Cardiac Testing Information

Your doctor may order one or more of the following tests depending on your symptoms discussed at your visit. The tests can help diagnose and manage heart conditions including coronary artery disease, heart failure, abnormal heart rhythms, and abnormalities in the heart valves. The following tests are done at our Bridgewater office and/or at RWJ University Hospital Somerset.

 

Tests may require authorization before scheduling based on your insurance. If this is the case, you will get a call from our office to schedule in about 1-2 weeks. If you do not hear from us, please call our office to follow up.

 

Below are the Cardiac tests that our group can perform:

Echocardiogram

  • What is it? This test is an ultrasound of your heart to look at the heart function, structure, and valves of your heart, and assess blood flow through the heart chambers and valves. It uses high frequency sound waves to produce images of the heart and does not involve any radiation exposure. This test can be done in the office, however sometimes for this test we need to give contrast medication through a peripheral intravenous (IV) line to view the walls of the heart better. If your doctor orders this test with contrast, then it will be done at the hospital.
  • What is the reason to get this test? Your doctor may order this test if you have symptoms such as chest pain, shortness of breath, palpitations, or leg swelling, or have a heart murmur. These symptoms could be caused by a weak heart or valve abnormality that can be seen on an echocardiogram. Another reason to get this test is to assess the heart function if you are receiving chemotherapy.
  • How long is this test? Please allow 45 minutes for this test.
  • How do I need to prepare? Wear clothing you can easily remove above the waist, such as a loose fitting T-shirt, button-down shirt or blouse. You will need to lay down for the test and also lay on your left side if able. If you are unable to lay down we can obtain images while sitting however they may be limited. Do not smoke 2 hour prior to the test.
  • How long does it take to get results? Within a week (results will also be available in MyChart).

Carotid Ultrasound

  • What is it? This is an ultrasound test to look at the carotid arteries in the neck that supply blood to the brain. This test is used to detect if there is significant plaque or blockage in these blood vessels that can affect the blood flow and increase the risk of a stroke.
  • What is the reason to get this test? Your doctor may order this test if you have blacked out or fainted, feel dizzy, have a history of a stroke, or have a bruit (turbulent blood flow through the carotid vessel that is heard with the stethoscope)
  • How long is this test? Please allow 30-45 minutes for this test.
  • How do I need to prepare? Wear clothing that does not cover the neck. Do not smoke 1 hour prior to the test.
  • How long does it take to get results? Within a week (results will also be available in MyChart).

Abdominal Aortic Ultrasound

  • What is it? This is an ultrasound looking at the largest blood vessel in our body called the aorta. This test particularly looks at the portion of the aorta in the abdomen, that provides blood supply to our intestines, kidneys, and legs. It is used to detect if there is an aneurysm (dilation) of the aorta – over time the dilation could increase to the point where there is a risk of rupture which can be fatal, thus it is important to screen for this condition in people who are at risk.
  • What is the reason to get this test? It is recommended to get this test if you have a history of smoking and are between the ages of 65-75 years old or if you have a family history of aortic aneurysms. Your doctor may also order this test if you have abdominal pain with no other clear cause.
  • How long is this test? Please budget 30-45 minutes for this test.
  • How do I need to prepare?
    • Wear a comfortable shirt that can easily be pulled up to your chest and pants that you can pull down.
    • Do not eat any food or drink water 6 hours prior to the test. You can still have your medications with a small sip of water.
    • Take 2 tablets of Gas-X (over the counter) 2 hours prior to the test
  • How long does it take to get results? Within a week (results will also be available in MyChart).

Peripheral Arterial Ultrasound

  • What is it? This is an ultrasound looking at the arteries that supply blood to your arms or your legs. It is used to detect if there is plaque build-up in the blood vessels that could be causing stenosis (narrowing) of the blood flow to either your arms or legs.
  • What is the reason to get this test? Your doctor may order this test if you have cramping pain in your arms or legs (particularly with exertion), or abnormal swelling or bruising. This test may also be done if you have an abnormal ABI/PVR test (described below).
  • How long is this test? Please allow 45 minutes for this test.
  • How do I need to prepare? You will need to pull up your sleeves (if upper extremity or arm ultrasound) or remove pants and keep underwear on (if lower extremity or leg ultrasound). Do not smoke 1 hour prior to the test.
  • How long does it take to get results? Within a week (results will also be available in MyChart).

