you exercise.

Ideally, you should have nothing to eat or drink for 8-12 hours prior to your procedure. You can take your home medicine prior to your stress test as suggested by your cardiologist or healthcare provider. Before to your stress echocardiogram, the technologist will insert an IV in your arm as a safety precaution to begin the test. There is no requirement for anesthesia (pain medicine). You will begin your test by exercising on a treadmill. Immediately following your exercise, a technologist will perform an ultrasound of your heart. The technologist will have you lie flat for approximately 30 minutes while he or she performs the evaluation. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Exercise Stress Test

An exercise stress test is a noninvasive procedure that allows your cardiologist or healthcare provider to assess your cardiovascular health while exercising. An exercise stress test is a quick, noninvasive way to evaluate your overall cardiovascular health and potentially identify the presence of coronary artery disease (cholesterol buildup).

Ideally, you should have nothing to eat or drink for 8-12 hours prior to your procedure. You can take your home medications prior to your stress test as suggested by your cardiologist or healthcare provider. Prior to your procedure, an IV will be inserted in your arm for safety purposes during your test. There is no requirement for anesthesia (pain medicine). This is typically done on a treadmill that incrementally increases the speed and incline during your test. While your test is being performed, your healthcare provider will monitor your EKG (electrocardiogram), heart rate and blood pressure for signs of coronary artery disease (cholesterol buildup). After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Nuclear Stress Test

During your nuclear stress test, you will either exercise on a treadmill or be given an injection that simulates exercise. During the exercise portion of your stress test, a small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart and allows him or her to identify areas of poor blood flow. The results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your nuclear stress test, you should not have any caffeine, food or drink for 8-12 hours. An IV will be placed on your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Chemical Nuclear Stress Test

During your chemical nuclear stress test, you will be given an injection that simulates exercise. A small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart and allows him or her to identify areas of poor blood flow. Results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your chemical nuclear stress test, you should not have any caffeine, food or drink for 8-12 hours prior to your procedure. An IV will be placed on your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your stress test.

Exercise Nuclear Stress Test

During your exercise nuclear stress test, you will exercise on a treadmill and a small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart during exercise and allows him or her to identify areas of poor blood flow. Results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your exercise nuclear stress test, you should not have any caffeine, food or drink for 8-12 hours. An IV will be placed in your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Myocardial Positron Emission Tomography (PET) Stress Test

During your myocardial positron emission tomography (PET) stress test, you will be given an injection that simulates exercise and a small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart and allows him or her to identify areas of poor blood flow. Results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your myocardial PET stress test, you should not have any caffeine, food or drink for 8-12 hours. An IV will be placed in your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Myocardial Viability Evaluation

During your myocardial viability evaluation, you will be given an injection that simulates exercise and a small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart and allows him or her to identify areas of poor blood flow. The results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your myocardial viability evaluation, you should not have any caffeine, food or drink for 8-12 hours. An IV will be placed in your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Transesophageal Echocardiogram (TEE)

A transesophageal echocardiogram (TEE) is an invasive heart procedure where an ultrasound probe is inserted into your esophagus (food pipe). A transesophageal echocardiogram allows your cardiologist to acquire detailed pictures pertaining to the structure, function and any valvular heart disease that many be present. This procedure demonstrates your cardiac function in much greater detail than a standard transthoracic echocardiogram.

Prior to your procedure, you should not have any food or drink for 8-12 hours. In most cases, you will be able to take your home medications as scheduled. Your cardiologist / healthcare provider will advise you if there are any requirements to alter your medication schedule. Prior to your transesophageal echocardiogram, the technologist will insert an IV in your arm as a safety precaution to begin the test. This will allow sedation to be given to make you more comfortable during your procedure. During your procedure, you will be required to lie flat for approximately 30 minutes while the test is being completed. After your transesophageal echocardiogram, you will need to refrain from driving for approximately 12 hours and will need someone to accompany you home after the procedure. You can return to your normal activities the morning after your procedure.

Transthoracic Echocardiogram

A transthoracic echocardiogram (ultrasound of your heart), is a common, noninvasive way to look at the structure and function of your heart. An echocardiogram is performed for a variety of reasons. You may need a transthoracic echocardiogram to allow your cardiologist / healthcare provider to identify common conditions such as coronary artery disease (cholesterol buildup), congestive heart failure and valvular heart disease. It allows your cardiologist / healthcare provider to look at your heart as it beats in real time.

