To learn more about these diagnostic tools and how they relate to your personal medical needs, talk to your healthcare provider.

ELECTROCARDIOGRAM (EKG/ECG)
An electrocardiogram is a diagnostic test that records the electrical activity of the heart. By performing this test the doctor is able to measure the rate and regularity or of heartbeats as well as the size and position of the chambers.

A painless and useful test, an electrocardiogram (EKG or ECG) measures the electrical activity of the heart. By monitoring the heart's electrical activity, an EKG can help a healthcare provider learn a great deal about the health of the heart and the source and location of any problems. For example, an EKG can detect:

• disturbances of the heart's rhythm or rate;
• abnormalities in the axis;
• the direction of the heart's electrical flow;
• an enlargement of the heart;
• and damage from a previous heart attack.

Simply put, heartbeats are the result of electrical activity in the cells of the heart. These electrical impulses cause the muscles of the heart to contract and relax in a regular rhythm, creating the pumping action that moves the blood through the body's circulatory system. The EKG records the patterns of that electrical activity.

An EKG takes about 15 minutes and is administered while the patient is lying down. Sometimes the patient will be asked to exercise on an exercise bike or treadmill. This is called a stress EKG. Electrodes, called leads, are attached to the chest with a light adhesive and connected by wires to the electrocardiograph, the machine that records the heart's electrical impulses. Different placements and combinations of leads provide different views of the heart.

The electrocardiograph prints a permanent record of the test on a strip of ruled graph paper so the healthcare provider can examine and evaluate the results later.

By the way, ECG seems a logical abbreviation for an ElectroGardioGram. Why then is it often called an EKG? K stands for the Greek word "kardia".

ECHOCARDIOGRAM (Echo)

An echocardiogram is a noninvasive procedure that uses sound waves (ultrasound) to evaluate how well the heart is working.

Gel is applied to the chest and a transducer (wand-like apparatus) is moved over the chest area to produce an image of the internal structures of the heart. The test will take from 30 to 90 minutes depending on the patient's condition and the type of echo needed.

This test will help the doctor to evaluate:

• how well the heart is moving
• how well the valves are working
• the size of the heart and its pumping chambers (ventricles)

TRANSESOPHAGEAL ECHO (TEE)
A transesophageal echocardiogram is a very effective diagnostic ultrasound test that allows a physician to look at the heart from a tube that is passed into the esophagus. This test allows very clear images of many parts of the heart structures and blood flow--usually better than a traditional echocardiogram that views the heart through the chest wall limiting clarity.

As with any type of ultrasound test, sound waves are directed to the heart via a transducer, and the heart deflects the sound waves. Associated computerized equipment records and analyzes the sound waves to:

• Assess the presence of congenital heart disease.
  
  
• Assess the presence of valve disease due to inability of valves to open or close completely, leakage through a valve when it is closed, and other structural abnormalities.
  
  
• Confirm proper structure and function of the heart after corrective heart surgery repair.

Why should I have this test?
A TEE helps your doctor detect abnormal tissue growth around the heart's valves as well as abnormalities in the blood flow. Sometimes, this procedure is performed concurrently with a surgical procedure.

NUCLEAR CARDIAC TEST
Nuclear Exams help define abnormalities in blood flow and can define areas of possible damage. They also help in defining wall motion and cardiac muscle function. Additionally, they aid in determining ejection fraction - the efficiency of the heart muscle. The exam itself is performed with exercise or drugs to raise the heart rate in order to see blood flow at rest and under load.

Why should I have this test?
Nuclear cardiac tests help your doctor in diagnosing heart disease.

HOLTER MONITOR
The Holter Monitor is a small portable electrocardiagram (EKG) device which the patient takes home and wears for a period of 24 hours during normal daily activity. During that 24 hour time frame the Holter Monitor takes EKG recordings of the heart's rhythm.

Cardiogram leads are placed on the patient's chest and attached to a small tape recorder which can be hooked to a belt or carried on a strap. While wearing the Holter monitor, a diary of activities should be kept, and especially report any complaints which may be related to the heart.

If cardiogram leads become loosened or detached from the chest with activity, they can be reinforced with tape. A shirt or blouse which buttons in front is suggested

After the monitor has been worn for 24 hours, it is taken off and brought or sent to Mid Coast Hospital to be "read." The recorded EKG is scanned electronically to see if there are any abnormal heartbeats. If any significant problem is found, the patient is notified immediately.

EVENT RECORDER
An event recorder is a small EKG device which the patient can wear for weeks at a time. It is ideal for patients who experience transient symptoms suggestive of a cardiac arrhythmia. Our monitors are slightly larger than a credit card and are capable of recording several events. When the patient experiences any chest pain or abnormalities they press a button to activate the device and begin recording the heart's rhythm. Afterwards, the patient can transmit results to Mid Coast Hospital over the phone.

TREADMILL STRESS TEST
Many doctors will ask their patients to go through a stress test to help them determine the cause of chest pain as well as determine the capacity of the heart for exercise after cardiac surgery or a heart attack. A Treadmill Stress Test records the heart's electrical activity (rate and rhythm) during exercise. During the test, the cardiologist and a technician are present. Electrodes will be placed on the chest the same as for an electrocardiogram (EKG).

The patient will be asked to walk on a motorized treadmill. The speed and incline of the treadmill will be gradually increased. The doctor will be looking for changes in the EKG pattern and any symptoms that the patient may experience. The patient may be on the treadmill for up to 15 minutes, depending upon his level of recovery and cardiovascular conditioning. The test will be stopped if the patient becomes too tired or has any symptoms such as chest pain.

The test will last about 30 minutes.

This test will help the doctor evaluate the patient's cardiac condition related to:

• Irregular heart rhythms
• If there is a decreased supply of blood and oxygen to the heart with exercise
• How hard the heart can work before symptoms develop
• How quickly the heart recovers after exercise
• The patient's overall level of cardiovascular conditioning
• What the patient's target heart rate (THR) should be