Peripheral Venous Ultrasound

  • What is it? This is an ultrasound looking at the veins in either the arms or legs which bring blood back to the heart. It can assess if there is a blood clot. It can also detect if there is significant backflow of blood (referred to as venous insufficiency) in the legs that could be causing swelling.
  • What is the reason to get this test? Your doctor may order this if you have swelling or pain in the arms or legs.
  • How long is this test? Please allow 45 minutes for this test.
  • How do I need to prepare? You will need to pull up your sleeves (if upper extremity or arm ultrasound) or remove pants and keep underwear on (if lower extremity or leg ultrasound). Do not smoke 1 hour prior to the test.
  • How long does it take to get results? Within a week (results will also be available in MyChart).

ABI/PVR Test

  • What is it? This stands for ankle brachial index/pulse volume recording. It is used to assess if there is a circulation problem in your legs. Blood pressure in the legs is measured and compared to the blood pressure in the arms. Sometimes, the test requires you to walk on a treadmill to compare the blood pressures before and after exercise.
  • What is the reason to get this test? Your doctor may order this test if you have cramping pain in your legs (especially with exertion).
  • How long is the test? Please allow 45 minutes for this test.
  • How do I need to prepare? Wear loose pants that you can remove for the test and shoes you can walk in if you need to walk on the treadmill. Do not smoke 1 hour prior to the test.
  • How long does it take to get results? Within a week (results will also be available in MyChart).

Exercise Treadmill Stress Test

  • What is it? This test evaluates if there is a significant narrowing or blockage in one of the large coronary arteries (blood vessels that supply blood to the heart) based on the electrocardiogram (ECG) or electrical activity of the heart during exercise. It involves walking on a treadmill with an incline to raise your heart rate. ECG leads are attached and serial ECGs are obtained. Blood pressure is also monitored during exercise. This test can be done both at our Bridgewater office and our Hillsborough office.
  • What is the reason to get this test? Your doctor may order this if you have chest discomfort or pain, shortness of breath, or instances when it is necessary to determine exercise tolerance.
  • How long is the test? Please allow 1-2 hours in the office for this test.
  • How do I need to prepare?
    • Refrain from eating food 4 hours prior to the test. You can drink water up to 1 hour prior to the test. Do not smoke 1 hour prior to the test.

    • You can also still have small sips of water with your medications. However, the following medications SHOULD NOT BE TAKEN the day of your test: Metoprolol or Toprol, carvedilol or Coreg, atenolol or Tenormin, bisoprolol, labetalol, propranolol, nebivolol or Bystolic, Ziac.

    • Wear comfortable clothing and sneakers or shoes you can easily walk in. You will need to remove clothing from the waist up to allow us to connect the ECG leads to your chest. Women can wear a regular bra and loose-fitting T-shirt during the test. Men may need to be shaved on areas of the chest where ECG electrode stickers need to be placed in order for them to adhere better.
  • How long does it take to get results? Your physician can discuss the findings with you immediately after your test. The final report will be completed within a week (results will also be available in MyChart).

Stress Echocardiogram Test

  • What is it? This test evaluates if there is a significant narrowing or blockage in one of the coronary arteries that affects the heart muscle particularly after exercise. Ultrasound images are obtained of your heart at rest while laying down. Then you walk on a treadmill with an incline to reach your target heart rate (based on your age) and to see if you have any symptoms during exercise. Once the target heart rate is reached, you lay down again and ultrasound images are obtained.
  • What is the reason to get this test? Your doctor may order this if you have chest discomfort or pain or shortness of breath.  
  • How long is the test? Please allow 1-2 hours in the office for this test.
  • How do I need to prepare?
    • Refrain from eating food up to 4 hours prior to your test. You can have water up to 1 hour prior to the test.

    • You can still have small sips of water with your medications. However, the following medications SHOULD NOT BE TAKEN the day of the test: Metoprolol or Toprol, carvedilol or Coreg, atenolol or Tenormin, bisoprolol, labetalol, propranolol, nebivolol or Bystolic, Ziac

    • Please shower or bathe the day of the test. DO NOT apply lotion or powder to your chest.

