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Cardiac consultation

An opportunity for patients to talk about their individual cardiac concerns, including current symptoms, personal risks, and lifestyle habits.

Cardiovascular consultation is the first step to ensuring better health for your heart. It is usually requested by your primary care physician or another specialist seeking more information from a provider specialized in cardiovascular medicine. This consultation may be for many different reasons, such as exploring a known diagnosis, treating an unknown diagnosis with new symptoms, managing a chronic condition, for a pre-operative cardiac clearance, or for a second opinion.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.

Electrocardiogram (ECG/EKG)

It is done routinely in patients who complain of chest pain, palpitations, dizziness, or shortness of breath. This non-invasive, quick, and easy test determines heart rate, irregularities in rhythm, and also identifies a heart that is enlarged or damaged. Electrodes are placed on your chest and legs which captures electrical signals of your heart and records it to paper.

Echocardiogram

It uses sound waves to create images of the heart, recorded on a computer. The images determine the size of the heart, strength of the heart muscles, presence of heart diseases, and heart valve malfunctions.

Stress testing

Determines the functioning of the heart under stress. You will be asked to walk on a treadmill or you will be given a medication to “stress” your heart while images are being taken of you heart. It is mainly done to detect the cause of chest pain, shortness of breath, rapid heartbeat, or fluttering in the chest.

Diagnostic heart catheterization

It is commonly done for patients who have signs of coronary artery disease. X-ray images examine the blood vessels or chambers of the heart for plaque or other problems. A catheter (thin, flexible tube) is inserted into the blood vessels in the upper thigh and moved to the heart. A contrast dye is then injected into the blood to make the blood vessels visible.

How do I prepare?

Transfer your previous medical records

Providing your previous medical records helps us become completely informed about your current health status. You can request to have your medical records sent directly to our office prior to your appointment or you can bring them with you on the day of your appointment.

Arrive early

We recommend you arrive at least 15 minutes prior to your appointment so you have time to complete any necessary patient forms.

Bring your current health insurance card and picture ID

Always bring your current health insurance card to your appointments along with a government-issued identification card such as a driver’s license. Please let the registration staff know if your insurance has changed or any personal information.

List your current medications

It is important to your care to have a list of your current prescriptions and any over-the counter-medications you are taking. Your cardiologist will review the list and make any necessary adjustments based on your current diagnosis and symptoms.

Prepare questions

Be prepared to ask questions and voice any concerns you have. It is important to us to hear from you, and also provide you with information to help you make healthy lifestyle choices.

Cancelling or rescheduling an appointment

If you need to cancel or reschedule your appointment, please contact one of our offices at least 24 hours before your appointment.


Pre-operative evaluation

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Electrophysiology consultation

Designed for the diagnosis and treatment of disturbances in the electrical activity of the heart.

The Heart Center of Nevada electrophysiology department is overseen by specialized cardiologists who have undergone extensive education and training in the diagnosis and treatment of cardiac electrical disorders.

What is electrophysiology?

A normal heart rhythm is dependent on a healthy electrical system of impulses from one part of the heart to the other. These impulses cause the heart to contract and relax, pumping blood to the body and vital organs. Disturbances in this electrical system may cause the heart to beat too fast, too slow, or beat irregularly (arrhythmia). You may have symptoms like palpitations, dizziness and even fainting. These symptoms could indicate the need for additional testing.

What can I expect?

Your doctor will discuss any current symptoms you are having, along with any risk factors or lifestyle habits that could be contributing factors. Further testing such as a tilt table test and electrophysiology studies may be suggested as a way to make a clear diagnosis. Based on results of these tests, your doctor could recommend the insertion of a pacemaker or defibrillator, cardioversion or even a cardiac ablation of the part of the heart anatomy that is malfunctioning.

Please call any of our offices if you have been referred to HCN for an electrophysiology consultation or have any questions.

Main Office: (702) 384-0022


Device (pacemaker and defibrillator) interrogations

Serve to help with early detection of any issues before they become problems.

Your pacemaker or defibrillator has the ability to communicate through the skin with a special computer we have in the office. We perform an interrogation of the device by placing a wand over your chest where the device is located. It takes only 10 or 15 minutes. Please call any office to schedule an appointment. Be sure to tell the technician what type of implanted device you have.

Why do I need it?

After a device is implanted, it needs to be monitored regularly. We routinely evaluate the programming of your device and confirm that the battery and wires (leads) are functioning appropriately and meeting your needs.

How is it done?

One of our trained technicians will place a wand over your device that is linked to a special computer. When the computer and the device communicate, valuable information can be obtained from the memory of your device and we can change the programmed settings if needed.

