If I need to have a cardiology consult, what is involved ?

alex · 04-10-2008, 01:27 AM

This depends on what your surgeon requires. Some of the more common tests include:

EKG/ECG: This is an electrocardiogram. The technician attaches leads to both legs at the ankle area and both arms at the wrist area. Six leads are attached to the front of your chest; one to either side of the breast bone (sternum) and four around the left side of the chest at the level of the breast. This is a diagnostic test that will tell the cardiologist if further testing is needed. It takes just a few minutes and is painless.
ECHOCARDIOGRAM: This is a test that evaluates how well your heart muscle is functioning and also looks at the valves of your heart. Most commonly, you lie on your left side while the cardiologist puts a water soluble lubricant on the end of a transducer (just like a sonogram). He/she will move the transducer around while looking at the image that is transmitted to the machine. The test takes about 15 minutes or so and you might experience a little discomfort when the MD presses down on the transducer.
STRESS TEST: If your cardiologist/surgeon wants a stress test you can expect that you’ll have an echocardiogram also because the stress test is usually done the same day as the echocardiogram. Some cardiologists want you NPO (nothing by mouth) after midnight while others allow you to eat a light breakfast. Expect to be given a list with foods and medications that are to be stopped one to three days before the stress test. You’ll be told to wear comfortable clothes and sneakers. When you arrive for the test, an IV will be started and medication will be given via this line for the two parts of the test. You’ll be hooked up to EKG/ECG leads as well. The procedure involves a relaxation part where you lie under a machine that scans your chest area and an exercise part where you walk on a treadmill that gradually increases in speed and incline. You’ll be scanned just as in the first part. The test is painless but can take up to 4 hours to complete. During the test, a cardiologist is present who reads your EKG/ECG and watches for irregular heartbeats (arrhythmias). If you have chest pain or feel faint, the test will be stopped.
NON-STRESS/NON-EXERCISE STRESS TEST: This test, and the preparation for it, is the same as the regular stress test only you will NOT exercise on the treadmill. The relaxation phase is the same as with the stress test but instead of walking on the treadmill for the second part, the cardiologist will inject a medication into your IV line that will mimic exercise and will make your heart beat faster. As with the stress test, the MD will be present to monitor your EKG/ECG for any changes. The x-ray scanning is the same as with the stress test.
DOPPLERS: If you have poor circulation to your legs/feet, poor pulses, or a lot of swelling (edema) in the lower extremities, the cardiologist might want to schedule dopplers of the legs. They can also be done on the carotid arteries in your neck. Dopplers can be venous or arterial and are done just like a sonogram. The technician will apply a water soluble lubricant to a transducer and press down to find the pulses in your legs. The pulses are in your groin, along the inner thigh, behind the knee area, and on the top of your foot. There is no preparation for this test and you’ll hear a swishing sound when the pulse is found. This test looks for blockages in the circulation and takes about 30 minutes.