    • Wear comfortable clothing and sneakers or shoes you can easily walk in. You will need to remove clothing from the waist up to allow us to connect the ECG leads to your chest. Women can wear a regular bra and loose-fitting T-shirt during the test. Men may need to be shaved on areas of the chest where ECG electrode stickers need to be placed in order for them to adhere better.

    • Do not smoke 1 hour prior to the test.
  • How long does it take to get results? Your physician can discuss the findings with you immediately after your test. The final report will be completed within a week (results will also be available in MyChart).

Exercise Nuclear Stress Test

  • What is it? This test evaluates if there is a significant narrowing or blockage in one of the large coronary arteries that supplies the heart muscle. The test involves giving a radioactive tracer (Technetium-99m) that is very safe and out of your body after 24 hours (for more information on Technetium-99m – please refer to Technetium-99m information page). The medication is taken up by healthy heart muscle and pictures are taken with a nuclear camera.

    A peripheral intravenous (IV) line will be placed in your arm and the radioactive tracer will be given. Pictures of your heart are taken at rest. You will be given a cup of water while waiting to get your images. Then ECG electrodes are applied to your chest. You will walk on a treadmill and once your heart reaches 85% of your maximum predicted heart rate (calculated by age), we administer the radioactive tracer again. You will be able to eat and drink afterwards. We then take pictures of your heart again. If you are unable to reach your target heart rate during the exercise portion, we can convert the test to a pharmacologic (Lexiscan) nuclear stress test. Information on this test is listed below.

  • What is the reason to get this test? Your doctor may order this if you have chest discomfort or pain or shortness of breath. Additional reasons for this test include evaluating blood flow after a coronary stent placement or after cardiac bypass surgery.
  • How long is this test? Please set aside 3-4 hours for this test.
  • How do I need to prepare?
      • Do not eat any food or drink anything for 6 hours prior to your stress test. If you are having your test in the morning, do not eat anything after midnight the day of your test. You can drink water up until your test.

     

      • Do not smoke, do not have regular or decaffeinated coffee/tea/sodas or caffeinated beverages and do not have chocolate for 24 hours prior to the stress test. If you are having the test done in the office, please bring in a snack or small sandwich that you can have during the test when instructed.

     

      • You can still have small sips of water with your medications before your test. However, the following medications SHOULD NOT BE TAKEN the day of the test: Diabetic medications, Metoprolol or Toprol, carvedilol or Coreg, atenolol or Tenormin, bisoprolol, labetalol, propranolol or Inderal, nebivolol or Bystolic, Ziac. DO NOT take Viagra at least 24 hours prior to the test.

     

      • Please shower of bathe the day of the test. DO NOT apply lotion or powder to your chest.

     

    • Wear comfortable clothing (loose fitting slacks or shorts) and sneakers or shoes you can easily walk in. You will need to remove clothing from the waist up to allow us to connect the ECG leads to your chest. Women can wear a regular bra (but NO metal underwire bras) and loose-fitting T-shirt during the test. Men may need to be shaved on areas of the chest where ECG electrode stickers need to be placed in order for them to adhere better.
  • How long does it take to get results? The final report will be completed within a week days (results will also be available in MyChart).

 

Pharmacologic (Lexiscan) Nuclear Stress Test

  • What is it? This test evaluates if there is a significant narrowing or blockage in one of the large coronary arteries that supplies the heart muscle. The test involves giving a radioactive medication (Technetium-99) that is very safe and out of your body after 24 hours (for more information on Technetium-99m – please refer to Technetium-99m information page). The medication is taken up by healthy heart muscle and pictures are taken with a nuclear camera.

    A peripheral intravenous (IV) line will be placed in your arm and the radioactive tracer will be given. Pictures of your heart are taken at rest. You will be given a cup of water while waiting to get your images. Then ECG electrodes are applied to your chest. For the second portion of the test, we give a medication called regadenoson (brand name is called Lexiscan) that dilates the blood vessels around the heart. This medication may cause you to feel short of breath, dizzy or lightheaded, chest discomfort, or nauseous – these side effects last for about 30 seconds to 1 minute. If these symptoms persist, we can give a medication or caffeinated soda to counteract these effects. You will be able to eat and drink after this part. Then we take pictures of your heart again.