Typically we start by evaluating the remaining lifespan of the battery and we can usually give you some idea about how long the battery will last. We test the function of the leads and make sure they conduct electricity both to and from your heart. We can also modify the programmed parameters to better suit your heart’s individual needs. If you have any questions or concerns about your pacemaker or defibrillator please bring them up and we can address them.

How do I prepare?

No preparation is needed. In the office, our staff will have the necessary equipment to check your pacemaker or defibrillator. At home, you will also have special equipment to transmit tracings over the phone.

Are there risks involved?

It is a very quick and safe procedure with little or no risk. You may feel some mild lightheadedness with the interrogation and testing of your device.


Heart rhythm monitoring

What is it?

Cardiac arrhythmia is one of the common heart disorders and is a condition of an irregular rhythm or heart beat. A slow heart rate is called bradycardia and a fast heart rate is known as tachycardia. The common symptoms of heart rhythm problems include palpitations, dizziness, and loss of consciousness. To assess the impaired cardiac rhythms various rhythm monitoring procedures are used, including:

Holter Monitor

Holter monitor is a portable ECG recorder that can be worn throughout the day. Electrodes are placed on your chest, electrical signals from the heart are recorded and stored in the Holter monitor. You will be advised to note down your activities and symptoms such as rapid heartbeats, dizziness or fainting episodes. After the test is complete, the Holter monitor is connected to a special computer that can analyze the recording.

Event Monitor

This device is similar to a Holter monitor and is worn during normal daily activities. It is worn for a longer period and is used to monitor arrhythmias that are less frequent. Electrodes are placed on to your chest and wires from the electrodes are attached to a box which is worn on the belt. When symptoms are felt, a button should be pressed which activates the recorder. The monitor will record the events that occur 60 seconds before the button is pressed to about 40 seconds after the arrhythmia.


Lead management

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Abdominal aortic aneurysm screening

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


VASCULAR ULTRASOUND (venous and arterial ultrasound)

What is vascular ultrasound?

A vascular ultrasound provides images of the arteries or veins throughout the body. The most common reason for a venous ultrasound is to search for blood clots, especially in the veins of the leg. This condition is known as Deep Vein Thrombosis (DVT). These blood clots can break off and move into the lungs, where they can cause a dangerous condition called pulmonary embolism. If the blood clot is found early enough, treatment can be started to prevent it from moving to the lung. An arterial ultrasound is used most often to detect the presence and location of peripheral arterial disease (PAD), narrowing of the arteries supplying the legs.

A vascular ultrasound study can also be performed to:
  • Locate and identify blockages and abnormalities in veins and arteries.
  • Determine the cause of leg swelling. In people with varicose veins, the valves that keep blood flowing back to the heart in the right direction may be damaged.
Uses high frequency waves that show blood flow in blood vessels, including the arteries and veins.

Your veins return blood to the heart. There are two sets of veins in the legs, deep and superficial. As you walk, calf muscle movement pushes blood upward and one-way valves in the veins prevent blood from flowing back into your feet.

Your arteries carry blood rich in oxygen and nutrients from your heart to the rest of your body. When the arteries in your legs become blocked, your legs do not receive enough blood or oxygen, and you may have a condition called peripheral artery disease (PAD). It can cause pain in your hips, buttocks, thighs, knees, shins, or upper feet when you walk.

A Doppler ultrasound study may be part of a venous or arterial ultrasound examination. Doppler ultrasound is a special ultrasound technique that evaluates blood flow through a blood vessel, including the body’s major arteries and veins to help evaluate:

  • Blockages to blood flow, such as clots
  • Narrowing of blood vessels

What should I expect?

Please allow 30 to 45 minutes for the exam but it oftentimes takes less time. It is easy, painless and relatively harmless. Your technician will ask you to undress from the waist down and lay flat down on an examination table. A warm gel is applied to the area being examined and a small wand (transducer) will be firmly pressed on the area. The transducer will record the flow of the blood through your blood vessels and displayed on a computer screen. You can return to your normal activities immediately following the exam unless your cardiologist has instructed otherwise.

What will it show?

Once your test is evaluated, your cardiologist will discuss the results with you and what they mean to your health. If a definitive diagnosis can be made, treatment may be initiated. In some cases, further testing may be necessary to further evaluate abnormal findings.


Carotid ultrasound

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Venous ablation

In addition to providing diagnostic lower extremity ultrasound testing in the office, we offer in-office lower extremity venous ablation procedures performed by our highly trained physicians.

What is it?

Venous insufficiency is a common condition in which the flow of blood from the legs back to the heart is abnormal. This lack of an upward flow back to the heart causes blood to pool in the legs, causing everything from unsightly varicose veins, lower extremity swelling, discomfort, a brownish discoloration in the lower legs, and venous ulcers.