There is no preparation required prior to your procedure. A transthoracic echocardiogram does not require any pain medicine or anesthesia. The technologist will have you lie flat for approximately 30 minutes while he or she performs the ultrasound. After your procedure, you are free to return to your normal activity and continue to take your normal medications as you did prior to your procedure.

Cardiac Device Monitoring

Cardiac device monitors allow your cardiologist or healthcare provider to remotely monitor the function of your heart rhythm and rate. It will alert your cardiologist or healthcare provider of any abnormalities related to your device function or your heart rhythm.

Ambulatory Cardiac Monitoring

An ambulatory cardiac monitor is a noninvasive way to evaluate your heart rhythm. It will allow your cardiologist / healthcare provider to assess your heart rates and rhythm while you undergo your normal, daily activities. Your cardiologist / healthcare provider will use the results of the monitor to assess for abnormalities in your heart rhythm which could show a potential need for a pacemaker or other heart rhythm testing. Typically, you wear the ambulatory cardiac monitor for up to 7 days.

There is no preparation required prior to your procedure. A technologist will apply the ambulatory cardiac monitor to the outside of your chest and give you instructions for its use. After your procedure, you are free to return to your normal activity and continue to take your normal medications as you did prior to your procedure.

Cardiac Holter Monitoring

A cardiac holter monitor is a noninvasive way to evaluate your heart rhythm. It will allow your cardiologist / healthcare provider to assess your heart rates and rhythm while you undergo your normal, daily activities. Your cardiologist / healthcare provider will use the results of the monitor to assess for abnormalities in your heart rhythm which could show a potential need for a pacemaker or other heart rhythm testing. Typically, a cardiac holter monitor is worn for 48 hours.

There is no preparation required prior to your procedure. A technologist will apply the cardiac holter monitor to the outside of your chest and give you instructions for its use. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Remote Pacemaker Monitoring

A remote pacemaker monitor allows your cardiologist or healthcare provider to remotely monitor the function of your heart rhythm through your implanted device. It will alert your cardiologist / healthcare provider of any abnormalities related to your device function or your heart rhythm.

Remote Defibrillator Monitoring

A remote defibrillator monitor allows your cardiologist or healthcare provider to remotely monitor the function of your heart rhythm through your implanted device. It will alert your cardiologist / healthcare provider of any abnormalities related to your device function or your heart rhythm.

Electrical Cardioversion (DCCV)

An electrical cardioversion (DCCV) is a noninvasive way to restore your heart’s rhythm. It allows your cardiologist / healthcare provider to treat common conditions such as atrial fibrillation (AFib) or atrial flutter.

Prior to your procedure, you should not have any food or drink for 8-12 hours and you should continue your home medications as you normally would. On the day of your procedure, a technologist will insert an IV in your arm as a safety precaution to begin the test. This will allow sedation to be given to make you more comfortable during your procedure. Once you are sedated, a small amount of electrical current will be delivered to your heart, likely restoring normal rhythm. After your electrical cardioversion, you will need to refrain from driving for approximately 12 hours and will need someone to accompany you home as you recover. You can return to your normal activities the morning after your procedure and continue your home medications.

Loop Recorder Implantation (Implantable Cardiac Monitor)

A loop recorder is an invasive procedure where a small implantable cardiac monitor is placed under your skin. It allows for long-term surveillance and daily reports of your heart rate and rhythm (up to 4 years) to help identify a potential abnormal heart rhythm such as atrial fibrillation (AFib) or atrial flutter. It is commonly used in patients who have intermittent heart rhythm problems that are difficult to identify on shorter duration monitors such as ambulatory cardiac monitors or cardiac holter monitors.

