Cardiopulmonary Services

Advanced Cardiac and Pulmonary Testing

The following cardiac and pulmonary tests are performed at Passavant Area Hospital. If you have questions about your cardiac or pulmonary testing or vascular concerns, call 217-479-3379. 

Echocardiogram

An echocardiogram is a test to check for problems inside and around your heart. It's often called an echocardiogram or an ECHO. Echocardiograms show what's happening, right now, in your heart. Harmless ultrasound waves are sent into the heart through the chest wall and are reflected back to the machine to create the images that you will see on the screen. The machine uses this information to create the images that you'll see on the screen. The images show your heart squeezing and relaxing, and your valves opening and closing in rhythm with your heartbeat.  Questions below in accordion format please.

Why am I having an echocardiogram?

An echocardiogram is performed to determine if the heart is the cause of your problem. Doctors may suggest an echocardiogram to evaluate your heart's valves, chambers and pumping function. You may have an echo if you have a heart murmur, high blood pressure or shortness of breath.

What happens during the exam?

After disrobing from the waist up and putting on a gown, you'll recline on an exam bed. Three electrodes will be attached to your chest for an electrocardiogram (ECG) at the same time. The ECG helps with the interpretation of the echocardiogram. A cardiac sonographer will perform your test. The sonographer will spread a small amount of special ultrasound gel on your chest and press a device, called a transducer, firmly against your skin. You'll be asked to roll over onto your left side and maybe breathe in a certain way.

Will it hurt?

Some patients may experience discomfort from the pressure of the transducer on the chest or abdomen. However, this discomfort is usually mild and lasts only a short time. You should tell the sonographer if you become uncomfortable during the test.

What else can I expect during the test?

The lights will be dim so the sonographer can see your heart's image on the screen more clearly. You will be able to see the screen and watch the images, which will be in both black-and-white and color. The Doppler echocardiogram uses colors to indicate the speed and direction of your blood as it flows through the heart and can detect leaking or narrowed heart valves, but just because you see color on the screen doesn't mean you have leaky valves. However, you may hear a pulsing "whoosh" sound. This is the blood flowing past the structures in your heart.

If your lungs or ribs block the view of ultrasound waves, the sonographer might suggest injection of a small amount of an intravenous contrast agent, Definity, to improve the images.

What do I need to do before the test?

No special care is needed.

How long does the test last?

Most echocardiograms take less than half an hour. You will able to return to your room or go home right after the test.

Are there any side effects?

No. The diagnostic ultrasound is safe.

When do I get the results?

A specially trained cardiologist will interpret the images. The final report will be sent to your doctor. This may take at least a day. Your doctor will then explain the results of the echocardiogram with you.

EKG

An EKG is a noninvasive test that records the electrical activity (rhythm and rate) of your heart. This painless test is one of the simplest and quickest ways to determine how well your heart works. 

What does the EKG machine do?

The machine records the electrical impulses going through your heart onto graph paper, which your doctor will see. 

What happens during an EKG?

A traditional EKG is conducted while you're lying down. If necessary, we will ask you to loosen your clothes. The technician will enter information into the EKG cart such as your name, birth date and so on. 

The technician will place 10 sticky, plastic electrodes on your body – one on each arm and leg and six on your chest. The technician will clip wires to the electrodes. The wires are connected to the EKG machine that monitors your heart's activity. The machine will begin to capture the electrical impulses. You'll see them on the screen as the familiar spiked line. Each spike represents a heartbeat. 
When the technician has a good recording, he or she will save it, unhook you and you're done. You'll be able to get up, adjust your clothing and leave or go on to your next test. 

How long will the test last?

The entire procedure should take no more than 10 minutes. 

What if I have symptoms during the test?

It's important that you report any symptoms such as chest pain or discomfort, dizziness or shortness of breath to the technician. Our skilled professionals are prepared to handle any symptoms you have have during the test. 

When will I know how my EKG turned out?

You will need to get the results of your test from your physician's office. 

After we do the EKG, we'll put the information into the Memorial computer system. Your physician will be able to review this unread copy right away either by computer access or by calling us for a faxed copy. 

We'll also make it ready for the cardiologist scheduled to read it. If the cardiologist detects any problems, they will be noted on the test. The cardiologist signs the test so your doctor knows a specialist has reviewed it. We will enter this into the computer for your doctor to see. This final report is also available by fax.  

Event Monitors

An Event Monitor is a small monitor that is used to record your heart beat at the time you are experiencing symptoms related to your heart problems. It records heart beats in the form of an electrocardiogram (EKG) just like heart monitors you may have seen in the hospital. The usual monitoring period is 30 days, but may differ depending on your physician's orders.

What does the Event Monitor do?

The Event Monitor is designed to record your EKG at the time you are experiencing symptoms. It is always on, but will only store your heart's activity when you push the record button. 

