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Interventional Cardiologist

Diagnosis: Cardiovascular Services

Cardiac Stress Test

A cardiac stress test measures how the heart performs in response to exercise or stress. The test monitors blood flow and oxygen levels as the heart beats faster and works harder. Stress tests are often performed to help determine the cause of chest pain or shortness-of-breath. A stress test can help diagnose coronary artery disease (CAD – narrowing of the heart’s blood vessels), which can cause chest pain and increases a patient’s risk for a heart attack. The test can also reveal irregular heart rhythms and determine if medical treatments have been effective.

Prior to the Treadmill Test, (also known as as an exercise stress test or an exercise ECG) patients are given an electrocardiograph (EKG or ECG) and an echocardiogram. The EKG measures heart rate, while the echocardiogram gives images of the heart’s structures. It assesses heart and valve health and blood flow. Both tests are painless and the patient’s heart rate, blood pressure and cardiac electrical system are monitored.

For the exercise test, electrodes are placed on the chest, arms and legs. A blood pressure cuff is worn on the arm and an oxygen monitor is placed on the finger. The patient exercises by walking on a treadmill or pedaling a bicycle until they develop symptoms or feels tired. The patient is given an EKG and echocardiogram afterward.

Metabolic stress testing – This test measures the performance of the heart and lungs while under physical stress. It is similar to an exercise stress test but includes an analysis of the patient’s respiratory system.

Pharmacological (medication-induced) stress echocardiogram – A stress echocardiogram integrates ultrasound imaging and exercise stress testing to measure how the heart functions while the patient walks on a treadmill or rides a stationary bicycle. Medication is be used to stimulate exercise for patients who are unable to exercise safely.

Nuclear stress test — Your provider may order a Nuclear Stress Test to assess the blood flow to your heart. This is done by taking two sets of pictures of your heart; one set of pictures shows the blood flow to your heart at rest, and the other set of pictures shows the blood flow to your heart at stress. Each set of pictures requires an intravenous injection of a radioactive material, which will not make you feel any different in any way. Your test may be scheduled with one set of pictures on different days, or it may be a one-day test. The stress test may be done on a treadmill, with medications, or a combination of both. For the pictures, you must lay very still on a table while a camera passes over your chest for about 15 minutes. While Nuclear Stress Testing is extremely safe, a provider will be at your side during stress testing.

Echocardiogram

A conventional or Transthoracic Echocardiogram (TTE) can be done in a resting state or during exercise (stress echo), the ultrasound source is outside the body, on top of the chest. A technician obtains views of the heart by moving a small instrument called a transducer to different locations on the chest or abdominal wall. A transducer, which resembles a microphone, sends sound waves into the chest and picks up echoes bouncing off the heart. A standard echo usually provides highly detailed images of the heart walls and chambers which can be analyzed by a cardiologist. There are no side effects from a TTE or recovery time needed.

Holter Monitor Applications and Interpretation

One tool that providers use to diagnose arrhythmia (an abnormal heart rhythm) is the Holter monitor. The Holter monitor, worn for one or two days, is a small appliance that can be attached to a belt or a shoulder strap. Several electrodes placed on the chest connect to the monitor. The monitor records heart rhythms. Patients may also be asked to keep a record of cardiac symptoms experienced while wearing the monitor. Symptoms include chest pain, heart flutters, faintness or dizziness. It is also helpful for the patient to record when he/she takes medications, exercises or experiences emotional events. The Holter monitor will not interfere with most activities, other than bathing or water-based activities, as it must remain dry.

Transesophageal Echocardiogram

Echocardiograms use sound waves bounced off the structures of the heart to generate images of the heart in motion. In some cases, most often when patients have serious lung disease, or are immobile or overweight, ultrasound images of the heart are not clear. In these cases, cardiologists may request a transesophageal echocardiography (TEE)

Unlike the standard echocardiogram, in which the transducer is placed over the chest wall, in TEE the transducer is passed into the esophagus (the swallowing tube) and sometimes into the stomach. The esophagus, in particular, provides an ideal viewing of the heart, aorta and other great vessels and produces high-quality images of these structures.