There is no preparation required prior to your procedure. On the day of your procedure, a nurse will administer local anesthesia (pain medicine) to the site of the implant. Once this has been completed, your cardiologist will insert the monitor. The total duration is less than one minute. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Venous Disease – Diagnosis and Management

Peripheral venous disease is a common condition that results peripheral edema (leg swelling), leg pain and leg discoloration. A cardiologist / healthcare provider will evaluate your venous circulation via a noninvasive ultrasound, allowing him or her to understand the health of your peripheral venous system. A peripheral venous ultrasound demonstrates abnormal or diseased blood vessels that result in peripheral edema (leg swelling), leg pain and leg discoloration.

There is no preparation required prior to your procedure. The day of your procedure, you will receive an injection of local anesthesia (pain medicine) prior to your ablation, Varithena or VenaSeal administration. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Radiofrequency Ablation (RFA)

A radiofrequency ablation (RFA) is an invasive, in office procedure in which your cardiologist will treat abnormalities of your venous system. A small catheter is inserted through the skin and the blood vessel is closed allowing return to potentially normal circulation. It requires a small amount of local anesthesia (lidocaine).

There is no preparation required prior to your procedure. The day of your procedure, you will receive an injection of local anesthesia (pain medicine) prior to your radiofrequency ablation (RFA). After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Chemical Ablation (Varithena)

A chemical ablation is an invasive, in office procedure in which your cardiologist will treat abnormalities of your venous system. A small catheter is inserted through the skin and subsequently a small amount of foam (Varithena) is injected in the blood vessel allowing a return to normal circulation.

There is no preparation required prior to your procedure. The day of your procedure, you will receive an injection of local anesthesia (pain medicine) prior to your Varithena administration. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

VenaSeal Closure System

The VenaSeal closure system is an invasive, in office procedure in which your cardiologist will treat abnormalities of your venous system. A small catheter is inserted through the skin and subsequently a small amount of foam (VenaSeal) is injected in the blood vessel allowing a return to normal circulation.

There is no preparation required prior to your procedure. The day of your procedure, you will receive an injection of local anesthesia (pain medicine) prior to your VenaSeal administration. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Peripheral Arterial Vascular Disease Screening (ABI)

An ABI test is a noninvasive way to assess the blood flow to your legs. This test is used to identify blockages (cholesterol buildup) in the arteries of your legs that commonly result in pain, discoloration and difficulty walking. The results of your test can identify if you may benefit from stenting to restore blood flow to your legs.

There is no preparation required prior to your procedure. During your procedure, you will have multiple blood pressure readings of your arms and legs. This information will then be used to evaluate the health of your peripheral arterial system (blood vessels). After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Carotid Artery Ultrasound

A carotid artery ultrasound is a noninvasive assessment that screens for blockages in the arteries of your neck. Your cardiologist or healthcare provider commonly orders this test to assess your risk for a stroke. This test allows your cardiologist or healthcare provider to view inside your carotid arteries and evaluate the health of your carotid arterial system (neck arteries).

There is no preparation required prior to your procedure. The day of your procedure, a technologist will use an ultrasound machine to assess your carotid arteries (neck arteries). You can expect to lie flat for approximately 30 minutes while your test is being completed. There is no requirement for local anesthesia (pain medicine). After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Inpatient Consultation

Our staff of cardiologists and nurse practitioners are available to evaluate your medical conditions while hospitalized at Johnson City Medical Center (JCMC), Franklin Woods Community Hospital (FWCH), Sycamore Shoals Hospital and Unicoi County Hospital. They are on call 24 hours a day, 7 days a week to help your primary care doctor manage any of your medical needs.

Left Heart Catherization

A left heart catherization is an invasive procedure and is used to diagnose and treat coronary artery disease (cholesterol buildup). A principle reason for you to undergo a left heart catherization is to evaluate all of your heart arteries for potential blockages and determine the best way to treat you in the future. This includes potentially receiving a stent which would treat a blockage in your heart, being placed on additional or different medications or the need for coronary artery bypass surgery (CABG).

Your doctor will instruct you on what medications you should refrain from taking on the day of your procedure. This is potentially different for each individual and is done on a case by case basis. Ideally, you should have nothing to eat for approximately 8-12 hours prior to your procedure. A nurse will insert an IV in your arm and this will be used to give you sedation (pain medication) for the procedure that will make you sleepy. A doctor will enter a camera through an artery in your wrist or groin. Using dye, a left heart catheterization allows for doctors to identify arteries in your heart. A left heart catherization takes approximately 30 minutes to complete. After your procedure, you may be required to stay overnight in the hospital, or you may be allowed to return home the same day. If you are able to return home the same day, you should have someone accompany you to drive you home after the procedure. In general, you should not engage in any vigorous exercise or daily activities until you see your cardiologist, usually within a week. The resumption of your home medications will be determined by your doctor after the procedure has been completed.