  • What is the reason to get this test? Your doctor may order this if you have chest discomfort or pain or shortness of breath. Additional reasons for this test include evaluating blood flow after a stent placement or after cardiac bypass surgery. This test is for patients who have difficulty walking, a left bundle branch block noted on ECG, or have a pacemaker.
  • How long is this test? Please set aside 3-4 hours for this test.
  • How do I need to prepare?
    • Do not eat any food or drink anything for 6 hours prior to your stress test. If you are having your test in the morning, do not eat anything after midnight the day of your test. You can drink water up until your test.
    • Do not smoke, do not have regular or decaffeinated coffee/tea/sodas or caffeinated beverages and do not have chocolate for 24 hours prior to the stress test. If you are having the test done in the office, please bring in a snack or small sandwich that you can have during the test when instructed.
    • You can still have small sips of water with your medications. However, the following medications SHOULD NOT BE TAKEN the day of the test: Diabetic medications, persantine, dipyridamole, Aggrenox Metoprolol or Toprol, carvedilol or Coreg, atenolol or Tenormin, bisoprolol, labetalol, propranolol or Inderal, nebivolol or Bystolic, Ziac. DO NOT take Viagra at least 24 hours prior to the test.
    • Wear comfortable clothing. You will need to remove clothing from the waist up to allow us to connect the ECG leads to your chest. Women can wear a regular bra (and loose-fitting T-shirt during the test. Men may need to be shaved on areas of the chest where ECG electrode stickers need to be placed in order for them to adhere better.
  • How long does it take to get results? The final report will be completed within a week (results will also be available in MyChart).

Coronary Calcium CT

  • What is it? This test is a CT scan of your heart to assess if any calcified plaque is present in the coronary arteries around your heart. The test does not require any medication. It can be done at RWJ Somerset Hospital or University Radiology centers.
  • What is the reason to get this test? Your doctor may order this to screen for coronary artery disease if you have risk factors or strong family history of heart disease. It can also help us decide if you may need to take a medication to lower your cholesterol or a baby Aspirin. The test can help us assess your risk for having a heart attack in the future.
  • How long is this test? Please budget one hour for this test.
  • How do I need to prepare?
    • Do not have coffee, chocolate, tobacco/smoke 6 hours prior to your exam.
    • Do not exercise 24 hours prior to your test.
    • You can take all your medications as prescribed on the day of your test.
    • Please wear comfortable clothing without metal snaps, buttons or zippers. Jewelry and other metallic accessories should not be worn if possible.
  • How long does it take to get results? The final report will be completed within a week (results will also be available in MyChart).

Coronary CT Angiogram

  • What is it? This test is a CT scan of your heart to assess if there is any calcified or non-calcified plaque in the coronary arteries around your heart. It can also help assess if there is a significant narrowing or blockage in the arteries. Sometimes this test is ordered with the coronary calcium CT. This test requires giving iodine contrast through a peripheral intravenous (IV) line. It also may require giving medications that lower the heart rate to allow for the technicians to get better images of the heart. The test can be done at RWJ Somerset Hospital or RWJ New Brunswick Hospital, Morristown Medical Center or University Radiology Centers.
  • What is the reason to get this test? Your doctor may order this if you have chest discomfort or pain or shortness of breath. Another reason may be for further evaluation after an abnormal stress test and also to assess if there are abnormalities in the anatomy of the coronary arteries.
  • How long is this test? Please budget 2-4 hours for this test
  • How do I need to prepare?
    • You may need blood work checking your kidney function within 30 days of your test date (because contrast is used for the test that is cleared by the kidneys). Your doctor will order the blood work if needed.
    • Please do not eat any food 4 hours prior to your appointment time. Do not smoke 6 hours prior. You may drink clear liquids within 2 hours of your appointment (e.g. water, apple juice, or broth).
    • Do not have caffeine (coffee, tea, chocolate, or caffeinated beverages) for 24 hours prior to your test.
    • You can still take your prescribed medications but DO NOT take diabetic medications.
    • DO NOT take erectile dysfunction medications for 72 hours prior to your appointment and for 24 hours after the test.
    • DO NOT exercise on the day of your test.
    • Please arrive one hour prior to your appointment time and bring a list of all of your medications (including herbal supplements and over-the-counter medications) you are currently taking.
    • Wear comfortable clothing without metal snaps, buttons or zippers. Jewelry and other metallic accessories should not be worn if possible.
    • If you have asthma, bring your inhaler with you to the test and if you are on dialysis, please make sure your next dialysis session is scheduled within 24 hours of the test.
  • How long does it take to get results? The final report will be completed within a week (results will also be available in MyChart).

