EKG

An electrocardiogram (EKG or ECG) is a recording of the heart's electrical activity as a graph or series of wave lines on a moving strip of paper. This gives the physician important information about the heart. For example, it can show the heart's rate and rhythm. It can also show an enlargement of the heart or the presence of either current or past heart attacks.

EKGs are noninvasive, quick, safe, painless and inexpensive tests that are routinely done if a heart condition is suspected.


EKG Preparations

  • Congenital Heart Clinic
  • EKG
  • Holter Monitor
  • Signal Average EKG
  • Stress Echocardiogram
  • Tilt Table
  • Treadmill

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Congenital Heart Clinic

For:

  • CHC
  • Heart Clinic
  • Cardiac Clinic

Common Reason for Exam:

  • Patients are referred from their Primary Care Physician. Once a patient is scheduled for the clinic, they are automatically rescheduled for follow up visits at the Cardiologists discretion.

Brief Description of Exam:

  • Patients are taken into the exam room and and EKG is performed. Patients are then sent to Medical Imaging to check in to have their PA Chest X-ray.

Preparation:

  • Patients are mailed a letter from the Heart Clinic Coordinator with the scheduled appointments. Patients will have an EKG and a PA Chest X-ray prior to their clinic visit.

Exam Time:

  • EKG: 15 minutes
  • Chest X-ray: 15 – 30 minutes
  • Clinic visit: 1 hour

Please Note:

  • Patients are taken into the exam room and an EKG is performed. Patients are then sent to Medical Imaging to check in to have their PA Chest X-ray.

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EKG

For:

  • Baseline EKG
  • EKG
  • ECG
  • Electrocardiogram
  • 12 Lead
  • Resting EKG
  • Routine EKG

Common Reason for Exam:

  • This exam is routinely ordered for patients who are experiencing chest pain or "fluttering in the chest." This is a routine test for pre-operative patients who are over 40 years of age. This may also be a baseline test for routine physicals.

Brief Description of Exam:

  • The patient will be asked to undress as above and lie on a stretcher or bed. They will be asked to relax and lie very still for a few minutes. There is no discomfort with this exam. Generally, the patient may leave after this examination is performed. If abnormalities are seen, the patient may be asked to get dressed while a technician has a Cardiologist review the exam.

Preparation:

  • No diet restrictions.
  • Patients should be as relaxed as possible.
  • Female patients will need to unhook bra and remove nylons (if applicable).
  • Patients must untuck their shirts if they are tucked in.

Exam Time:

  • 15 – 20 minutes

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Holter Monitor

For:

  • 24 Hour Monitor
  • Holter Recorder
  • Ambulatory EKG

Common Reason for Exam:

  • Shortness of breath, chest pain, fluttering, palpitations, dizziness, light headedness, atrial fibrulation, ventricular ectopy (irregular heartbeat).

Brief Description of Exam:

  • The Holter Monitor is a small recorder ran by 4-AA batteries and a data card. It is worn for approximately 24 hours and then returned to the Non Invasive Cardiology Department at the hospital. Upon the patients arrival, the technician will apply rubbing alcohol and an omni prep on 5 different areas of the patients chest. The tech will then apply electrodes to these areas. Wires will then be attached to the electrodes and taped over to assure that the wires will stay in place.
  • The patient will be given a diary to take home. They will be instructed to keep track of any unusual occurrences (see common reasons for this exam).
  • The patient will also be given instructions on how to remove the monitor. (If the patient is unable to bring the Monitor back, he/she may have a friend or family member return it for them).

Preparation:

  • No dietary restrictions.

Exam Time:

  • This examination is completed over a two-day period.
    • 1st day: 45 minutes (this is the actual hook-up of the monitor).
    • 2nd day: The monitor will be dropped off by the patient, or unhooked.

Please Note:

  • The patient will also have an EKG prior to the hook up of the Holter Monitor.
  • If the patient is having any x-ray of the upper body (chest x-ray, back x-ray), a Holter Monitor will not be scheduled for the same day.
  • If the patient is to be scheduled for an Echocardiogram (Echo) or a Treadmill in addition to a Holter Monitor, these exams should be scheduled for the day the Holter Monitor is taken off.

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Signal Average EKG

For:

  • Late Potential

Common Reason for Exam:

  • V Tach, passing out.

Brief Description of Exam:

  • Patient's skin is cleaned with alcohol and omni prep (skin cleaner). Area may be shaved, if needed, to apply electrodes.
  • Patient will have to lie very still and relax during this test.

Preparation:

  • No diet restrictions.

Exam Time:

  • 30 – 45 minutes

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Stress Echocardiogram

Common Names:

  • Stress Echo
  • Exercise Echo
  • Dobutamine Stress Echo

Common Reason for Exam:

  • The stress echocardiogram is often ordered for patients who have cardiac symptoms or conditions that suggest underlying coronary artery disease. A stress echocardiogram combines an ultrasound study of the heart with an exercise stress test. This allows doctors to evaluate how the heart functions when it is made to work harder.

Brief Description of Exam:

  • An echocardiogram is first done at rest, then immediately after an exercise (treadmill) test. Patients who cannot exercise may be given an injection of Dobutamine that will produce a stress on the heart similar to exercise. The stress echo is done in three parts:
    • First, a resting echocardiogram is performed.
    • Next, the patient will walk on a treadmill.
    • Immediately afterward, another echocardiogram will be performed while the heart is still beating rapidly. It is important that these next echo views be recorded within one to two minutes from the time the patient stops running on the treadmill.

Preparation:

  • No diet restrictions.
  • No bowel preparation.

Exam Time:

  • 1 – 2 hours

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Tilt Table

Common Reason for Exam:

  • Syncope
  • Dizziness
  • Light-headedness

Brief Description of Exam:

  • Patient comes in and has an IV started and monitoring electrodes attached. Then patient is tilted on a table to a 70-degree upright position for 45 minutes. Blood pressure and EKGs are taken every 5 minutes.

Preparation:

  • Nothing to eat or drink after midnight before the test.

Exam Time:

  • 1 – 2 hours

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Treadmill

Common Names:

  • Cardiac Stress Test
  • Exercise Stress Test
  • Exercise Tolerance Test
  • ETT

Common Reason for Exam:

  • Chest pain
  • Syncope
  • Light-headedness
  • Jaw or arm pain

Brief Description of Exam:

  • EKG monitoring electrodes on placed on the patient. Patient exercises until heart rate achieved, symptoms appear or EKG changes.

Preparation:

  • The patient should wear loose, comfortable clothing and comfortable shoes.
  • The patient may have a light breakfast.
  • The patient must receive instructions from his or her physician regarding their medication intake prior to this exam.

Exam Time:

  • 1 hour

Please Note:

  • Echo's should be done after Treadmill.
  • Stress Tests and Holter Monitors should be done the day before Treadmill.
  • This test CANNOT be done on patients weighing over 350 lbs.