Right Heart Catherization

A right heart catherization is an invasive procedure that is used to measure the pressure inside your lungs. It can help diagnose common conditions such as valvular heart disease and pulmonary hypertension, just to name a few. This procedure can also be used to diagnose and treat conditions associated with the onset or progression of shortness of breath. A right heart catherization allows your cardiologist to understand the relationship between your lung function and your cardiac function.

The day of your procedure your cardiologist will instruct you on what medications you should refrain from taking. This is potentially different for each individual and is done on a case by case basis. Ideally, you should have nothing to eat for approximately 8-12 hours prior to your procedure. A nurse will insert an IV in your arm, and this will be used to give you sedation (pain medication) for the procedure that will make you sleepy. During your procedure, a small catheter will be inserted into your lungs to measure the pressures within your lung tissue. This information is used to help your cardiologist or healthcare provider diagnose and treat common conditions noted above. You should have someone accompany you to drive you home after the procedure. In general, you should not engage in any vigorous exercise or daily activities while you are recovering until you see you cardiologist, usually within a week. The resumption of your home medications will be determined by your doctor after the procedure has been completed.

Abdominal Aortic Angiography

An aortic angiogram is an invasive procedure that requires peripheral arterial access. A small catheter is used to image your aorta by injecting a small amount of dye to evaluate you for an abdominal aortic aneurysm or for other peripheral arterial abnormalities.

Coronary Stent

During your heart catherization, a blockage to blood flow may be identified in the arteries of your heart. To improve blood flow to your heart, your cardiologist may insert a coronary artery stent. This is done to alleviate chest pain, treat heart attacks and improve your functional capacity after you leave the hospital. A stent is a small metal device that is inserted on the inside of the blood vessel to treat a blocked artery.

The day of your procedure your cardiologist will instruct you on what medications you should refrain from taking. This is potentially different for each individual and is done on a case by case basis. Ideally, you should have nothing to eat for approximately 8-12 hours prior to your procedure. A nurse will insert an IV in your arm, and this will be used to give you sedation (pain medication) for the procedure that will make you sleepy. For this reason, you should have someone accompany you to drive you home after the procedure. In general, you should not engage in any vigorous exercise or daily activities until you see your cardiologist, usually within a week. The resumption of your home medications will be determined by your cardiologist after the procedure has been completed.

Temporary Transvenous Pacemaker

A temporary transvenous pacemaker is inserted through a large blood vessel in the groin or the neck to support your heart rate. Sometimes an individual’s heart rate becomes dangerously low and this pacemaker is required to temporarily protect your heart function.

Defibrillator Implantation

A defibrillator is used to regulate your heart rate or rhythm. Defibrillators are devices commonly placed in people with known heart disease who have a weakened heart condition that places them at risk for sudden cardiac death.

Dual Chamber, Single Chamber and Biventricular Defibrillator Implantation

A defibrillator implantation may be used to regulate your heart rate or rhythm. Defibrillators are devices commonly placed in people with known heart disease who have a weakened heart condition that places them at risk for sudden cardiac death. A small incision is made under your left collarbone and the pacing system is placed through a large blood vessel.

Your cardiologist will instruct you on what medications you should refrain from taking on the day of your defibrillator implantation. This is potentially different for each individual and is done on a case by case basis. Ideally, you should have nothing to eat for approximately 8-12 hours prior to your defibrillator implantation. A nurse will insert an IV in your arm and this will be used to give you sedation (pain medication) for the procedure that will make you sleepy. For this reason, you should have someone accompany you to drive you home after the procedure. In general, you should not engage in any vigorous exercise or daily activities until you see your cardiologist, usually within a week. The resumption of your home medications will be determined by your doctor after the procedure has been completed.