Venous ablation is the latest technology helping to alleviate patient symptoms associated with venous insufficiency. Venous ablation eliminates the abnormal vein by sealing it closed since it is no longer effective because it has lost the ability to direct blood flow in the correct direction.

What should I expect?

Venous ablation surgery is performed at our Shadow Lane office by one of our specially trained cardiologists under ultrasound guidance. The procedure takes approximately one hour with minimal discomfort, and no significant down time. There may be some mild to moderate discomfort for a week to ten days, but over-the-counter medications are generally effective.

When will I see results?

The venous ablation procedure improves blood flow immediately. However, it may take a few weeks for the original symptoms to go away, and large varicose veins may need some additional minor treatment.


Myocardial perfusion scan

The coronary arteries supply blood to heart muscles. A cardiac perfusion scan can help determine whether they are blocked.

What is it?

A myocardial perfusion scan examines the blood flow to your heart at rest and while your heart is working harder as a result of exertion or a special medication. The test provides images that can show areas of low blood flow through the heart that may need additional treatment. Heart Center of Nevada is able to perform this test right in our office by trained technicians being overseen by our board-certified cardiologists.

Do I need it?

If you are having chest pain, your cardiologist may recommend a perfusion study as a way to take a closer look at the blood vessels that supply the heart. This test allows clinicians to see if any of your coronary arteries are blocked, which can lead to chest pain. If so, they may recommend further interventions to open the blocked arteries such as an angiogram.

What should I expect?

Your test will take place in our Nuclear Medicine room. The testing area is supervised by a cardiologist. The test involves taking two sets of images of your heart — one while you’re at rest and another after you heart is “stressed” by medication (radioactive tracer).

In a myocardial perfusion scan the lab technician will inject a radioactive dye into your bloodstream to either speed up the heart rate or dilates the arteries. When the peak heart rate is reached, the patient is injected again with a medication through an IV that increases blood flow to your heart muscle — simulating what exercise does — for the test. Depending on which medication is used, possible side effects may be similar to those caused by exercise, such as a flushing or shortness of breath. As soon as it has circulated throughout the bloodstream the gamma camera takes more pictures. This phase of the procedure is called the “stress scan” of the heart. The camera will record images that show blood flow through your heart during exercise. These images will be compared to the first set.

Can I eat or drink on the day of the test?

DO NOT eat or drink anything after midnight the day of the test. If you must take medications, drink only small sips of water.

Avoid all products that contain caffeine for 24 hours before the scan because it can interfere with test results. This includes coffee (caffeinated and decaffeinated), tea, soft drinks, and most chocolate products.

DO NOT smoke the day of test, as nicotine will interfere with the results.

Should I take my medications the day of the test?

Please bring a copy of all of your medications, including over-the-counter medications and supplements you routinely take, to the appointment. You can review and print the forms at the top of the page for more information. Please follow these guidelines about taking your medications the day of the test:

Medications with caffeine

DO NOT take any over-the-counter medication that contains caffeine for 24 hours before the test.

If you have asthma

DO NOT take theophylline (Theo-dur) for 48 hours before the test. Please bring your asthma inhaler medication to the test.

If you have diabetes

If you take insulin to control your blood sugar, ask your cardiologist how much insulin you should take the day of the test. Your cardiologist may tell you to take only half of your usual morning dose and to eat a light meal four hours before the test. If you take pills to control your blood sugar, do not take your medication until after the test is complete. Bring your diabetes medications with you. Do not take your diabetes medication and skip a meal before the test. If you own a glucose monitor, we recommend you bring it with you to check your blood sugar levels before and after your test. If you think your blood sugar is low, tell the technician immediately. Plan to eat and take your blood sugar medication following your test.

If you take heart medications

DO NOT take the following heart medications on the day of the test unless your cardiologist tells you otherwise, or unless it is needed to treat chest discomfort the day of the test:

  • Isosorbide dinitrate (for example: Dilatrate®, Isordil®)
  • Isosorbide mononitrate (for example: Imdur®, Monoket®)
  • Nitroglycerin (for example: Nitropatches®, Nitrostat®)
  • Dipyridamole (Persantine®) – Stop taking 48 hours before the test
  • Beta Blockers (for example: metoprolol, metoprolol XL, atenolol)

If you have any questions about your medications, please call any office before your test. Do not discontinue any medication without first talking with your cardiologist.

What should I wear for the test?

Please wear comfortable clothing and shoes.

What if I need to cancel or reschedule?

We ask that you call our office to cancel or reschedule your scan at least 24 hours prior. You may be charged a fee if not because the medication ordered cannot be used on another patient.