TEE examinations are useful in helping providers diagnose and evaluate patients with embolisms (clots), valvular heart disease, bacterial infections, lesions, aortic abnormalities and injuries, and congenital heart disease. TEE is also used to evaluate critically ill patients and potential heart surgery candidates. A TEE carries more risk than the standard echocardiogram procedure (which is essentially risk-free) but is still very safe and under the right circumstances can be extremely useful.

Contact Information

CMHVI Diagnostic Testing Center 
60 High Street, Y1
Lewiston, Maine 04240
(207) 795-8200

Services:

  • Cardiac Catheterization Lab
  • Cardiac Diagnostic
  • Cardiac MRI
  • Cardiopulmonary Rehab
  • Electrophysiology (EP) Lab
  • Vascular Lab
  • Vein Center
  • Wound Center – 795-8260

_________________________________

Lipid Clinic 
60 High Street, ground floor
Central Maine Heart Associates
(207) 753-3900

_________________________________

Single-Stay Unit (SSU) 
60 High Street, Y3
Lewiston, Maine 04240
(207) 753-3907

Read more about Diagnostic Tests

Heart Failure

Your heart has a big job: To pump enough blood to every part of your body. A healthy heart has no trouble doing this, but in people with heart failure, which is also known as congestive heart failure, the heart can’t pump enough blood to meet the body’s needs. The name “heart failure” is a little misleading. If you have heart failure your heart is still working; it simply isn’t working as well as it should.

Our cardiac specialists can provide you with the full range of care you need for heart failure. Our team of cardiologists, specially trained nurses and other care providers work closely with you to create a fully personalized treatment plan to treat your condition.

Although there is no cure for heart failure, medications, treatments and smart lifestyle choices can help you feel more comfortable and live a longer, more active life.

Give Your Heart a Break: Learn about Heart Failure

If you are one of the 5.7 million Americans living with heart failure, you understand that how hard your heart works. And if you suffer with diabetes, lung disease, coronary artery disease , arrhythmia, high blood pressure and other heart conditions, the impact is even greater.

If your heart weakens, it can cause fluid buildup in the lungs and other parts of the body. This fluid buildup can contribute to the most common signs and symptoms of heart failure, which include:

  • Shortness of breath
  • Trouble breathing
  • Fatigue 
  • Swelling in the ankles, feet, legs or abdomen
  • Swelling in the veins of the neck

What to Expect During Diagnosis

There is no single test used to diagnose heart failure. In addition to giving you a physical exam and talking with you about your medical history, your provider may administer one or more of the following diagnostic tests:

  • Electrocardiogram (ECG):  This test uses small sensors (electrodes) attached to your chest and arms to record electrical signals as they travel through your heart. 
  • Echocardiogram: In this noninvasive test, sound waves are used to produce a video image of your heart in motion. 
  • Cardiac stress test (also known as a treadmill test or exercise EKG or ECG): This test measures how your heart performs in response to exercise or stress by monitoring blood flow and oxygen levels as your heart beats faster and works harder.
  • Holter monitor:  Worn for one or two days, the Holter monitor is a small appliance that can be attached to a belt or a shoulder strap. Several electrodes placed on the chest connect to the monitor, which records heart rhythms. 
  • Chest X-ray: This test can show whether your heart is enlarged and whether you have fluid in your lungs. 
  • BNP blood test:This test measures the amount of a hormone in your blood known as BNP, which increases in people with heart failure.
  • Doppler ultrasound: This is a test that uses sound waves to learn more about how your blood is flowing through your heart and to your lungs. 
  • Nuclear heart scan: During this test, you receive an injection of a safe radioactive substance known as a tracer. Using special scanners, your provider can see images of your heart and learn more about how well blood is flowing through your heart. 
  • Catheterization and angiogram: During this test, a cardiologist guides a catheter (a thin plastic tube) through an artery in the arm or leg into coronary arteries. Dye is injected through the catheter, to make images that can be captured in an X-ray. This test can measure blood pressure and blood oxygen levels and detects blockages that may have to be repaired.
  • Cardiac MRI: This test uses magnets and radio waves to create images of your heart as it beats. It can show damage whether heart failure has caused damage to your heart. 