When you are having possible heart-related symptoms, you must push the red button. The recorder has a memory of two minutes, so pushing this button instantly stores the last two minutes of your EKG. The recorder will continue to store new heart beats for approximately 30 more seconds. The monitor also records your EKG in two ways to give your physician better information about your heart rhythm. 

How is the Event Monitor worn?

The monitor is attached to you with three electrode stickers and wires. It is worn all day, every day during the testing period. 

A technician will take you into a private room and explain the operation of the monitor in detail. You will be taught to use the recorder, change your electrode stickers every other day and to call in the recording. The technician will be happy to answer any questions you may have. 

If you have a symptom, you press the red RECORD or STORE button. The recorder will store your EKG. At your first opportunity, you must call the testing office and send the stored EKG over the phone so it can be reviewed and a copy sent to your physician. 

When will I know my Event Monitor Results?

After your Event Monitor recordings are received by the testing center, results are sent directly to your physician's office. Your physician will be able to review the test and let you know your results.    

Holter Monitors

The Holter Monitor creates a continuous recording of your electrocardiogram (EKG) while worn. 

What does the Holter Monitor do?

A Holter Monitor is a small device that records your heart beats for either a 24 or 48 hour period, depending on you physician's request. 

You are asked to note your symptoms in an activity diary which will be reviewed in conjunction with your EKG recording. This will help your physician know if the symptoms you are feeling are related to your heart's activity. 

How is Holter Monitor testing done?

You will be connected to the monitor with five electrode stickers and wires. It is very important that these electrodes remain in place during the entire recording. You will not be able to take a bath, shower or go swimming during the testing. You will be able to take a sink bath, being careful not to get the electrodes or recorder wet. 

The technician will show you an activity diary and explain how and when to make notes. The technician will also explain how you will know when the test is completed, instruct you on removing the electrodes and where to return the recorder. 

When will I know my Holter Monitor results?

You will need to get the results of your test from your physician's office. 

After your monitor is returned, the recording is downloaded, the entire recording is scanned and a report is created. This report is then available for the cardiologist to review. If the cardiologist detects a problem, it will be noted on the report which will be made available to your physician.

Nuclear Stress Test

A nuclear stress test is a noninvasive test that involves either exercise (walking on a treadmill) or a special medication that increases the blood flow to the heart, called Lexiscan. 

A Dual Isotope (walking) stress test is a test in which you will walk on a treadmill to increase your heart rate. A radioactive tracer is administered through an IV (placed in your arm at the beginning of the test) before resting pictures and again during the stress test. Pictures are taken before and after walking on the treadmill.

The purpose of this test is to assist in evaluating blood flow through your heart muscle. EKG’s and blood pressures are monitored during the test and an ACLS trained Stress RN will be present in the room at all times, along with the rest of the stress team.

A pharmaceutical nuclear stress test is a test in which you are given a medicine through an IV (placed in your arm at the beginning of the test) to stress your heart. A radioactive tracer is administered through the IV for nuclear images to be taken of the heart, before and after getting the stress medicine. This type of test is used for patients who have difficulty walking uphill and for long periods of time on a treadmill, or if taking certain medications. The purpose of this test is to assist in evaluating blood flow through your heart muscle. EKG’s and blood pressures are monitored during the test and an ACLS trained Stress RN will be present in the room at all times, along with the rest of the stress team. 

Why is a nuclear stress test performed?

  • Evaluate the blood flow to your heart.
  • Determine the likelihood of having coronary artery disease.
  • Evaluate the extent of coronary artery disease.
  • Evaluate the effectiveness of your cardiac treatment plan.

Can I eat or drink before the test?

  • Do not eat or drink ANY Caffeine or Decaffeinated products for 24 hours prior to this test. This includes coffee, tea, chocolate, soda/soft drinks, or medications that contain caffeine (Excedrin and Anacin). Caffeine may interfere with the test.
  • Do not eat or drink anything (may have sips of water) for 4 hours prior to your test.
  • However, if necessary to maintain your blood sugar for your diabetes, you may eat a small piece of toast and have a glass of juice before arriving. Please check your blood sugar before you arrive for your test if you are diabetic. 
  • You will be offered a light snack/beverage after your test.

Should I take my medications?

  • Do not take your diabetic medications prior to test (unless instructed by the physician ordering your test to do so). You may bring them with you to take after the test.
  • Do not take your (beta blocker) heart medications (unless instructed by the cardiologist ordering your test to do so) for 24 hours prior to your test if an exercise stress test is ordered as these medications can prohibit the heart rate from elevating. Examples of these medications include: Atenolol/Tenormin, Nebivolol/Bystolic, Coreg/Carvedilol, Labetolol/Trandate, Metoprolol/Lopressor, Propranolol/Inderal, Toprol XL/Metoprolol ER, Sotalol/Betapace. Please bring them with you to take after the test. 
  • Do not take Theophylline/Aminophylline for 24 hours prior to your test.
  • Do not take Persantine/Dipyridamole (including Aggrenox) for 48 hours prior to your test.
  • You may take your other medications with a sip of water. 
  • If you have any questions about which medications to take, you can bring them with you, and/or call your doctor or the stress room (217-479-2887) for clarification.
  • Please bring all medications with you that you have not taken that you normally do in the morning to take after the test.
  • Please bring a list of your medications that you currently take with you to your test.

