OTHER DIAGNOSTIC TESTS
ABI-Exam (Ankle-Brachial Index)
Pain in your legs walking? The ABI-exam is a quick test to check for the presence of peripheral artery disease
What is the ABI-Exam and how does it work?
The ankle-brachial index exam is a quick and noninvasive way to check for peripheral artery disease (PAD).
The ankle-brachial index test compares the blood pressure measured at your ankle with the blood pressure measured at your arm. A low ankle-brachial index number means narrowing or blockage of the arteries in your legs.
You may have ankle-brachial index testing before and immediately after walking on a treadmill. An exercise ankle-brachial index test can assess the severity of the narrowed arteries during walking.
Why would you need an ABI-exam?
The ankle-brachial index test is done to check for PAD — narrowed arteries that reduce blood flow, usually in your legs.
Research indicates that PAD affects about 10 percent of people over age 55. PAD can cause leg pain when walking and increases the risk of heart attack and stroke.
Your doctor might recommend an ankle-brachial index test if you have leg pain while walking or risk factors for PAD, such as:
• History of tobacco use
• High blood pressure
• High cholesterol
• Restricted blood flow (atherosclerosis) in other parts of your body
During the ABI-exam
Nothing but relax
This is a minimally invasive procedure that is the gold standard investigation to determine the presence of coronary artery disease. It is used to visualize the coronary arteries and assess the severity of any blockage and pinpoint the exact location.
What is a Coronary Angiogram and how does it work?
The procedure is now often performed via a small blood vessel in the arm (radial artery). A short tube is placed in the artery under local anesthetic. Wires and longer tubes (called catheters) are then passed through the small tube towards the heart. This is not painful.
Contrast is then injected into the arteries of the heart and a short XR film/image is performed. At the end of the procedure all tubes are removed from the body.
The procedure generally takes 10-20 minutes but may be longer if additional tests are performed during the angiogram.
These may include pressure wire assessment (fractional flow reserve / instant wave-free ratio), intravascular ultrasound (IVUS) and optical coherence tomography (OCT).
What risks are involved?
There is a less than 0.2% (1 in every 500 patients) risk of a serious complication developing during the procedure. Bleeding from the access site is the most common complication.
Further risks involved will be discussed with you personally prior to the investigation.
Why do you need a Coronary Angiogram?
When your cardiologist strongly suspects the presence of coronary artery disease.
During the Coronary Angiogram
You will be fully awake. In general, no anesthesia and no sedation are necessary, only in the case of severe anxiety.
The vessels don’t have pain receivers so that after the catheter introducer has been placed inside the artery, there is no more pain sensation.
You can talk to your cardiologist during the procedure, and he will be able to explain what exactly is happening at any moment. Also, you can see the images of your coronary arteries on the monitor.
In case the radial artery access is not possible due to anatomical variations, we may have to switch to the groin access. Again, the only thing you feel will be the needle stick of the local anesthetic at the puncture site.
At the end, a bracelet-like pressure bandage will be applied to the wrist or an intravascular closure device to the groin artery.
You will be monitored for bleeding signs from the access puncture for several hours after the procedure. In case the groin was accessed, you will have to keep the leg straight for at least 12 hours.
Healthy Heart Screening
CardioCare takes cardio-vascular health check-ups very seriously.
What is a Healthy Heart Screening and how does it work?
Preventive medicine has gained importance since technological advances have made comprehensive medical tests easily available and easy to perform at low or no performance risk.
The goal is:
prevention – early detection – risk reduction – sustainable health status
The ideal is to evaluate a patient’s health status as detailed as possible, including family history and their behavioral bad habits.
Blood tests, ECG’s and imaging techniques like ultrasound are performed to obtain sufficient information about your physical status and function. Metabolic risk factors will be evaluated.
What are the reasons for needing this test?
People understand that the key to a happy active and successful life is a healthy body and mind. Stress and behavioral risk factors don’t only reduce our daily functional capacity, but they also put us at increased risk for early disease.
Changing risk factors before disease strikes means true preventive medicine.
Early detection means bigger chances for improvement and healing. Patients have different reasons why they decide to go for a comprehensive healthy heart check. However, if you are:
If you are an athlete or have decided to start advanced physical activity
Have a very stressful life
Have a strong family history of cardio-vascular disease
Or if you smoke, are overweight or take other recreational drugs
you should have your heart checked regularly.
