Most of these services are available at the Buffalo Medical Group’s three main locations: 295 Essjay Road,Williamsville; 85 High Street, Buffalo, and 3345 Southwestern Boulevard, Orchard Park. Appointments can be made by calling Cardiology Scheduling at
857-8777. Invasive testing is scheduled directly with the cardiologist’s staff.
This ultrasound test, also known as an “echo”, shows how well the muscles and valves inside the heart are working. Physicians use it to determine if there is any heart disease or damage. In an echocardiogram, high frequency sound waves are bounced off the heart and converted to images on a screen much like a sonogram. Using color echo and Doppler (which measures the speed of blood traveling through the heart), flow patterns are studied as blood moves through the heart chambers and valves. The test is very safe and painless, and takes about 30 minutes to perform. No preparation is necessary. A qualified technician performs the test and a cardiologist interprets the results and sends them to the ordering physician.
The Cardiology Department provides three types of stress testing: regular stress test,
nuclear/cardiac stress test, and
persantine/adenosine stress test. A cardiologist is present during all types of stress testing.
A regular stress test records the heart rate and electrical activity of the heart while a patient walks on a treadmill. The speed and the grade of the treadmill are increased gradually to affect the workload on the heart. The patient’s blood pressure also is monitored during this test. The test helps the doctor determine the cause of various symptoms a patient may be experiencing such as chest pain, shortness of breath, heart palpitations and dizziness. This test also is used to measure the strength of a patient’s heart after a heart attack or open heart surgery. Regular stress testing takes approximately 45 minutes and is available at the BMG 85 High Street and 295 Essjay Road locations.
The nuclear/cardiac stress test is performed on patients who have had a
prior heart condition, a previous regular stress test that was
inconclusive, or in some cases, to screen for blocked arteries (coronary
disease). The test may be administered in one day or over two days and
compares the electrical activity of the heart during exertion and at
rest. During the “stress” portion an IV will be started and the patient
will walk on a treadmill. A small and harmless amount of nuclear isotope
is injected through the IV. After the exercise, a special camera which
picks up the rays emitted by the nuclear isotope is used to produce
images of the heart. During the “rest” portion of the test, the patient
will receive another injection, and more images are produced. The
physician will then compare the two sets of images and look for changes
that may indicate significant coronary disease.
If a patient is physically unable to walk on a treadmill, the physician
will administer a medication that helps to dilate blood vessels and
create a cardiac response similar to what would occur during exercise.
As in the case of the treadmill nuclear/cardiac stress test, this
procedure enables the physician to determine if there is significant
coronary disease.
Nuclear/cardiac stress testing is performed at 85 High Street in
Buffalo, and 295 Essjay Road, Williamsville.
The persantine/adenosine stress test is designed for people who have a
difficult time using a treadmill for the cardiolite stress test. Instead
of asking the patient to exercise, the physician will administer either
persantine or adenosine, medications that help to dilate blood vessels
and create a cardiac response similar to what would occur during
exercise. As in the case of the cardiolite test, this procedure enables
the physician to determine if there is significant coronary disease.
Persantine/Adenosine stress tests are now performed at both the 85 High
Street and 295 Essjay Road locations.
A stress echo is an echocardiogram and stress test combined during which the cardiologist looks for any changes in the heart muscle that may indicate blockage in one or more of the coronary arteries. In the first part of the test, a complete two-dimensional echo is performed. After this, selected echo images from specific walls of the heart are stored in a digital format. Then, under the supervision of a cardiologist, a treadmill stress test is performed. After the stress test and while the patient still has a high heart rate, digital echoes are again obtained, stored and compared with the previous digital echoes. A stress echo takes about one hour and is performed at 295 Essjay Road.
Cardiac monitors often are ordered when patients experience symptoms of heart palpitations, lightheadedness or fainting. A physician uses the test to evaluate and manage abnormal heart rhythms (arrhythmias) and to determine if there are times when a patient’s heart is not receiving enough oxygenrich blood. This is called cardiac ischemia. The Buffalo Medical Group offers two types of ambulatory monitors – holter and event.
A portable EKG device, the holter is a small recorder worn for 24 hours that monitors a patient’s heart rhythm. While wearing the holter, the patient keeps a diary of symptoms and activities. When the holter is returned, it is scanned and computed by a qualified monitor technician and interpreted by a cardiologist. Holter monitors are available at the Buffalo Medical Group’s main locations: 85 High Street, Buffalo; 295 Essjay Road,Williamsville, and 3345 Southwestern Boulevard, Orchard Park.