Left Cardiac Catherization

  • What is it? This is a test that looks directly at the coronary arteries around the heart to see if there is a significant narrowing or blockage present. For the test, medications are given that make you sleepy and comfortable. Local anesthesia is applied around the radial artery in your wrist. A small catheter and wire is then inserted into the radial artery that travels up to the blood vessels around your heart. Contrast dye is injected and we use X-rays to visualize the blood vessels around the heart. If we are unable to reach the heart through the radial artery in the wrist, we then go through the femoral artery in the groin. Both groin areas are shaved and cleaned prior to starting the test in the event we may have to access the femoral artery. If we see a significant narrowing or blockage, we may place a stent to help improve the blood flow.

    If we use the radial artery during the procedure, you will have a band around your wrist for a few hours to stop the bleeding at your wrist. A nurse will gradually take air out of the band and make it less tight as the bleeding resolves.

  • What is the reason to get this test? This test is recommended if you have a significant abnormality on a stress test or significant narrowing in a coronary artery seen on a CT scan, especially also if you have symptoms of chest discomfort or shortness of breath. It is also commonly performed if you are found to have a weak heart based on echocardiogram results. Furthermore, this test is done emergently if you are having a heart attack that suggests there is a complete blockage in one of the coronary arteries.
  • How long is this test? The length of this test depends on if there is a blockage present or not. If there is no blockage, then the test may last up to 1 hour. If there is a blockage and stents are placed, the test may take up to 2 hours. Depending on how the procedure goes, you may be able to leave after 4-6 hours. In some cases, you may be monitored in the hospital overnight. You will need someone to drive you home.
  • How do I need to prepare?
    • Do not eat any food 8 hours prior to your procedure. If you have an early morning appointment, do not eat any food after midnight. You can drink water up to 4 hours prior to your procedure.
    • You can take your medications with a sip of water including Aspirin and Plavix
    • DO NOT take any diabetic medication. Stop taking Metformin (Glucophage) 24 hours prior to procedure.
    • You must stop taking Coumadin (Warfarin) at least 4 days prior to procedure.
    • You must stop taking Xarelto, Pradaxa or Eliquis 48 hours prior to procedure.
    • Wear comfortable clothing that you can easily remove. You will have to remove your clothes including your undergarments and put on a patient gown.
    • Do not smoke starting the evening prior to the test.
    • Arrive at the hospital 1.5 hours before your appointment.
    • Bring someone with you who can drive you home from the hospital given you will receive sedative medication during the test.
  • How long does it take to get results? Your physician can discuss the findings with you during and immediately after your test. The final report will be completed within a week (results will also be available in MyChart).

Right Cardiac Catheterization

  • What is it? This test measures the pressures in the right side of the heart and blood vessels in the lungs. It is used to assess if there is pulmonary hypertension or elevated pressures in the lungs and also evaluates if there are elevated pressures in the heart, which can help us decide what treatments to give.
  • What is the reason to get this test? Your doctor may order this test if you have shortness of breath or signs of pulmonary hypertension seen on an echocardiogram. The test also is used to determine if you have fluid retention due to the heart alone.
  • How long is this test? This test may take up to 1 hour depending on the findings.
  • How do I need to prepare?
    • Do not eat any food 8 hours prior to your procedure. If you have an
      early morning appointment, do not eat any food after midnight.
    • You can take your medications with a sip of water including Aspirin and Plavix.
    • DO NOT take any diabetic medication. Stop taking Metformin (Glucophage) 24 hours prior to procedure.
    • You must stop taking Coumadin (Warfarin) at least 4 days prior to procedure.
    • You must stop taking Xarelto, Pradaxa or Eliquis 48 hours prior to procedure.
    • Wear comfortable clothing that you can easily remove. You will have to remove your clothes including your undergarments and put on a patient gown.
    • Do not smoke starting the evening prior to the test.
    • Arrive at the hospital 1.5 hours before your appointment.
    • Bring someone with you who can drive you home from the hospital given you will receive sedative medication during the test.
  • How long does it take to get results? Your physician can discuss the findings with you during and immediately after your test. The final report will be completed within a week (results will also be available in MyChart).