Pacemaker Implantation

A pacemaker is used to regulate your heart rate or rhythm. Pacemakers are devices commonly placed in people with known heart disease who have a weakened heart condition that places them at risk for sudden cardiac death.

Dual Chamber, Single Chamber and Biventricular Pacemaker Implantation

A pacemaker implantation may be used to regulate your heart rate or rhythm. Pacemakers are devices commonly placed in people with known heart disease who have a weakened heart condition that places them at risk for sudden cardiac death. A small incision is made under your left collarbone and the pacing system is placed through a large blood vessel.

Your cardiologist will instruct you on what medications you should refrain from taking on the day of your pacemaker implantation. This is potentially different for each individual and is done on a case by case basis. Ideally, you should have nothing to eat for approximately 8-12 hours prior to your pacemaker implantation. A nurse will insert an IV in your arm and this will be used to give you sedation (pain medication) for the procedure that will make you sleepy. For this reason, you should have someone accompany you to drive you home after the procedure. In general, you should not engage in any vigorous exercise or daily activities until you see your cardiologist, usually within a week. The resumption of your home medications will be determined by your doctor after the pacemaker implantation has been completed.

Transcatheter Aortic Valve Replacement (TAVR) / Non-Surgical Aortic Valve Replacement

A transcatheter aortic valve replacement or tavr is the replacement of a patient’s aortic valve without the need for open heart surgery. This procedure is highly technical and variable as to the preoperative procedure. Your cardiologist or healthcare provider will speak with you in more detail with regard to this procedure.

PFO Closure

A PFO closure procedure allows your cardiologist to close a small “hole” in your heart. It is used to prevent a stroke and could require long-term monitoring with an echocardiogram. This procedure is highly technical and variable as to the preoperative procedure. Your cardiologist or healthcare provider will speak with you in detail with regard to this procedure.

Watchman Device

The watchman device is implanted through an invasive procedure, commonly used in patients with atrial fibrillation (AFib). It allows your cardiologist to reduce your risk for stroke and does not require long-term blood thinner administration. This procedure is highly technical and variable as to the preoperative procedure. Your cardiologist or healthcare provider will speak with you in detail with regard to this procedure.

Stress Echocardiogram

A stress echocardiogram or a stress echo is a noninvasive procedure that combines a stress test with an ultrasound of your heart. It allows your cardiologist or healthcare provider to assess your heart’s structure, function and response to exercise, usually on a treadmill. A stress echocardiogram is used to detect the presence of coronary artery disease (cholesterol buildup), valvular heart disease and many other conditions that can be present while you exercise.

Ideally, you should have nothing to eat or drink for 8-12 hours prior to your procedure. You can take your home medicine prior to your stress test as suggested by your cardiologist or healthcare provider. Before to your stress echocardiogram, the technologist will insert an IV in your arm as a safety precaution to begin the test. There is no requirement for anesthesia (pain medicine). You will begin your test by exercising on a treadmill. Immediately following your exercise, a technologist will perform an ultrasound of your heart. The technologist will have you lie flat for approximately 30 minutes while he or she performs the evaluation. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Exercise Stress Test

An exercise stress test is a noninvasive procedure that allows your cardiologist or healthcare provider to assess your cardiovascular health while exercising. An exercise stress test is a quick, noninvasive way to evaluate your overall cardiovascular health and potentially identify the presence of coronary artery disease (cholesterol buildup).

Ideally, you should have nothing to eat or drink for 8-12 hours prior to your procedure. You can take your home medications prior to your stress test as suggested by your cardiologist or healthcare provider. Prior to your procedure, an IV will be inserted in your arm for safety purposes during your test. There is no requirement for anesthesia (pain medicine). This is typically done on a treadmill that incrementally increases the speed and incline during your test. While your test is being performed, your healthcare provider will monitor your EKG (electrocardiogram), heart rate and blood pressure for signs of coronary artery disease (cholesterol buildup). After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Nuclear Stress Test

During your nuclear stress test, you will either exercise on a treadmill or be given an injection that simulates exercise. During the exercise portion of your stress test, a small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart and allows him or her to identify areas of poor blood flow. The results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your nuclear stress test, you should not have any caffeine, food or drink for 8-12 hours. An IV will be placed on your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Chemical Nuclear Stress Test

During your chemical nuclear stress test, you will be given an injection that simulates exercise. A small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart and allows him or her to identify areas of poor blood flow. Results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your chemical nuclear stress test, you should not have any caffeine, food or drink for 8-12 hours prior to your procedure. An IV will be placed on your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your stress test.

