Any patient with chest discomfort or shortness of breath may need a cardiac stress test. Patients scheduled to undergo surgery may also require a preoperative cardiac evaluation by completing a cardiac stress test. Patients may or may not feel symptoms at rest, so by exercising the patient on a treadmill we can improve our ability to detect possible blockages in your coronary arteries.
During exercise, normal coronary arteries are able to provide enough blood flow to the heart to prevent chest pain or significant shortness of breath. If there are blocked arteries, the coronary arteries are unable to provide enough blood flow to the heart and the patient will develop either chest pain, shortness of breath, or EKG changes.
At Sonoran Heart Cardiology, we are one of very few officially certified cardiac stress test centers in Arizona. We offer a wide variety of cardiac stress testing modalities located directly within our clinic. We have several highly trained Cardiovascular Specialists with special expertise in cardiac stress testing who perform and interpret every single cardiac stress test.
An Exercise Treadmill Test will require the patient at avoid eating for the night prior to the test. Specific instructions will be given in regards to which medications to avoid for the night prior leading up to the test. You will begin with light walking on a treadmill with gradual increase in speed and treadmill incline. Once your target heart rate is achieved, the test is completed. The entire experience will take less than one hour from the time of your appointment. Your cardiologist will discuss in detail with you the results of the test at your regularly scheduled follow up clinic visit.
If a patient is unable to exercise on a treadmill, we also offer pharmacologic (ie, chemical) stress testing that does not require the patient to exercise.
A Pharmacologic Stress Test will require the patient to avoid eating for the night prior to the test. Specific instructions will be given in regards to which medications to avoid for the night prior leading up to the test.
Upon arrival to your scheduled Stress Test appointment, an IV will be placed. You will then undergo imaging of your heart prior to administration of the pharmacologic agent. Repeat images of your heart will then be performed concluding your cardiac stress test.
The entire experience will take less than two hours from the time of your appointment. Your cardiologist will discuss in detail with you the results of the test at your regularly scheduled follow up clinic visit.
Many patients are unable to exercise on a treadmill due to other physical or medical conditions. Therefore, we offer pharmacologic (ie, chemical) stress testing in order to accommodate these situations.
Adenosine, lexiscan, and Dobutamine are the most commonly used ‘chemical’ stress test protocols. Your cardiologist will decide which specific protocol is appropriate for your cardiac stress test.
The Electrocardiogram (ie, EKG) is a simple, quick, but very important part of every single patient evaluation.
Prior to meeting the cardiologist, a medical assitant will perform an EKG in the patient exam room. Small adhesive electrodes are applied to the patient's chest, arms and legs. You will be asked to remain very still for a few seconds while the EKG recording is completed. Your Sonoran Heart cardiologist will interpret the EKG for you during your examination.
Patients with periodic rapid heart rates, palpitations, dizziness, or lightheadedness may require an event monitor or holter recording.
An event monitor involves the patient wearing EKG electrodes at home in order to acquire continuous heart rate and rhythm monitoring for a 14 to 30 day time period. Once your cardiologist has decided this is clinically indicated, the device will be mailed to you within 48-72 hours. It is easily hidden by normal clothing and only involves attaching adhesive electrodes to your chest.
There is no discomfort associated with use of this device. The results are automatically transmitted by satellite for interpretation of any abnormal findings. Your cardiologist will be contacted directly for any significant abnormalities at the time it occurs. Following completion, the device is simply returned by mail and you will be seen at your regularly scheduled clinic follow up visit.
A Holter monitor is a similar device, but only involves a 24-hour recording. Once your cardiologist has decided this is clinically indicated, you will be given a scheduled appointment to pick up the device. It will be attached to your chest with adhesive electrodes at that time and the device must be returned the following day for interpretation.
You are encouraged to perform all of your normal daily activities without limitations. You will also be asked to maintain a written diary of your symptoms while wearing the device. These will be correlated with any findings on the holter recording.
Cardiac Catheterization is a specialized study of the heart involving the insertion of a small catheter into the artery of the groin. Under x-ray guidance, the catheter is positioned into the heart for direct imaging of the coronary arteries. Imaging dye is injected into the arteries to visualize any blockages that may be present in the coronary arteries. If present, Sonoran Heart trained professionals are able to insert a coronary stent to fix the blockage. There is no surgery involved and you are able to leave the hospital by the next day.
This procedure is typically indicated in patients who experience frequent chest pain, shortness of breath, or heart attack.
Sonoran Heart Cardiology Group offers some of the most highly trained and experienced interventional cardiologists in Arizona. We specialize in all aspects of coronary intervention and use the latest technologies to provide the highest quality of care.
There are minimally invasive procedures used in the treatment of peripheral arterial disease that offer the patient an alternative to more invasive vascular treatments.
These consist of angioplasty or stent placement (as is done in the heart for CAD) or clot-removal treatment. They are nonsurgical and are performed through an intra-arterial catheter which is inserted percutaneously to reach the blocked artery.
A tiny balloon is inflated inside the artery to open the clog. A stent, a tiny wire mesh cylinder, may also be implanted at this time to help hold the artery open.
Sometimes a medicine can be given through the catheter or a special device can be inserted through it to remove a clot that's blocking the artery.
The recovery time is much quicker through the percutaneous treatment approach and offers similar outcomes to traditional surgical approaches.
Carotid angioplasty is a minimally invasive procedure that opens clogged arteries to prevent or treat stroke. The carotid arteries are located on each side of your neck and are the main arteries supplying blood to your brain. The procedure involves temporarily inserting and inflating a tiny balloon where your carotid artery is clogged to open the artery.
Carotid angioplasty is often combined with the placement of a small metal coil called a stent in the clogged artery. The stent helps keep the artery open and decreases the chance of it narrowing again.