This test requires a small recorder about the size of a pager, to be worn by a patient for up to 30 days to detect infrequent arrhythmias (abnormal heart rhythms). Unlike the holter, it does not make a continuous recording. Instead, the monitor is activated when a patient presses a button during a symptom or event to record a preset amount of the patient’s heart rhythm. The recordings are then transmitted to a receiving center where they are evaluated by a qualified technician. Event recorders may be helpful for the patient who has intermittent symptoms that may be missed during a 24 hour period when a holter
monitor is used. To schedule an appointment to obtain an event monitoring
device, please call 630-1484.
Some patients may have heart rhythms that are too slow or too rapid for their heart to pump blood efficiently. They may require a surgically implanted electronic cardiac device such as a Pacemaker or Implanted Cardioverter Defibrillator (ICD). A Pacemaker can help to ensure the heart rate is not too slow, help provide adequate heart rates during exercise, and in some cases, help maintain the timing between the top and bottom chambers of the heart. An ICD, while it contains a Pacemaker to perform the services described previously, can also shock the heart when it is beating at a dangerously fast rate to restore a more normal rhythm. Pacemakers and ICDs require regular evaluation to ensure they are set according to the patient’s changing needs; to monitor device battery status, and to gather the computerized diagnostics needed by the physician to manage a patient’s care. The BMG Cardiac Device Center is staffed by highly trained, experienced clinical nurse specialists under the direction of a cardiologist. The implantation of cardiac devices is a physician referred service.
Appointments for device evaluation can be made by calling
630-1484.
Syncope is a term used to indicate a loss of consciousness or fainting. It may be caused by heart rhythm or heart rate disturbances (arrhythmias), a drop in blood pressure, or neurological disorders such as a stroke. Head Up Tilt (HUT) testing can help diagnose a common faint that results from a heart rate or blood pressure disturbance. The test is designed to observe a faint or near faint under controlled conditions. During the test, the patient lies on a tilt table, which is gradually elevated until the patient is in a supported, standing, motionless position. Symptoms, heart rhythm, heart rate, blood pressure, and level of consciousness are monitored continuously. The observed findings enable the physician to choose the most effective treatment option. The test can last up to two hours and is administered by specially trained registered nurses under the direction of a cardiologist.
This service is physician referred, and appointments can be made by calling 630-1484.
Some patients have symptoms caused by heart rhythm disturbances, which may be serious or even lifethreatening. In such cases, patients may benefit from testing performed in a hospital Electrophysiology Lab by a specialized cardiologist called an electrophysiologist.
An Electrophysiology Study (EPS) is an invasive, diagnostic procedure that enables the physician to locate abnormal sites in the heart that are causing an arrhythmia. During an EPS, electrode catheters (long, flexible wires) are inserted into a blood vessel and threaded into the heart. Once placed, the catheters can be used to locate and trace abnormal electrical heart rhythms and simulate (induce) arrhythmias under controlled conditions. Medications may be given to test their effectiveness in controlling abnormal rhythms. Information obtained in the EPS will help the physician choose the best treatment option.
This is a procedure that has proven effective in treating some arrhythmias. Once the arrhythmia is located in a diagnostic EPS, the tip of one of the catheters is positioned at the origin of the abnormal heart rhythm. Radiofrequency energy is used to cause a scar to form at the site of the catheter tip. Since scar tissue cannot transmit electrical impulses, successful RFA procedures can result in curing a patient’s arrhythmia. Appointments for a consultation about RFA can be made by calling
630-1484.
Cardiac Catheterization is a common nonsurgical procedure during which a catheter (a long thin flexible tube) is inserted into a blood vessel by a physician, and gently guided toward the heart. Once the catheter is in place, a dye is injected to follow the blood flow to the heart. The images are used to obtain information about the heart and the coronary arteries.
Balloon Angioplasty is used to open blocked or narrowed arteries. A balloon-tipped catheter is inserted into a coronary artery to press plaque buildup against the vessel wall. This widens or unblocks the artery to restore blood flow and relieve coronary artery disease symptoms.
A Coronary Stent is a wire mesh tube inserted through a catheter and placed in an artery to keep it open and help improve blood flow to the heart. The stent is designed to hold the passageway open permanently to reduce the rate of renarrowing of the artery. Stenting is usually performed immediately after balloon angioplasty while the catheter is still in place.
Cardiac catheterization, balloon angioplasty and coronary stenting are performed by several Buffalo Medical Group cardiologists.
The Buffalo Medical Group Cardiology Department offers a comprehensive range of services performed by a team of skilled, highly trained and dedicated cardiologists, nurses, technicians and support staff whose goal is to provide their patients with the highest quality care. Services include echocardiogram, stress testing, stress echo, cardiac monitoring, cardiac device management, electrophysiology study, radiofrequency catheter ablation and angiography.