Exercise Nuclear Stress Test

During your exercise nuclear stress test, you will exercise on a treadmill and a small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart during exercise and allows him or her to identify areas of poor blood flow. Results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your exercise nuclear stress test, you should not have any caffeine, food or drink for 8-12 hours. An IV will be placed in your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Myocardial Positron Emission Tomography (PET) Stress Test

During your myocardial positron emission tomography (PET) stress test, you will be given an injection that simulates exercise and a small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart and allows him or her to identify areas of poor blood flow. Results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your myocardial PET stress test, you should not have any caffeine, food or drink for 8-12 hours. An IV will be placed in your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Myocardial Viability Evaluation

During your myocardial viability evaluation, you will be given an injection that simulates exercise and a small amount of a radioactive tracer will be injected through your IV. This allows your cardiologist / healthcare provider to inspect your heart and allows him or her to identify areas of poor blood flow. The results of this test allow your cardiologist / healthcare provider to identify the presence of coronary artery disease (cholesterol buildup).

Prior to your myocardial viability evaluation, you should not have any caffeine, food or drink for 8-12 hours. An IV will be placed in your arm to allow the technologist to give you the nuclear tracer. During the service, the technologist will require you to lie on your back for approximately 20 minutes to attain your pictures. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Stress Echocardiogram

A stress echocardiogram or a stress echo is a noninvasive procedure that combines a stress test with an ultrasound of your heart. It allows your cardiologist or healthcare provider to assess your heart’s structure, function and response to exercise, usually on a treadmill. A stress echocardiogram is used to detect the presence of coronary artery disease (cholesterol buildup), valvular heart disease and many other conditions that can be present while you exercise.

Ideally, you should have nothing to eat or drink for 8-12 hours prior to your procedure. You can take your home medicine prior to your stress test as suggested by your cardiologist or healthcare provider. Before to your stress echocardiogram, the technologist will insert an IV in your arm as a safety precaution to begin the test. There is no requirement for anesthesia (pain medicine). You will begin your test by exercising on a treadmill. Immediately following your exercise, a technologist will perform an ultrasound of your heart. The technologist will have you lie flat for approximately 30 minutes while he or she performs the evaluation. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Transesophageal Echocardiogram (TEE)

A transesophageal echocardiogram (TEE) is an invasive heart procedure where an ultrasound probe is inserted into your esophagus (food pipe). A transesophageal echocardiogram allows your cardiologist to acquire detailed pictures pertaining to the structure, function and any valvular heart disease that many be present. This procedure demonstrates your cardiac function in much greater detail than a standard transthoracic echocardiogram.

Prior to your procedure, you should not have any food or drink for 8-12 hours. In most cases, you will be able to take your home medications as scheduled. Your cardiologist / healthcare provider will advise you if there are any requirements to alter your medication schedule. Prior to your transesophageal echocardiogram, the technologist will insert an IV in your arm as a safety precaution to begin the test. This will allow sedation to be given to make you more comfortable during your procedure. During your procedure, you will be required to lie flat for approximately 30 minutes while the test is being completed. After your transesophageal echocardiogram, you will need to refrain from driving for approximately 12 hours and will need someone to accompany you home after the procedure. You can return to your normal activities the morning after your procedure.

Transthoracic Echocardiogram

A transthoracic echocardiogram (ultrasound of your heart), is a common, noninvasive way to look at the structure and function of your heart. An echocardiogram is performed for a variety of reasons. You may need a transthoracic echocardiogram to allow your cardiologist / healthcare provider to identify common conditions such as coronary artery disease (cholesterol buildup), congestive heart failure and valvular heart disease. It allows your cardiologist / healthcare provider to look at your heart as it beats in real time.

There is no preparation required prior to your procedure. A transthoracic echocardiogram does not require any pain medicine or anesthesia. The technologist will have you lie flat for approximately 30 minutes while he or she performs the ultrasound. After your procedure, you are free to return to your normal activity and continue to take your normal medications as you did prior to your procedure.