Holter Monitor

  • What is it? This test monitors your heart rhythm over a certain period of time. It involves placing a small patch on your chest and is used to assess if you have an abnormal heart rhythm.
  • What is the reason to get this test? Your doctor may order this test if you have palpitations, dizziness, low heart rate or high heart rate, history of fainting or history of a stroke.
  • How long is this test? The duration of this monitor can vary. Depending on your symptoms and condition, your physician may order a Holter monitor that lasts for 24 hours, 48 hours, 72 hours, or 5 days. There are also longer term monitors that last up to 3 weeks.
  • How do I need to prepare?
    • The Holter monitors are placed in our office – this takes about 15 minutes. Please wear comfortable clothing when you come in for a Holter placement. DO NOT apply any lotion or oils on the chest area the day of the appointment.
    • While wearing the Holter, you can shower with the monitor facing away from the shower head. It cannot be submerged in the pool or bath.
    • The longer-term monitors (that last up to 3 weeks) are mailed to your home with instructions on how to put on. You can remove the monitor when you shower.
  • How long does it take to get results? Within 1 week. If there is a critical finding on the longer-term monitor while you are wearing it, the physician gets notified in real time and the office will reach out to you.

Implantable Loop Recorder

  • What is it? This is a device that can record your heart rhythm for up to 3-6 years. It is used to assess for an abnormal heart rhythm that may be highly suspected but not picked up on a Holter monitor. It is placed just under the skin in the middle of the chest, and can be removed once the battery is dead.
  • What is the reason to get this test? This procedure is done in patients who have persistent palpitations, history of fainting with no clear cause or history of a stroke and no evidence of an abnormal heart rhythm on the Holter monitor.
  • How long is the test? The procedure to place and remove the loop recorder takes about 30 min.
  • How do I need to prepare? Wear comfortable clothing. You will need to remove your clothing including undergarments and wear a patient gown.
  • How long does it take to get results? We will be able to check your heart rhythm when you come into the office. The heart rhythm can also be monitored remotely and results will be sent to our office monthly. We will also receive results if you report symptoms that could be due to an abnormal heart rhythm or if you have an abnormality in your heart rhythm.

Transesophageal Echocardiogram (with or without electrical cardioversion)

This can be performed at RWJ University Hospital Somerset

  • What is it? This is an ultrasound of your heart but instead of the ultrasound probe being placed on your chest to obtain images, it is on a small tube that goes into your esophagus (similar to an endoscopy). You are given medications by an anesthesiologist that make you go to sleep and the ultrasound probe is then placed. Ultrasound images of your heart are obtained.
  • What is the reason to get this test? This procedure is done to evaluate if there is an infected heart valve or to obtain additional information about a valve abnormality that may have been seen on the transthoracic echocardiogram. This procedure is also ordered for an abnormal heart rhythm such as atrial fibrillation or atrial flutter if we plan to shock the heart to get it back into a normal rhythm (called electrical cardioversion). We must first make sure there is no blood clot in the heart before the heart is shocked. If you are getting an electrical cardioversion, adhesive pads are placed on the front of the chest and back to deliver the shock.
  • How long is the test? Please budget 3 hours for this test.
  • How do I need to prepare?
    • Do not eat any food 8 hours prior to the test. If you have an early morning appointment, do not eat any food after midnight. You can take your medications with small sips of water however DO NOT take diabetic medications the morning of your procedure and DO NOT take Wegovy/Ozempic within 1 week prior to your procedure.
    • Arrive one hour prior to your procedure.

    • Wear comfortable clothing that you can easily remove. You will have to remove your clothes including your undergarments and put on a patient gown.

    • Bring someone with you who can drive you home from the hospital. You will receive sedative medication during the test that could impact your ability to drive right afterwards.
  • How long does it take to get results? Your doctor can discuss the results right after the test once you are awake. The finalized report will be done within a week (results will also be available in MyChart).