General test instructions

  • Please wear comfortable shoes/clothing for your test (no flip flops, steel toe boots, etc)
  • Please allow up to 3 hours for this exam.
  • Please do not apply lotions to chest area the day of test. 

After your test

After your stress test, you may feel some fatigue or weakness. This is due to the medications you received or the activity if you had a treadmill test. The medications that are commonly used for a nuclear stress testing are the nuclear agent, Sestamibi, and Lexiscan and Aminophylline for the pharmacologic nuclear stress test. Some minor symptoms such as shortness of breath, headache, dizziness, and abdominal cramping are common; however, they typically go away after a few minutes. If you experience any chest discomfort, shortness of breath, eye discomfort, or pain after the test is completed, please notify your nurse (if still in the hospital) or doctor (if you have left the hospital). 
 

Pulmonary Function Tests

Pulmonary function tests, commonly known as PFTs, are a broad range of tests led by a Respiratory Therapist, trained in pulmonary function testing. These tests measure how well the lungs take in and exhale air and how efficiently they transfer oxygen into and remove carbon dioxide from the blood.

These tests require special equipment, trained personnel to conduct them, and a specialist to interpret the results. The tests can last 30 minutes for the basic test and up to 2 hours for a more complete study. The exact procedure is different for each type of test and is ordered by the physician. 

When performing the tests, you will do a variety of breathing maneuvers, such as blowing, inhaling, and breath-holding into a PFT machine. Your doctor uses the information from these tests, along with the results from other tests, to help identify the possible causes of your breathing difficulties or monitor the progression of your lung disease or your lungs’ improvement due to treatment.

Can I eat or drink before the test?

  • Do not eat or drink ANY Caffeine or Decaffeinated products for 8 hours prior to your test. This includes coffee, tea, chocolate, soda/soft drinks, or medications that contain caffeine (Excedrin and Anacin). Caffeine may interfere with the test.
  • Otherwise, you may eat and drink normally except for the final meal right before your test. This should be a light meal.

Should I take my medications?

  • Do not take any short-acting bronchodilators such as albuterol (ProAir, Proventil, Ventolin, Volmax), Combivent, Atrovent, Xopenex, or Maxair for 8 hours prior to your test.
  • Do not take long-acting bronchodilators such as Advair, Symbicort, Dulera, Brovana, or Spiriva for 24 hours prior to your test.
  • Do not take cromolyn sodium nasal spray for 8 hours prior to your test.
  • Do not take liquid theophylline for 12 hours prior to your test.
  • Do not take long-acting theophylline for 48 hours prior to your test.
  • You may take your other medications with a sip of water.
  • If you have any questions about which medications to take, you can bring them with you, and/or call your doctor for clarification.
  • Please bring a list of your medications that you currently take with you to your test. You will be asked to fill out a health questionnaire prior to the test.

General Instructions

  • Please allow up to 2 hours for this exam.
  • Please do not smoke for at least 6 hours prior to your test. This may interfere with the test.
  • Please wear comfortable clothing so your ability to take big breaths will not be limited during this test.

Regular Exercise (Treadmill) Stress Test

An exercise (treadmill) stress test is a noninvasive test that involves walking on the treadmill to increase your heart rate, while being connected to the continuous EKG monitor.

There is no imaging component associated with this test. The purpose of this test is to evaluate your heart rate and rhythm and response to stress. EKG’s and blood pressures are monitored during the test and an ACLS trained Stress RN will be present in the room at all times, along with the rest of the stress team. 

Why is an Exercise Stress Test performed?

  • Evaluate your heart rate and rhythm under stress.
  • Determine the likelihood of having coronary artery disease and if further testing is warranted.
  • Evaluate the effectiveness of your cardiac treatment plan.
  • Help to assess symptoms, such as chest pain, shortness of breath or palpitations, to determine whether they are coming from the heart

Can I eat or drink before the test?

  • Do not eat or drink anything (may have sips of water) for 4 hours prior to your test.
  • However, if necessary to maintain your blood sugar for your diabetes, you may eat a small piece of toast and have a glass of juice before arriving. Please check your blood sugar before you arrive for your test if you are diabetic. 

Should I take my medications?

