EKG / Electrocardiogram
The electrocardiogram amplifies and records the tiny electrical signal which your heart makes with each beat. It is a simple non invasive test

Echocardiogram
This 'sonar' study is a safe and painless test which uses a handheld ultrasound probe which is applied to your chest to make pictures of the heart valves and chambers, identifying abnormal structures and function of your heart. Here at Primary Care Cardiology we offer the latest equipment and skilled technologists that are highly trained in cardiac echocardiography. Each test is expertly interpreted by Dr. Hack himself, along with your chart and any previous echocardiograms that have been done in our office. This allows the diagnoses process to be accurate to your specific case. Please note that we are proud to announce that our lead technician Martha Hanright RDCS has been granted certification by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL).

Stress Testing
We offer several different types of stress testing. The type of stress test you receive will depend on your current physical condition as well as any medical factors.

• Exercise Tolerance Test (ETT) During an ETT a trained professional will monitor your EKG while you walk on a treadmill with varying speeds and inclines.
• The Nuclear Stress (Myoview) test is like an ETT monitored treadmill test with the added component of a radioisotope injected through an intravenous line. The radioisotope is injected at the peak of exercise on a treadmill, followed by images taken by a special camera. This test combines exercise and nuclear imaging to evaluate the blood flow to your heart muscle and heart muscle function.
• Pharmacologic stress testing or 'chemical stress test' is prescribed for individuals who can’t or shouldn’t walk on the treadmill. There are two types of Pharmacologic stress testing.
  • Persantine or Adenosine Myoview Stress Testing again uses nuclear imaging to evaluate the blood flow and function of your heart. This testing also identifies blockages in the coronary arteries. The medication persantine causes the coronary arteries to dilate and simulates the effects of exercise.
  
  
  • Dobutamine Stress Echocardiogramis a test done for our patients that not only can’t or shouldn’t walk on a treadmill, but also suffer from lung disease which may be worsened with Persantine stress testing. This test is done with an infusion of Dobutamine which once again mimics exercise. The heart is visualized through echocardiogram images before, during and after the infusion to evaluate any weaknesses in the heart muscle.

Microvolt T-Wave Alternans Testing
This is a simple test that determines if you are at risk for sudden cardiac death. It is a noninvasive test which takes about 30 minutes. During the test, patients walk gently on a treadmill, while certain aspects of their heart rhythm are monitored with a special EKG machine. Unlike a standard stress test, there is no running involved. The information provided by the test can help physicians determine who is at risk for sudden cardiac death. This test can be done for patient with or without a pacemaker.

Pacemaker Monitoring
For those patients that have an implanted pacemaker and or defibrillator can be checked with a simple 20 minute office visit. It is important to check our patients on a regular basis to accurately track the function of your device.

Event Monitor
This is a small device which attaches to the chest wall by two patches. These can be changed whenever you want, and the device is usually worn for 1-4 weeks. When you have a symptom, you activate the monitor and send us your EKG over the telephone. Hookup and instruction require about 45 minutes.

Holter Monitoring
Here at Primary Care Cardiology we have several types of heart monitoring that can be done. Our standard 24 hour recorder consists of 5 EKG leads placed on your chest and connects to a small recorder which can be worn like a beeper on your belt or a shoulder strap if you prefer. Every heart beat is recorded for 24 hours. This, combined with a patient diary of symptoms, is very helpful in determining the cause of palpitations, lightheadedness, and fainting as well as several other symptoms you may be experiencing.

Event Recording
While similar to holter monitoring, event recording monitors your heart for 21 days consecutively. The two electrodes can be removed daily for bathing. We utilize event recorders that can either automatically detect abnormalities, or ones which require the user to record an episode based on their own symptoms. Event recorders are monitored at an off-site facility where trained technicians are on duty 24 hours a day to monitor your heart rhythm for abnormalities. This is a very useful tool in diagnosing more serious arrhythmias.

Anticoagulation Therapy
Coumadin (warfarin) is an effective medication which prevents blood clotting in patients for whom blood clots may cause injury. Patients with artificial heart valves, rhythm abnormalities such as atrial fibrillation and flutter and blood clots in large veins in the body are often managed with this medication. Our staff helps manage the safe dosing of Coumadin by closely following a blood test called the International Normalized Ratio (INR). Our policy includes INR checks every 2 weeks or more frequently if needed for the patients safety. Our nursing staff takes a simple finger stick which gives an immediate INR result and the accurate dosing is given on the spot along with another appointment time that is convenient for you to come back for your next INR check. We offer as much Coumadin education that is needed for the patient to feel comfortable with this drug.

Carotid Ultrasound (CNI)
This is a painless and harmless test that uses high-frequency sound waves to create images of the insides of the carotid arteries on either side of your neck. It is important to assess these arteries for plaque in order to assess your risk for a stroke.

Abdominal Aortic Ultrasound
This is a painless and harmless test that uses high-frequency sound waves to view the abdominal aorta. This is the large blood vessel (artery) that passes down the back of the chest and abdomen. We use this test to rule out abdominal aortic aneurysms.