Electrical Cardioversion

 

  • What is it? This is a procedure where an electric shock is delivered to the heart to convert the heart back to a normal rhythm if it is in an abnormal rhythm, most commonly atrial fibrillation. Adhesive pads are placed on the front of the chest and back to deliver the shock. You are given anesthesia and are asleep during this procedure. Often, we perform a transesophageal echocardiogram (described above) first to make sure there is no blood clot in the heart that could form when someone is in atrial fibrillation, especially if not on a blood thinner medication.
  • What is the reason to get this test? This procedure is done most commonly for patients in atrial fibrillation with elevated heart rates that are difficult to control with medications, if with symptoms such as palpitations or shortness of breath, or if the heart is weak due to an abnormal heart rhythm. This procedure is also done emergently if someone has an abnormal heart rhythm and low blood pressure with difficulty managing on medications alone.
  • How long is the test? Please budget 3 hours for this test.
  • How do I need to prepare?
    • If your test is in the morning, do not eat or drink after midnight. If your test is in the afternoon, do not eat or drink for 8 hours prior to your procedure. You can take your medications with small sips of water however DO NOT take diabetic medications the morning of your procedure.
    • Arrive one hour prior to your procedure.
    • Wear comfortable clothing that you can easily remove.
    • Bring someone with you who can drive you home from the hospital given you will receive sedative medication during the test that could impact your ability to drive right afterwards.
  • How long does it take to get results? Your doctor can discuss the results right after the test once you are awake. The finalized report will be done within a week (results will also be available in MyChart).

PYP Scan

  • What is it? This is a nuclear scan of the heart that helps diagnose a rare disease called cardiac amyloidosis. Cardiac amyloidosis occurs when a certain protein molecule in our body becomes deformed and aggregates together forming amyloid fibrils that can deposit into organs including the heart. Patients who have this disease are at risk for heart failure. For the test, the technician will inject a small amount of Tc99m-PYP (radioactive tracer) into a vein in your arm through an IV. About an hour later, you will lie on your back on an exam table.   The radioactive tracer will be picked up by a special camera that will take two types of pictures that will help provide a 3-dimensional image of your heart structure.
  • What is the reason to get this test? This test is done to diagnose a special type of cardiac amyloidosis called transthyretin amyloidosis or TTR-amyloidosis. Your doctor will order this test if there is a suspicion of this disease based on echocardiogram results and/or symptoms including shortness of breath, dizziness/lightheadedness, leg swelling, or history of certain medical conditions including bilateral carpal tunnel syndrome.
  • How long is the test? Please budget 3 hours for this test.
  • How do I need to prepare? Wear comfortable clothing.
  • How long does it take to get results? The results are reported by a radiologist and the finalized report will be done within a week (results will also be available in MyChart).

Cardiac MRI

This test is done at RWJ New Brunswick Hospital

 

  • What is it? Magnetic resonance imaging or MRI uses radio waves and magnetic fields to generate images of the body. A cardiac MRI looks at the structure and function of the heart specifically. You will be given a contrast medication called gadolinium through a peripheral IV line in the arm. This is different than iodine contrast. ECG leads will also be placed on your chest for the test.
  • What is the reason to get this test? This test is recommended if you have a weak heart with no clear cause or to further evaluate certain congenital abnormalities that may be seen on an echocardiogram. It can be used to diagnose inflammation in the heart muscle (myocarditis) if suspected and assess the amount of healthy heart muscle tissue in cases where we may be deciding to place stents.
  • How long is the test? The test itself may last 30 min to 1.5 hours. Depending on where you have the test done, you will be given specific instructions on the timing of the test.
  • How do I need to prepare? Wear comfortable clothing, you will likely need to change into a patient gown for the test. You do not need to fast. You will need to remove all jewelry or any metal objects prior to the test. If you have any metal implants or objects inside of your body, you may need to check ahead of time if they are safe for an MRI. Most dental metal implants are safe for MRI but it is best to confirm with your dentist. Coronary stents are safe. Loop recorders and more recent pacemaker and defibrillator devices are also safe for MRI however we can confirm ahead of time with the companies to make sure they are safe.
  • How long does it take to get results? The results are reported by a radiologist and finalized report will be done within a week (results will also be available in MyChart).