During the Healthy Heart Check
The session will involve a discussion with the consultant regarding your health history and any heart conditions suffered by closely-related family members, and then you will have several tests: ECG’s, Ultrasound of the heart and your vessels.
Please refer to the individual “check-up programs” pages for more detailed information.
A transrectal ultrasound test to examine your prostate for the presence of any abnormalities, cancer, or other prostate-related conditions.
What is a Prostate Ultrasound and how does it work?
The prostate ultrasound exam is an ultrasound scan of your prostate obtained with a thin probe via your rectum (transrectal), which allows close visualization of the prostate gland.
Why would you need a Prostate Ultrasound?
It is a quick and non-invasive test to obtain images of the prostate gland. Size and tissue changes, possible tumors, can be detected.
Most men are screened for prostate cancer with a transrectal ultrasound device.
BPH (Benign Prostate Hyperplasia) is another condition regularly requiring transrectal ultrasound examination.
During the Prostate Ultrasound test
You will be asked to lie down on your back or side on an examination table and bend your knees. To perform a transrectal ultrasound (TRUS), a transducer will be inserted into the rectum and moves it around gently to get images of your prostate from various angles.
For a biopsy, the doctor will slowly insert a needle alongside the transducer into your prostate to remove the tissue.
Tilt Table Test
The tilt table test is predominately used to determine the cause of syncope or fainting
What is the Tilt Table Test and how does it work?
Simply put, it is a test changing your body position trying to induce dizziness and fainting due to cardio-vascular dysregulation, not related to arrhythmias. It is being performed with the nurse and doctor present.
Prior to the test, electrodes will be attached to your chest and a blood pressure cuff is placed around an upper arm.
You then take your place on a table which pivots, placing your feet in the supports while safety straps are placed around your body.
Why would you need a Tilt Table Test?
In case of unclear fainting or dizziness spells the tilt table test helps to detect sudden heart rate or blood pressure drops in relation to body position causing positional orthostatic dizziness and fainting related to fast changing positions of your body. This is the test to demonstrate this dysregulation problem. The Tilt Table Test is very frequently used in the diagnose of postural tachycardia syndrome (PoTS) in young adolescents.
During the test
The test begins with you lying horizontally on the table. After 5 to15 minutes, the table is suddenly raised into a vertical position - normally between a 60-90 degree angle - which reflects a change in position from lying down to standing up. The table will then be kept in the upright position for up to 45 minutes, during which time your heart rate and blood pressure are monitored. While in the upright position you must remain as still as possible.
During the vertical element of the test, you should alert a member of the medical team if you feel symptoms such as nausea, sweating, feeling faint / dizzy or irregular heartbeats.
If you faint during the test, the table is immediately returned to the horizontal position and your condition is closely monitored. Most patients regain consciousness almost immediately. In some cases, if blood pressure and heart rate changes indicate you are about to faint, the table is returned to a horizontal position and you may not lose consciousness.
24H-Holter BP (Blood Pressure Monitor)
The small digital device measures your blood pressure at regular intervals in order to provide a clear picture of how your blood pressure changes throughout the day.
What is the 24H-Holter BP and how does it work?
A cuff is placed around your upper arm and the machine itself can be attached to a belt for comfort.
The digital machine is programmed to take a reading every 15 minutes during the day and then every 30 minutes during the night. Just before a reading is due to be taken, the machine will beep to make you aware the recording is due to commence. When this occurs, you should relax the arm and sit or stand still. If possible, ensure the cuff is at the same height as your heart.
You should also note down what you were doing immediately before the recording as this provides context to the reading. Other notable events such as taking BP medication and symptoms such as dizziness should also be noted.
The 24H-Holter BP usually lasts for 24 hours, at which point you return the machine to the clinic and the results are then analyzed and prepared for your doctor.
Why would you need the 24H-Holter BP?
You need a continuous blood pressure monitoring over 24h either to accurately diagnose an elevated blood pressure condition which may alter during the day or to evaluate how successful your treatment really is. The night and early morning values are of special interest.
During the 24H-Holter BP test:
You must continue your daily activities as usual, do not spend the day relaxing on the sofa careful not to rise your blood pressure! Your medication and diet should also be continued as usual.