Carotid angioplasty and stenting may be used when traditional carotid surgery isn't feasible or is too risky. For patients who meet certain eligibility criteria, carotid stenting offers a less invasive approach than carotid endarterectomy, the traditional surgical treatment for carotid artery blockages.
Carotid angioplasty and stenting may be used when traditional carotid surgery isn't feasible or is too risky. For patients who meet certain eligibility criteria, carotid stenting offers a less invasive approach than carotid endarterectomy, the traditional surgical treatment for carotid artery blockages.
During carotid endarterectomy, an incision is made in the neck at the site of the carotid artery blockage. The artery is isolated and the plaque and diseased portions of the artery are surgically removed. The artery is then sewn back together to improve blood flow to the brain.
In contrast, carotid stenting can be performed while the patient is awake, reducing recovery time and the risk of complications and re-narrowing.
An ASD/PFO is a congenital abnormality involving an open communication between the left and right atrium of the heart. Over time, this may cause deoxygenated blood to reach the rest of your body. This most commonly causes increasing shortness of breath. In other words, less oxygen will be able to reach your vital organs which results in the development of symptoms.
Other symptoms may include stroke, fluid retention, and higher risk for arrhythmias. The diagnosis is easily made with cardiac ultrasound (ie, echocardiogram). If clinically indicated, your cardiologist may decide that closing this abnormality will offer improvement of symptoms and better long-term prognosis.
At Sonoran Heart, we are one of the only cardiology groups in Arizona that offer comprehensive management of structural heart disease abnormalities, such as ASD/PFO closure. We have highly trained Interventional Cardiology specialists who are specifically trained in closing these defects percutaneously without the need for surgery or lengthy hospitalization.
A ventricular septal defect (VSD) is most commonly a congenital abnormality involving an open communication between the left and right ventricles of the heart. This may also result as a complication following a myocardial infarction (ie, heart attack). Over time, this may cause deoxygenated blood to reach the rest of your body. This most commonly causes increasing shortness of breath.
In other words, less oxygen will be able to reach your vital organs which results in the development of symptoms. Another commonly reported symptom is fluid retention. The diagnosis is easily made with cardiac ultrasound (ie, echocardiogram). If clinically indicated, your cardiologist may decide that closing this abnormality will offer improvement of symptoms and better long-term prognosis.
At Sonoran Heart, we are one of the only cardiology groups in Arizona that offer comprehensive management of structural heart disease abnormalities, such as ASD/PFO closure. We have highly trained Interventional Cardiology specialists who are specifically trained in closing these defects percutaneously without the need for surgery or lengthy hospitalization.
An echocardiogram is a commonly used diagnostic tool used by cardiologist in several different clinical scenarios. Patients with shortness of breath, chest pain, palpitations, leg swelling, lightheadedness, dizziness, or fainting episodes are most often scheduled to complete an echocardiogram.
Several cardiac observations can be made with an echocardiogram including overall heart function, presence or absence of valve disease, possible cardiac cause of stroke, or congenital heart defects. Sonoran Heart Cardiology has several Board Certified Echocardiography specialists who are highly trained in performing and interpreting these tests. We have one of the few officially certified echocardiography laboratories in Arizona and it is located directly in our clinic.
After your cardiologist has decided this test is clinically indicated, you will be given a scheduled appointment for completion of the test. Upon arrival, one of our highly trained echo technologists will take you to an exam room where the imaging will be completed. This is a completely noninvasive test using ultrasound gel and an imaging probe to obtain images. The imaging tech will apply light pressure with the ultrasound probe to your chest wall in multiple areas to image each specific area of the heart.
Occasionally, an IV will need to be placed in order to improve image quality or for additional imaging techniques. The entire test takes approximately one-half hour. You will obtain the results of your echocardiogram at your regularly scheduled follow up visit with your cardiologist.
Pacemakers are small electrical devices used most commonly to treat patients with slow heart rates who experience dizziness, lightheadedness, or fainting episodes.
Automated intracardiac defibrillators (AICD) are small electrical devices used most commonly to treat patients at increased risk for sudden cardiac death. The are identical appearing to pacemakers and the implantation technique is identical.
At Sonoran Heart, we are one of the premier cardiology groups in Arizona who offer comprehensive diagnostic and management services to patients with arrhythmias and those at risk for sudden cardiac death. Following your initial clinical evaluation, your cardiologist will decide if a pacemaker/AICD device is clinically indicated.
If so, you will be scheduled for an implantation by our Electrophysiologist (ie, pacemaker and AICD expert). This involves a brief hospitalization (less than 24hrs) following the surgical implant. The procedure involves only conscious sedation and local anesthesia typically under the left collar bone. The pacemaker/AICD is inserted underneath the skin and the device electrodes are inserted into the heart chambers.
Full recovery takes approximately two weeks. Sonoran Heart Cardiology group offers comprehensive long-term management of all pacemaker/AICD related issues in regards to device function.
Percuatneous valvuloplasty is procedure that opens up stenosed (narrowed) heart valves.
Percutaneous valvuloplasty is procedure that opens up stenosed (narrowed) heart valves. This is performed using catheter based treatment through the femoral artery and does not require open heart surgery. For aortic valve stenosis this is performed in patients that are high risk surgical candidates. It is performed by guiding a special balloon within the narrowing and widening the valve through balloon inflation. We have been invovled in the investigational use of percutaneous valve replacement. Valvuloplasty can serve as a bridge to percutaneous valve replacement, when it is FDA approved.
Similiarly, for mitral and pulmonic valve stenosis selected patients can benefit from a balloon procedure. For these valves, the results have proven long term benefit.
