Electrocardiograms (EKG)
Your doctor may suggest you get an electrocardiogram — also called an EKG or ECG — to check for signs of heart disease. It’s a test that records the electrical activity of your ticker through small electrode patches that a technician attaches to the skin of your chest, arms, and legs.
EKGs are quick, safe, and painless. With this test, your doctor will be able to:
- Check your heart rhythm
- See if you have poor blood flow to your heart muscle (this is called ischemia)
- Diagnose a heart attack
- Check on things that are abnormal, such as thickened heart muscle
- Detect if there are significant electrolyte abnormalities, such as high potassium or high or low calcium.
How Should I Prepare?
Some things you can do to get yourself ready:
- Avoid oily or greasy skin creams and lotions the day of the test because they can keep the electrodes from making contact with your skin.
- Avoid full-length hosiery, because electrodes need to be placed directly on your legs.
- Wear a shirt that you can remove easily to place the leads on your chest.
What Happens During an Electrocardiogram?
A technician will attach 10 electrodes with adhesive pads to the skin of your chest, arms, and legs. If you’re a guy, you may need to have your chest hair shaved to allow a better connection.
During the test you’ll lie flat while a computer creates a picture, on graph paper, of the electrical impulses that move through your heart. This is called a “resting” EKG, although the same test may be used to check your heart while you exercise.
It takes about 10 minutes to attach the electrodes and complete the test, but the actual recording takes only a few seconds.
Your doctor will keep your EKG patterns on file so that they can compare them to tests you get in the future.
Echocardiogram
An echocardiogram (echo) is a graphic outline of the heart’s movement. During an echo test, ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest provides pictures of the heart’s valves and chambers and helps the sonographer evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart’s valves.
Why is an echocardiogram performed?
The test is used to:
- Assess the overall function of your heart
- Determine the presence of many types of heart disease, such as valve disease, myocardial disease, pericardial disease, infective endocarditis, cardiac masses and congenital heart disease
- Follow the progress of valve disease over time
- Evaluate the effectiveness of your medical or surgical treatments
Test Details
Can I eat or drink on the day of the test?
Yes. Eat and drink as you normally would the day of the test.
Should I take my medications the day of the test?
Take all of your medications at the usual times, as prescribed by your doctor.
What should I wear on the day of the test?
You may wear anything you like. You will change into a hospital gown before the test. Please do not bring valuables. You will be given a locker to store your belongings during the test.
What happens during the test?
- Before the test, the healthcare provider will explain the procedure in detail, including possible complications and side effects. You will have the opportunity to ask questions.
- Your test will take place in the Echo Lab located at J1-5. The testing area is supervised by a physician.
- You will be given a hospital gown to wear. You’ll be asked to remove your clothing from the waist up.
- A cardiac sonographer will place three electrodes (small, flat, sticky patches) on your chest. The electrodes are attached to an electrocardiograph (EKG) monitor that charts your heart’s electrical activity during the test.
- The sonographer will ask you to lie on your left side on an exam table. The sonographer will place a wand (called a sound-wave transducer) on several areas of your chest. The wand will have a small amount of gel on the end, which will not harm your skin. This gel helps produce clearer pictures.
- Sounds are part of the Doppler signal. You may or may not hear the sounds during the test.
- You may be asked to change positions several times during the exam so the sonographer can take pictures of different areas of the heart. You may also be asked to hold your breath at times.
How will I feel during the test?
You should feel no major discomfort during the test. You may feel a coolness on your skin from the gel on the transducer, and a slight pressure of the transducer on your chest.
How long does the test take?
The appointment will take about 40 minutes. After the test, you may get dressed and go home or go to your other scheduled appointments.
How do I get the results of my test?
After a cardiologist has reviewed your test, the results will be entered into your electronic medical record. Your physician will have access to the results and will discuss them with you.
Consultation
Effective health care requires teams of generalists and specialists with complementary expertise. Many clinical conditions require the input of more than one clinical provider, either because the diagnosis and recommended treatment is uncertain or because a patient may have multiple diseases that may be best managed by involving multiple specialists.
To consult is to seek advice from someone with expertise in a particular area, whereas consultation refers to the meeting or comparable outcome arising from that request. Medical consultation takes several forms. Its most traditional forms include in-hospital consultation in which physicians provide recommendations or perform procedures for a hospitalized patient, and out-patient consultations, in which patients are seen in the office setting. More contemporary forms of consultation include e-consultations, telemedicine evaluations, and remote medical second opinions. In these forms, the consultant may not actually see the patient but, nonetheless, assumes the responsibility of evaluating the patient’s clinical condition, assessing and analyzing pertinent clinical data, and offering a synthesis and appropriate recommendations.
While forms of medical consultation evolve, basic responsibilities associated with medical consultation endure. These responsibilities can be divided into those that fall to the requesting physician or non-physician practitioner; the consultant, who provides the consultation; and the health system, hospital, or organization that must support this important medical encounter.
Responsibilities of the Requesting Practitioner
Before requesting a consultation, the provider should ensure that the patient endorses the purpose of the consultation, understands the role of the consultant, and anticipates the likely outcomes of the encounter. Further responsibilities of the requesting practitioner include being specific and communicating clearly the reason for the consultation. Vague messages such as, “Please evaluate” are not as helpful as more specific inquiries such as, “What is the cause of the declining kidney function?” or, “How should this asymptomatic pulmonary nodule be evaluated?” To the extent possible, the requesting practitioner should provide the relevant clinical information, summarized as succinctly as possible. Urgency should be clearly conveyed, typically with a phone call or other direct communication.
