Physicians and clinically-trained technicians use a variety of tests to construct a detailed profile of your heart’s function.  Below you will find five cardiac tests described in detail, to help you understand what to expect if you are going to receive one of these procedures.

Catheterization
Cardiac ultrasound
EP (electrophysiology) study
Event or Holter monitor
Stress test
Tilt table

What to expect during a catheterization:

Your physician has ordered this test in order to learn:

• Whether the blood vessels giving blood to your heart muscle are narrowed or blocked
• How well your heart is pumping
• If your heart valves are working properly
• If you were born with any heart defects
• If your heart has been damaged by disease

Your doctor may recommend a cardiac catheterization based upon your symptoms, medical history, physical exam and other related diagnostic studies.

DIRECTIONS     This test is performed at NSMC Salem Hospital, in the cardiac catheterization lab located on Phippen 5. Once at the hospital, park in the lot near the Wheelock 5 entrance.

Step by step:

• A cardiologist will perform the procedure with a specialized team of nurses, physician assistants and cardiovascular technologists.
• Your nurse will prepare you for your cardiac catheterization.
• You will wear a hospital gown and will have an intravenous needle placed in your arm. 
• The catheterization site, usually the groin but may also be the arm, will be cleansed and shaved.
• Heart monitors will be placed on your chest. 
• During the procedure, a flexible tube called a catheter will be placed into a blood vessel on your groin or arm. This catheter will be guided toward your heart. Dye will be injected into each coronary artery while an x-ray camera takes pictures. The team will view those pictures on screens above you to see inside your heart.
• The procedure is not painful. You will receive a topical anesthetic, but may feel a little discomfort during the insertion of the catheter into your groin.
• You will remain awake during the procedure. Your nurse can give you medications through the intravenous to keep you comfortable.
• The complete procedure may take one to two hours.
• Please arrange for a family member or friend to drive you home after the procedure. After one-day of rest at home, you may return to your usual level of activity unless told otherwise.
• You will receive discharge Instructions prior to going home. Please contact your cardiologist or Primary Care Provider with any questions.

FOLLOW UP     The cardiologist performing the procedure will discuss the results of the diagnostic procedure at the time of the procedure. Sometimes, if cardiologists find a blockage or narrowing of the coronary artery, they can perform another procedure to improve blood flow to the heart. This procedure is called balloon angioplasty. After balloon angioplasty, a stent may be placed in the artery. A stent is a tiny, scaffold-like structure that holds the artery open permanently. Depending on the type of stent, it may also deliver medication to prevent plaque or other material from building up again and causing another blockage. Whether your angioplasty includes a stent or not, you will be admitted to the hospital for the night for observation.

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What to expect during a cardiac holter or event monitor:

Your physician has scheduled this test in order to learn whether you have an irregular rhythm to your heart. A holter monitor is a continuous recording of your heart’s rhythm during normal activity, usually for 24 hours. An event monitor is similar to a holter monitor, but you will wear for a longer period of time. You press a button to record a symptom as you are experiencing it.

DIRECTIONS    This test is performed at NSMC Salem Hospital (in the Diagnostic Cardiology Department on Macomber 5) and at  NSMC Union Hospital (in South 1).

• Registration at NSMC Salem Hospital takes place in Ambulatory Care Registration on Davenport Four. 
• Registration at NSMC Union Hospital takes place in South 1, the same place where the test is performed.

Step by step:

• No preparation is necessary. Wear loose fitting clothing to the procedure.
• Arrive about 15 minutes before your appointment. You will be directed to a private room in the cardiology suite.
• A technician will place electrodes (small conducting patches) on your chest and attach a small recording monitor that can be carried in a pocket or a small pouch worn around your neck. This will take about 20 minutes.
• You will not require help leaving the hospital. You will need to return the monitor after the specified time (usually 24 hours).

FOLLOW UP :   Your PCP will go over the results of the test with you. The results are available three working days after the monitor is returned.

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What to expect during a cardiac stress test:

Your physician has scheduled this test in order to learn your heart’s reaction to increased demand for oxygen. A stress test records electrical activity of the heart during physical stress. A cardiologist and a technician will perform the test.

DIRECTIONS      This test is performed at NSMC Salem Hospital (in the Diagnostic Cardiology Department on Macomber 5) and at NSMC Union Hospital (in South 1).

• Registration at NSMC Salem Hospital takes place in Ambulatory Care Registration on Davenport Four.
• Registration at NSMC Union Hospital takes place in South 1, the same place where the test is performed.

• Do not eat, smoke, or drink caffeine or alcohol-containing beverages for three hours before the test. No preparation is necessary. Wear loose fitting clothing to the procedure.
• Continue all medications unless instructed otherwise.
• You will be asked to undress from the waist up and put on a hospital gown.
  A technician will place electrodes (conductive patches) on your chest to record the heart’s activity. Baseline heart rate, ECG, and blood pressure will be taken before exercise starts.
  You will start walking on a treadmill. The pace will be gradually increased. Rarely, people may experience chest discomfort, palpitations, dizziness, or shortness of breath during the test.
• The test will take about 45 minutes total. You will only be walking for five to ten minutes.
• You will not need help leaving the hospital after the test.

FOLLOW UP:   Your PCP will review the results with you. The results are available three working days after the test is performed.

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What to expect during a tilt table test:

Your physician has ordered this test to find out why you are experiencing fainting spells. The Tilt Table test produces syncope (fainting spells) under controlled conditions, which enables your physician to diagnose whether you have a condition called vasovagal syncope. A cardiologist and registered nurse will perform this test.

DIRECTIONS:     This test is performed at NSMC Salem Hospital, in the cardiac catheterization lab located on Phippen 5. Once at the hospital, you must first register at the Ambulatory Registration in Macomber building, 5^th floor. Then proceed down the hall to the cardiac diagnostic laboratory.

Step by step:

• You should not have anything to eat after midnight. Your physician may ask you not to take any medications starting the night before testing occurs.
• You will lie on a table which tilts upright.
• You will be continually monitored via electrocardiagram.
• Your blood pressure and heart rate will be checked frequently during the test
• The complete procedure may take one to two hours.
• You will need to designate a driver to pick you up after your test is completed.

FOLLOW UP: If you have a question regarding the procedure, you may call your physicians office. The results of the test will be discussed with you at the conclusion of the test, by the cardiologist.