Cardiology
Saint Mary’s Heart and Vascular department provides care for both patients admitted into the hospital as well as outpatients. All procedures are performed under the direction of specially trained heart doctors (cardiologists), technologists and registered nurses. We can be conveniently found in two locations.
To schedule a procedure:
616.685.4000
Heart and Vascular Service
Main Hospital, First floor,
200 Jefferson
Grand Rapids, MI 49503
616.685.6175
Cardiovascular Testing Center
310 Lafayette, suite 310
Grand Rapids, MI 49503
616.685.5331
Non-Invasive procedures
Non-Invasive Procedures
EKG (ECG)
Every time the heart beats it creates a small electrical charge, this charge signals the heart muscle to contract in a specific order. Special sensors (electrodes) can be placed on the skin that measure the electrical charge created by the heart. Depending on the placement of those sensors, we get a different picture of how the heart is performing.
12-lead EKG
Ten sensors are placed on the chest, legs and arms. These sensors are then used to create 12 different tracings of electrical charge created by the heart. This is a very sensitive test and can be used to identify irregular heart rates, rhythms, heart attacks, a lack of oxygen and the size of the chambers.
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Holter Monitor (24- or 48-hour)
Five sensors are placed on the chest and connected to a small recording device. The sensors and recording device are worn for 24 or 48 hours, depending on how long your physician wants you to wear it. When you are done wearing the monitor, you return it back to Saint Mary’s Health Care, where trained technicians use a special computer that analyzes your recording. A detailed report is then created to identify any irregular heart rates and rhythms as well as your normal rates and rhythms. A heart doctor (cardiologist) then reviews the report and provides guidance on the significance of any findings.
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Event Monitor
Two sensors are placed on the chest and connected to a small recording device. Since the event monitor can be worn up to 30 days, you will also be given additional sensors to replace them as needed. The event monitor is always on, but will only keep a record of tracings when you press the event button due to an abnormal spell or symptomatic episode. After you have recorded an event, you can send a copy of the recording over the phone to a 24-hour monitoring service. The technician who puts the monitor on you will teach you how to do this. The monitoring service will then generate a report of the heart’s rhythm during the events and send this to the heart doctor. Any dangerous rhythms will be immediately sent to the doctor. At the end of the 30 days, all events will be reviewed and a heart doctor will provide a report.
Patient Prep-
EKG-None
Monitors-None
Approximate amount of time for procedure-
EKG: 5 minutes
Monitors: set up 20 minutes
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Echocardiogram (Echo)
An echo is an ultrasound picture of the heart. Sound waves are directed through the body using a small camera. The sound waves bounce back to the camera, and the computer inside the ultrasound machine is able to create a picture. The picture is able to show us the size and function of the chambers, valves and great vessels of the heart. We are also able to see and measure the direction and speed of the blood as it travels through the heart. The echo is a good test to look for abnormal structures of the heart, stiff valves, leaky valves, damage caused by a heart attack, lack of oxygen, high blood pressure and fluid around the heart.
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Transesophageal Echocardiogram (TEE)
A transesophageal echocardiogram uses ultrasound to create a picture of the heart. This is the same as an echocardiogram but the camera is on the end of a tube. The camera is placed in your esophagus just after you have been lightly sedated. You will need a ride home because the medicine may make you drowsy, and most patients will not remember the procedure. The esophagus is right next to the heart so we are able to get the same information as an echocardiogram but with greater detail.
Patient Prep-
Echocardiogram: None
Transesophageal Echocardiogram: No food 4 hours before
Approximate time for procedure-
Echocardiogram: 45-60minutes
Transesophageal Echocardiogram: 30-60 minutes
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Treadmill Stress Test
A stress test is a procedure to show how well your heart functions while under a heavy workload. During a stress test you will be monitored for symptoms, blood pressure, and EKG changes. You will have a continuous 12-lead EKG recording and your blood pressure will be monitored every three minutes while on the treadmill. These recordings will be compared to recordings taken just before you started the treadmill. The purpose of the stress test may be to assess if you have coronary artery disease due to symptoms like chest pain or shortness of breath. Stress tests can also be done to assess for arrhythmias (irregular heartbeat) and symptoms like palpitations.
Patient Prep-
Treadmill Stress Test: No food 2 hours before
Approximate time for procedure-
Treadmill Stress Test: 45 minutes
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Stress Echocardiogram (Echo)
This type of stress test includes additional ultrasound images of your heart. Along with the information collected during a regular treadmill stress test, we will perform an echocardiogram of your heart. The echocardiogram is used to take a set of pictures before and immediately after you walk on the treadmill. The echocardiogram provides a more accurate picture of the heart allowing the physician to see specific areas that are affected by coronary artery disease.
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Nuclear Treadmill Stress test
This type of stress test uses nuclear imaging of your heart along with the information collected during a regular treadmill stress test. A small dose of a radioactive tracer is injected through an IV in your arm while you are at rest. A set of pictures is then taken to see how much of the tracer is absorbed into the muscle of the heart. A normal heart would have equal absorption of the tracer. After the set of resting images have been taken, you will be given a treadmill stress test. When the heart has reached a specific workload during the stress test more tracer will be injected. A set of pictures will then be taken to see how well the muscles absorbed the tracer while being stressed. The heart doctor will then compare the resting and stress images for any abnormal absorption of the tracer. The nuclear images provide a more accurate picture of the heart identifying specific areas that are affected by coronary artery disease.
Patient Prep-
Stress Echocardiogram: No food 2 hours before
Nuclear Treadmill Stress: No food 4 hours before,
Approximate time for procedure-
Stress Echocardiogram: 60-90 minutes
Nuclear Treadmill Stress: 3.5-4 hours
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Pharmacologic stress test
If your doctor does not believe that you would be able to walk on a treadmill long enough for an accurate test, they may order a pharmacologic (medication) stress test. This during this test you will be monitored for symptoms, EKG changes, and blood pressure changes. Nuclear or echo images will be also be taken. Instead of the treadmill creating a workload on the heart, a medication will simulate the effects of the treadmill. Either dobutamine or adenosine will be used. These medications work by increasing your heart rate (dobutamine) or by increasing blood flow (adenosine).
A set of resting images will be taken before any medication is given, and then a set of images will be taken during a dobutamine stress echo or after the medication for an adenosine nuclear. The heart doctor will then compare the resting and stress images and look for any abnormalities. The pharmacologic stress test allows for identification of coronary artery disease in patients that cannot walk on a treadmill.
Patient Prep-
Dobutamine Stress Echocardiogram: No food 2 hours before
Adenosine Nuclear Stress: No food 4 hours before, No Caffeine for 24 hours, No smoking or tobacco for 24 hours
Approximate time for procedure-
Stress Echocardiogram: 60-90 minutes
Adenosine Nuclear Stress: 3.5-4 hours
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