Holter monitoring is a method of recording your heartbeat or electrical activity for a full 24 hour period, in an effort to determine if your heart rhythm has any abnormalities. As with the standard EKG, electrodes are placed on the chest. The electrodes connect to a lightweight unit, which attaches to a belt or shoulder strap. While wearing the monitor you are instructed to keep a diary of activities that you perform and the time of day that the activities occur. This will assist your doctor in determining if any of the irregularities in your EKG are related to physical exertion, emotional stress, etc.

Cardiac catheterization is a non-surgical procedure that assists your doctor in diagnosing a heart problem. To perform the procedure, your cardiologist inserts a long, flexible tube called a catheter, into a blood vessel in your arm or groin area. The catheter is gently guided through the blood vessel to your heart. Once the catheter is in place, x-ray pictures and other readings are taken to help your doctor evaluate how well your heart is working.

The information gathered during the cardiac catheterization can help to identify narrowed arteries in the heart, heart valve problems, or abnormalities in the structure of the heart (usually something a person is born with). During the procedure the doctor can view the blood flow through the arteries that feed the heart, the pumping action of the heart muscle, the opening and closing of each heart valve, and various pressure readings inside the heart structure. The data collected during this procedure are used to help the doctor make the best possible treatment recommendations for abnormal heart conditions.

A dobutamine stress test uses the drug (dobutamine) to make your heart beat faster, as if you were exercising. After this drug is injected, an echocardiogram test is performed to image your heart. Viewing the echocardiogram while the heart is under stress helps to determine if certain portions of the heart muscle are not getting enough blood supply. See ECHOCARDIOGRAM for more information about how the sound wave images are produced.

An echocardiogram is a test that uses harmless sound waves to create an image of your heart. It shows how well your heart muscle and heart valves are working. It also shows the size of your heart. The image of your heart is created via a transducer device that looks like a microphone. The transducer is coated with a cool gel and is moved firmly over the surface of your chest to record sound waves off your heart. A computer then changes these sound waves into images that are seen on a TV screen.

The electrocardiogram is a test that will record the electrical impulses of the heart's activity through electrodes placed on the chest, shoulders, and legs. These electrical impulses stimulate the heart to pump. If abnormalities in the impulses occur, the heart may beat irregularly or the appearance of the EKG may change shape. The information gathered from this simple test provides much preliminary data for the doctor, that will assist in diagnosing a potential heart problem or in determining what additional testing is needed to make an accurate diagnosis.

Electrophysiology (EP) studies help your doctor to determine the exact type of heart rhythm distrubance (abnormality in the speed or pattern of your heartbeat) you have. During the EP study one or more small flexible tubes (electrode catheters) are inserted in the groin or neck vein and gently threaded into the heart. The electrode catheters record electrical activity in the heart and find where and when these electrical signals begin and how often they are sent.

The electrode catheter can also send electrical signals to stimulate the heart. If these signals cause an abnormal heart rhythm (arrhythmia), medications can given through an IV line to test if they can stop or prevent the arrhythmia from occurring. Arrhythmias can also be stopped by using electrode catheters to regulate (pace) the heartbeat. In some cases an electric shock (defibrillation) is needed to stop the arrhythmia.

An exercise stress test records your heartbeat while you walk on a treadmill. The test is often used to evaluate the cause of chest pain. In addition, the test can also evaluate maximum exercise tolerance and/or the effectiveness of medical therapy for a heart condition. During the test electrode pads are placed on your upper body to monitor your heart. The exercise test starts at a low intensity and gradually gets harder until you have reached your maximum tolerance.

Positron emission tomography has the ability to measure chemical changes that occur in the body as a result of many disease processes. The application of PET in heart patients involves the analysis and location of heart muscle viability as well as coronary blockages. Analysis of the viability of the muscle tissue is very important information when a doctor is in the process of determining the best treatment for a patient with heart muscle damage, after a heart attack. Attempting to increase blood circulation (via angioplasty or bypass surgery) to a portion of the heart muscle that is dead (not viable) is useless. PET therefore provides the information necessary to determine which areas of the heart muscle would benefit from this type of intervention.

The nuclear stress test is similar to a regular stress test in that your heartbeat is recorded while you walk on a treadmill, to a maximum exercise level. See EXERCISE STRESS TEST for more information. In addition, this test involves injecting an intravenous (IV) tracer, then stopping the exercise and immediately scanning the heart. Pictures are taken immediately after exercise and then several hours later in order to determine how well the blood flows to each region of the heart muscle.

Transesophageal Echocardiography is a test that allows your doctor to record images of your heart from inside your esophagus, or food pipe. The esophagus lies just behind the heart, therefore viewing heart images from this position produces clearer pictures of the heart's movement, than does standard echocardiography taken from outside the chest. During TEE, as with standard echo, harmless sound waves bounce off your heart. The images created with these sound waves help your doctor to identify and treat problems such as infection, disease, or defects in your heart's walls or valves.