Work with a Specialist to Find the Right Treatment

Your treatment options for heart failure depend on the type and severity of heart failure you have and how early heart failure is diagnosed. Treatment strategies include:

  • Diagnosing and treating the causes of heart failure: For example, if your heart failure is caused by coronary artery disease, arrhythmia or high blood pressure, you’ll receive treatment or medication for those conditions. 
  • Improving symptoms: Treating symptoms such as excessive swelling can help you feel better. For example, medications can help lower your blood volume and make it easier for your heart to move blood throughout your body and diuretics can reduce fluid buildup in your lungs and swelling in your legs, ankles and feet. 
  • Making healthy lifestyle changes: Quitting smoking, improving your diet, being more active and losing weight may help relieve symptoms of heart failure and improve your outcome. 
  • Pacemaker:This small device, which is implanted near your heart, sends signals to your heart to help it beat at the correct pace. 
  • Implantable cardioverter defibrillator: This device, which is implanted near your heart, produces electrical pulses that can correct irregular heart rhythm and reduce the risk of sudden cardiac arrest. 
  • Mechanical heart pump: This device, which is surgically implanted in your chest, helps your heart pump blood. 
  • Heart transplant: This surgery, which is reserved for end-stage heart failure as a life-saving intervention, replaces your heart with a healthy heart from a deceased donor. 

Improve Quality of Life with Cardiac Rehabilitation

If you have heart failure or any other heart conditions, CMHVI offers cardiac rehabilitation as part of its Cardiopulmonary Rehabilitation Program. Our cardiac rehabilitation is a medically supervised program that helps heart patients recover with an individualized plan that provides evaluation and instruction on physical activity, nutrition, stress management and other health-related areas as needed. Cardiac rehabilitation can make a significant difference in the lives of heart patients.

  • Coronary artery disease
  • Angina
  • Coronary artery angioplasty or stents
  • Open heart surgery such as coronary bypass or valve surgery
  • Heart failure
  • Heart transplantation

We also invite you to join Mended Hearts™, a patient-run support group affiliated with the American Heart Association that offers support and encouragement through its visiting program, monthly meetings and educational forums. To learn more, call 207-795-8230.

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    Central Maine Heart and Vascular Institute (CMHVI) brings skilled medical specialists and innovative treatments to the people of central Maine and bey… Learn More >

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    Diabetes and other endocrine-system conditions are complex, and when you’ve been diagnosed with one, it’s hard to know what to do next. Learn More >

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    Welcome to Central Maine Medical Center Imaging Services. We take pride in providing our community with technologically advanced, up-to-date imaging s… Learn More >

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    At Central Maine Healthcare, our long-term care feels exactly like home. We believe in taking complete care of you or your loved one’s physical, med… Learn More >

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    Central Maine Healthcare's neurologists and other doctors are specialists in epilepsy, movement disorders and other neurological disorders. Learn More >

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    Clinical Nutrition A Registered Dietitian (RD) is a “food and nutrition expert” who has completed a Bachelor’s or Master’s degree ... <a class… Learn More >

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    The Orthopedic Institute of Central Maine (OICM) serves the people of Central, Western and Midcoast Maine. OICM works collaboratively with our outpati… Learn More >

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    Central Maine Healthcare's palliative care is specialized medical care for people with serious illness. This type of care is focused on providing reli… Learn More >

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    Plastic and reconstructive surgery is a personal choice, and a personal journey. At Central Maine Healthcare, our double-board certified physician a… Learn More >

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  • Wound Care

    Central Maine Medical Center’s Comprehensive Wound Center is a centralized location for all aspects of wound care. Our team of specialists provides… Learn More >

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