Computerized Tomography Coronary Angiogram (CTA) Interpretation

A coronary CTA is a noninvasive procedure that allows the evaluation of your coronary arteries (arteries around your heart). It is commonly performed to identify blockages in your arteries that may ultimately require stenting or coronary artery bypass grafting (CABG).

A nurse will insert an IV in your arm, and this will be used to give you sedation (pain medication) for the procedure that will make you sleepy. It is also used to deliver the dye that allows for the imaging of your coronary arteries. In general, you should not engage in any vigorous exercise or daily activities until you see your cardiologist, usually within a week. The resumption of your home medications will be determined by your doctor after the procedure has been completed.

Stress Echocardiogram

A stress echocardiogram or a stress echo is a noninvasive procedure that combines a stress test with an ultrasound of your heart. It allows your cardiologist or healthcare provider to assess your heart’s structure, function and response to exercise, usually on a treadmill. A stress echocardiogram is used to detect the presence of coronary artery disease (cholesterol buildup), valvular heart disease and many other conditions that can be present while you exercise.

Ideally, you should have nothing to eat or drink for 8-12 hours prior to your procedure. You can take your home medicine prior to your stress test as suggested by your cardiologist or healthcare provider. Before to your stress echocardiogram, the technologist will insert an IV in your arm as a safety precaution to begin the test. There is no requirement for anesthesia (pain medicine). You will begin your test by exercising on a treadmill. Immediately following your exercise, a technologist will perform an ultrasound of your heart. The technologist will have you lie flat for approximately 30 minutes while he or she performs the evaluation. After your procedure, you are free to return to your normal activities and continue to take your normal medications as you did prior to your procedure.

Implantable Cardioverter-Defibrillator (ICD) Implantation

An implantable cardioverter-Defibrillator (ICD) is a small battery-powered electrical impulse generator that is implanted in patients who are at risk of sudden cardiac death due to ventricular fibrillation and ventricular tachycardia. The device is programmed to detect cardiac arrhythmia and correct it by delivering a jolt of electricity. In current variants, the ability to revert ventricular fibrillation has been extended to include both atrial and arrhythmias. There also exists the ability to perform biventricular pacing in patients with ventricular or bradycardia.

The process of implantation of an ICD is similar to implantation of a pacemaker. Similar to pacemakers, these devices typically include electrode wire(s) that pass through a vein to the right chambers of the heart, usually lodging in the apex of the right ventricle. The difference is that pacemakers are more often temporary and are generally designed to correct bradycardia, while ICDs are often permanent safeguards against sudden arrhythmias.

The most recent development is the subcutaneous ICD (S-ICD). Current state-of-the-art electronics and batteries have enabled an implantable device to deliver enough energy to defibrillate the heart without the need for a lead in or on the heart. This prevents lead-related problems and the risk of dangerous infections in or near the heart. This ICD is positioned just under the skin and outside the ribcage. It can be placed during a minor procedure under conscious sedation.

Abdominal Aortic Angiography

Aortic angiography is a procedure that uses a special dye and x-rays to see how blood flows through the aorta, the major artery leading out of the heart, and through your abdomen or belly. Angiography is an imaging test that uses x-rays and a special dye to see inside the arteries. Arteries are blood vessels that carry blood away from the heart.

Right Heart Catheterization

A right heart catheterization is performed to determine how well the heart is pumping and to measure the pressures in the heart and lungs.

In a right heart cath, the doctor guides a special catheter (a small, hollow tube) called a pulmonary artery (PA) catheter to the right side of the heart and passes it into the pulmonary artery, the main artery carrying blood to the lungs. The doctor observes blood flow through the heart and measures the pressures inside the heart and in the lungs.

Left Heart Catheterization

Left heart catheterization is the passage of a thin flexible tube (catheter) into the left side of the heart to diagnose or treat certain heart problem

Carotid Ultrasound

In human anatomy, the left and right common carotid arteries are arteries that supply the head and neck with oxygenated blood; they divide in the neck to form the external and internal carotid arteries.

Carotid ultrasonography is an ultrasound-based diagnostic imaging technique to reveal structural details of the carotid arteries, so as to look for blood clots, atherosclerotic plaque buildup, and other blood flow problems.