  • DO NOT take your (beta blocker) heart medications, as these medications do not allow the heart rate to increase to the rate needed for a conclusive test. Examples of these medications include: Atenolol/Tenormin, Nebivolol/Bystolic, Coreg/Carvedilol, Labetolol/Trandate, Metoprolol/Lopressor, Propranolol/Inderal, Toprol XL/Metoprolol ER, Sotalol/Betapace. Please bring them with you to take after the test. 
  • Do not take your diabetic medications prior to test (unless instructed by the physician ordering your test to do so). You may bring them with you to take after the test.
  • You may take your other medications (including other blood pressure medications not listed above) with a sip of water. 
  • If you have any questions about which medications to take, you can bring them with you, and/or call your doctor or the stress room (217-479-2887) for clarification.
  • Please bring all medications with you that you have not taken that you normally do in the morning to take after the test.
  • Please bring a list of your medications that you currently take with you to your test.

General test instructions

  • Please wear comfortable shoes/clothing for your test (no flip flops, steel toe boots, etc)
  • Please allow up to 1 hour for this exam.
  • Please do not apply lotions to chest area the day of test. 

After your test

After your stress test, you may feel some fatigue or weakness. This is due to the increased exertion from walking on the treadmill. If you experience any chest discomfort, shortness of breath, eye discomfort, or pain after the test is completed, please notify your nurse (if still in the hospital) or doctor (if you have left the hospital). 

 

Stress Echo

A stress echocardiogram (ultrasound of your heart) is a noninvasive test that involves either exercise (walking on a treadmill) or a special heart stimulating medication called Dobutamine. 

An Exercise Stress Echocardiogram is a test in which you will walk on the treadmill to increase your heart rate. You will have echocardiogram (Doppler of your heart) pictures taken before you get on the treadmill, and again after your heart rate is elevated with walking. An IV will be placed, and may be used to give an image enhancing medicine for the Echocardiogram pictures. The purpose of this test is to evaluate the wall motion/function of your heart. EKG’s and blood pressures are monitored during the test and an ACLS trained Stress RN will be present in the room at all times, along with the rest of the stress team.

A Dobutamine Stress Echocardiogram is a test in which you will receive a medication (Dobutamine) through an IV (placed in your arm or hand) to increase your heart rate. You will have echocardiogram (doppler of your heart) pictures taken before the medication is given, and again as your heart rate is elevated. This type of stress test is used for patients with difficulty walking long periods of time and/or on an elevated surface. You may be asked to do a little activity while lying on the stretcher to assist with increasing your heart rate. The purpose of this test is to evaluate the wall motion/function of your heart. EKG’s and blood pressures are monitored during the test and an ACLS trained Stress RN will be present in the room at all times, along with the rest of the stress team. List questions below in accordion format.

Why is a stress echo performed?

  • Evaluate your heart and valves.
  • Determine the likelihood of having coronary artery disease.
  • Evaluate the extent of coronary artery disease.
  • Evaluate the effectiveness of your cardiac treatment plan.

Can I eat or drink before the test?

You may not eat or drink four hours prior to the test. After the test is completed, you may consume a regular diet, unless told otherwise by the stress nurse or your physician. 

Should I take my medications?

  • DO NOT take your (beta blocker) heart medications, as these medications do not allow the heart rate to increase to the rate needed for a conclusive test. Examples of these medications include: Atenolol/Tenormin, Nebivolol/Bystolic, Coreg/Carvedilol, Labetolol/Trandate, Metoprolol/Lopressor, Propranolol/Inderal, Toprol XL/Metoprolol ER, Sotalol/Betapace. Please bring them with you to take after the test. 
  • Do not take your diabetic medications prior to test (unless instructed by the physician ordering your test to do so). You may bring them with you to take after the test.
  • You may take your other medications (including other blood pressure medications not listed above) with a sip of water. 
  • If you have any questions about which medications to take, you can bring them with you, and/or call your doctor or the stress room (217-479-2887) for clarification.
  • Please bring all medications with you that you have not taken that you normally do in the morning to take after the test.
  • Please bring a list of your medications that you currently take with you to your test.

General test instructions

  • Please wear comfortable shoes/clothing for your test (no flip flops, steel toe boots, etc)
  • Please allow up to 1.5 hours for this exam.
  • Please do not apply lotions to chest area the day of test. 

After your test

After your stress test, you may feel some fatigue or weakness. This is due to the medications you received or the activity if you had a treadmill test. The medications that are commonly used for stress testing are Dobutamine, Atropine and Definity. Some of these medications may leave you feeling jittery, nauseated or dizzy. These symptoms should not last very long after you have something to eat and rest for a short time. If you experience any chest discomfort, shortness of breath, eye discomfort, pain or visual disturbances please notify your nurse (if still in the hospital) or doctor (if you have left the hospital). If you begin to experience any eye or visions problems that you did not have before your test, contact your primary care physician or ophthalmologist.