Non-Invasive & Diagnostic Cardiovascular Services

Stress-testing measures heart and
blood vessels' response to increasing
exertion.

Medical, or non-invasive, Cardiology, deals with the diagnosis and non-surgical treatment of heart conditions including angina, congestive heart failure, acute myocardial infarction and other related conditions.

Diagnostic testing is a requirement in evaluating risk and determining heart disease severity. All services are offered at both campuses, with the exception of the Tilt Table, which is only offered at Chippenham.

DIAGNOSTICS OFFERED AT CJW

EKG & Signal Average EKG

Holter Monitoring

Transthoracic or Intraoperative
Echocardiogram

Transesophageal Echocardiogram

Nuclear Cardiology

Tilt Table Studies

Cardioversion

Exercise Stress Testing to ECG

For descriptions of the tests and non-invasive cardiovascular procedures, see below. All diagnostics and non-invasive treatments are offered at both campuses with the exception of the Tilt Table Testing which is offered at Chippenham's Levinson Heart Hospital only.

EKG & Signal Average EKG
Electrodes (small, plastic patches) are placed at certain locations on the chest, arms, and legs. It measures the electrical activity of the heart so it can be interpreted, and printed out for the physician's information and further interpretation.

A signal-averaged electrocardiogram is a more detailed type of ECG. During this procedure, multiple ECG activities are obtained over a period of approximately 20 minutes in order to capture abnormal heartbeats which may occur only intermittently. A computer captures all the electrical signals from the heart and averages them to provide the physician more detail regarding how the heart’s electrical conduction system is working.

Echocardiogram (also called echo)
An echocardiogram is a test in which ultrasound is used to examine the heart. Sometimes an echocardiogram or a nuclear test is done in conjunction with the stress test which offers added information to help diagnose coronary heart disease. Echocardiography has the following benefits: clearer delineation of the size of the heart chambers, evaluation of collateral flow and improved assessment of infarction (heart attack) size.

We operate two full service special procedure/stress labs, one each on the Chippenham and Johnston Willis campus. These labs specialize in the performance of cardiovascular testing across the spectrum from ECG through echocardiography. 

Holter Monitoring
The Holter monitor is a recording device that has a strap you wear over your shoulder or around your waist. It is battery-powered and holds a regular-sized cassette tape, much like one you would use in an audio tape player. The monitor has 5 to 7 wires called leads which attach to metal disks called electrodes, which you wear on your chest. These electrodes are very sensitive, and can pick up the electrical impulses of the heart. The impulses are recorded by the Holter monitor and give your doctor a 24-hour record of your heart's electrical activity.

Transesophageal Echocardiogram
This test allows the cardiologist to view the internal structures of the heart and the heart's major vessels by inserting a a thin flexible tube with a special tip down the esophagus.

Stress Test
Testing the heart during activity is often more revealing than a test conducted at rest. A stress test may be recommended to help diagnose heart disease, to evaluate cardiovascular physical fitness and to measure the heart's response to medical or interventional treatments. 

Tilt Table Studies
Only offered at our Chippenham Campus, a Tilt Table Study is used to check for changes in heart rate and blood pressure when your body's position is changed. This test is most commonly done when a person has periods of losing consciousness or nearly fainting. 

Transthoracic or Intraoperative Echocardiography
Echocardiography is a diagnostic test that uses high frequency ultrasound waves to produce a picture of the heart. In transthoracic echocardiography, a transducer that emits sound waves is placed on the chest in the area of the heart. “Transthoracic” means “through the chest.” Also called simply echocardiography.  

Cardioversion
This is a brief procedure where an electrical shock is delivered to the heart to convert an abnormal heart rhythm back to a normal rhythm. Most elective or "non-emergency" cardioversions are performed to treat atrial fibrillation or atrial flutter, benign heart rhythm disturbances originating in the upper chambers (atria) of the heart. Cardioversion is used in emergency situations to correct a rapid abnormal rhythm associated with faintness, low blood pressure, chest pain, difficulty breathing, or loss of consciousness.

Nuclear Cardiology
Nuclear cardiology studies use noninvasive techniques to assess myocardial blood flow, evaluate the pumping function of the heart as well as visualize the size and location of a heart attack. A PET scan is one example of a nuclear cardiology study.