A carotid duplex is a carotid ultrasonography carried out by duplex ultrasonography. A duplex carotid ultrasound may include a Doppler ultrasound, a special test able to reveal the movement of blood cells through the carotid arteriess.

Congestive Heart Failure Clinic

Infusions are tailored to fit each patient and are usually given one to three times per week. The duration of each infusion is typically four hours. The patient has a peripherally inserted central catheter (IV PICC) inserted into the vein of his/her arm by either IV team or the radiology department. The PICC line allows for ease of blood draws for laboratory tests and for infusion of mediations. The PICC line may be used indefinitely, and only needs to be changed if it clots or is infected.

Cardiac Holter and Ambulator Cardiac Monitoring

In medicine, a Holter monitor (often simply “Holter” or occasionally ambulatory electrocardiography device) is a portable device for continuously monitoring various electrical activity of the cardiovascular system for at least 24 hours (often for two weeks at a time). The Holter’s most common use is for monitoring heart activity (electrocardiography or ECG), but it can also be used for monitoring brain activity (electroencephalography or EEG) or arterial pressure. Its extended recording period is sometimes useful for observing occasional cardiac arrhythmias or epileptic events which would be difficult to identify in a shorter period of time. For patients having more transient symptoms, a cardiac event monitor which can be worn for a month or more can be used. The Holter monitor is named after physicist Norman J. Holter, who invented telemetric cardiac monitoring in 1949. Clinical use started in the early 1960s.

When used for the heart, (much like standard electrocardiography) the Holter monitor records electrical signals from the heart via a series of electrodes attached to the chest. Electrodes are placed over bones to minimize artifacts from muscular activity. The number and position of electrodes varies by model, but most Holter monitors employ between three and eight. These electrodes are connected to a small piece of equipment that is attached to the patient’s belt or hung around the neck, and is responsible for keeping a log of the heart’s electrical activity throughout the recording period.

Cardiac Device Monitoring

Cardiac monitoring systems, crucial to cardiovascular care, are used by clinicians to assess the presence and severity of cardiac disease and to evaluate the efficacy of treatments such as drugs, interventions, operations and device implants. We develop, manufacture and market a family of advanced diagnostic cardiology devices such as electrocardiograph systems, stress test systems and holter monitoring systems.

Stress Echocardiography

An electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart. An EKG translates the heart’s electrical activity into line tracings on paper. The spikes and dips in the line tracings are called waves.

Echocardiography

Echocardiogram, often referred to cardiac echo or simply an echo, is a sonogram of the heart. (It is not abbreviated as ECG, which in medicine usually refers to an electrocardiogram.) Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart.

Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases. It is one of the most widely used diagnostic tests in cardiology. It can provide a wealth of helpful information, including the size and shape of the heart (internal chamber size quantification), pumping capacity, and the location and extent of any tissue damage. An Echocardiogram can also give physicians other estimates of heart function such as a calculation of the cardiac output, ejection fraction, and diastolic function (how well the heart relaxes).

Echocardiography can help detect cardiomyopathies, such as hypertrophic cardiomyopathy, dilated cardiomyopathy, and many others. The use of Stress Echocardiography may also help determine whether any chest pain or associated symptoms are related to heart disease. The biggest advantage to echocardiography is that it is noninvasive (doesn’t involve breaking the skin or entering body cavities) and has no known risks or side effects.

To Our Patients

In response to the outbreak of COVID-19, our offices are dedicated to keeping you safe while providing you with the highest quality healthcare. Below is a list of new policies put into action to limit the spread of COVID-19.

  • Disinfecting high touch areas every two hours
  • Providing face masks at patient facing encounters
  • Daily screening of employee temperatures
  • Pre-visiting patient screening for COVID-19 symptoms
  • Limit non-essential, non-patient personnel into our offices

In addition, we offer Telehealth appointments. Using a smartphone, tablet or computer, you can talk to a doctor or nurse practitioner without leaving your home. Call (423) 926-4468 to schedule or reschedule an appointment today.

We hope you and your loved ones stay safe and healthy during this time.

Sincerely,

Karing Hearts Cardiology