What can the test show?

The myocardial perfusion scan has the ability to identify:

  • Normal blood flow during rest and exercise – this means heart function appears to be normal at all times. You probably do not have coronary artery disease and no further testing is likely required.
  • Normal blood flow during rest, abnormal during exercise – part of the heart muscle is not getting sufficient blood during physical activity. This means there is a probability of coronary artery disease (blocked arteries).
  • Poor blood flow both during exercise and rest – this indicates the heart is never getting all the blood it needs to function properly. This may be due to previous heart attack or severe coronary artery disease.

How do I get the results of my test?

After the cardiologist reviews the images from your scan, the results will go into your electronic medical record. A follow-up appointment will made to discuss your results. Your referring physician will also have access to the results.


Treadmill stress test

What is it?

A treadmill stress test, sometimes called an exercise stress test, is used to help your cardiologist determine how well your heart handles small amounts of exercise. As your body is forced to work harder during the test due to walking, the heart must pump more blood because of an increased need for oxygen.

What should I expect?

This procedure usually takes about 45 minutes. You will be hooked up to a monitor that is continuously monitoring your heart rate and rhythm. The treadmill will begin moving slowly and will also be put on a small incline. This allows for determining your heart’s ability to handle having to work.

How do I prepare?

You only need to wear comfortable clothing and sneakers appropriate for walking. You do not have to fast or restrict any medications.

What will the results show?

The test can show if the blood supply is reduced in the arteries that supply the heart with oxygen-rich blood. This will allow your cardiologist to better understand any chest pain you are experiencing. It can also set a safe level of exercise to promote a better heart health.


Echocardiogram

What is it?

An echocardiogram uses sound waves to produce images of your heart. This commonly used, non-invasive test allows your doctor to see how your heart is beating and pumping blood. Your cardiologist can use the images from an echocardiogram to identify various abnormalities in the heart muscle and valves.

This exam can be done right in our office. Our echocardiography lab is accredited in transthoracic echocardiography by the Intersocietal Accreditation Commission (IAC). IAC accreditation ensures that our staff follows strict standards, enabling us to provide consistent quality testing for our patients. All of our technicians are registered adult cardiac sonographers; earning credentials from either the ARDMS or CCI credentialing organizations. Our lead technologist is registered by the ARDMS in both adult cardiac sonography and vascular sonography.

Why do I need it?

Your cardiologist may recommend an echocardiogram if you have any signs or symptoms of a heart problem such as shortness of breath or swelling in the legs. The test can look at your heart’s structure and check how well your heart functions, including the heart’s chambers, walls, and blood vessels.

How do I prepare?

We suggest you wear something comfortable. You can eat and drink before the test as you usually would. Take all your medications as prescribed by your doctor.

What should I expect?

Echocardiograms are done by our specially trained technicians in the office. The test takes often takes less than 1 hour.

  • You lie on a table in an exam room so your technician can better see the video monitor.
  • Gel is put on your chest to help sound waves pass through your body.
  • A small probe is moved across your chest so it can produce sound waves that bounce off your heart and “echo” back.
  • The sound waves are changed into pictures and displayed on a computer capable of recording the images so your cardiologist can view them.

Are there risks involved?

An echo does not hurt and has no known side effects.

When do I get the results?

Your cardiologist will discuss your results either after the test or at a follow-up appointment.


Multigated acquisition (MUGA) scan

Nuclear medicine imaging test that checks how well the heart is pumping during rest or exercise.

A Multigated Acquisition (MUGA) scan is a nuclear medicine imaging test that creates video images of the movement of the blood through the heart during rest and exercise. It is a very accurate test that can pinpoint many heart conditions early on, which allows for early treatments and complication prevention. Heart Center of Nevada is able to perform this exam in our office with a nuclear medicine technologist who has been specially trained.

Why do I need it?

Your cardiologist may recommend a MUGA to evaluate the pumping action of the two lower ventricles in the heart, any abnormalities in the wall of the ventricles, or abnormal movement of blood between chambers

What should I expect?

During the test, a small amount of radioactive tracer is injected into a vein. A special camera detects the radiation released by the tracer to produce computer-generated movie images of the beating heart. The MUGA scan is a highly accurate test used to determine the heart’s pumping function.

How do I prepare?

We suggest you wear comfortable clothes that can be easily removed. You can eat and take your medications as you normally would.

Are there side effects?

The potential risk for the low exposure of radiation during the exam is low compared to the benefits from the accurate results it can show. There is a rare, but potential risk of being allergic to the radiopharmaceutical given intravenously.


Ankle-branchial index (ABI) scan

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.