Screenings, Diagnostics & Prevention
Keeping track of your cardiovascular health helps you prevent serious problems. Rely on UNC REX Healthcare for the tools to identify heart and vascular issues early, when they’re easiest to address.
Ask your doctor whether you’d benefit from one or more of the following tests. They can reveal issues that may warrant treatment, lifestyle changes and/or long-term monitoring.
Echocardiogram & Transesophageal Echocardiogram
An echocardiogram uses ultrasound to show the heart’s structure and valves in detail as the heart beats. A technician passes a small device called a transducer over your chest during this test.
When your physician wants to check for a hole—a patent foramen ovale or an atrial septal defect—between your heart’s upper chambers, you may receive an injection of saline with bubbles. The solution makes the relevant part of your heart more visible.
If your doctor needs more information than a standard echocardiogram can provide, he or she may recommend a transesophageal echocardiogram. During this test, a technician guides a thin, flexible tube with a probe down your throat to take ultrasound pictures from the back side of the heart. You’ll receive a sedative to relax you and medicine to numb your throat before the test.
For an electrocardiogram (EKG), a technician attaches painless electrodes to your skin to briefly measure your heart’s electrical signals. This procedure reveals heart rhythm problems (arrhythmia) you experience all the time, including at the moment of testing. But if your arrhythmia comes and goes or occurs only as you exercise, your doctor may recommend a specialized type of EKG such as stress testing, Holter monitoring or event monitoring.
Stress testing measures how well your heart responds to exercise or to a drug that mimics the effect of physical activity. In most cases, you’ll walk on a treadmill as electrodes measure the increase in heart rate. If you can’t walk on a treadmill, you’ll receive medication—dobutamine or adenosine—to make your heart beat faster or to dilate your blood vessels without exercise.
In addition to recording the heart’s electrical activity, your doctor may look at your heart or blood vessels by using:
- Stress echocardiogram – Takes ultrasound images of the heart before and after exercise testing
- Stress cardiolite – Injects a radioactive tracer into your bloodstream to make blood vessels show up better in imaging scans during the exam, called a nuclear stress test
Holter Monitor & Cardiac Event Monitor
An echocardiogram uses ultrasound to show the heart’s structure and
Holter monitors and cardiac event monitors are small devices that connect to electrodes on your chest to record the heart’s rhythm over time. You’ll likely wear a Holter monitor for one or two days, during which the monitor continuously records the heart’s electrical activity. In contrast, you wear an event monitor for up to 30 days and must manually start recording when you feel symptoms such as shortness of breath, chest discomfort or palpitations.
Ask your doctor about convenient, discreet wireless monitors that make it easier for you to enjoy your typical athletic and recreational activities.
Heart PET Scan
If an echocardiogram or stress test can’t provide enough detail about your heart, you may get a PET (positron emission tomography) scan. For this test, you’ll receive an injection of radioactive tracers to make your heart and blood vessels show up on a special gamma camera. Before the exam, a technician places electrodes on your skin to track your heartbeat and tell a computer when to take a picture. The results can reveal poor blood flow to your heart or show damage to the muscle.
Coronary Calcium Scan (Cardiac Scoring)
During a coronary calcium scan, also called cardiac scoring, high-speed computed tomography (CT) technology takes pictures that may reveal calcium buildup in the coronary (heart) arteries. This buildup can block blood flow to the heart and cause heart failure.
You may benefit from this three-minute test if you meet three or more of the following criteria:
- Man older than 45
- Woman older than 55
- Current or former smoker
- Family history of heart disease
- High cholesterol
- High blood pressure
A computed tomography (CT) angiogram visualizes blood vessel problems such as aneurysms or blockages. During this test, you’ll receive an injection of a contrast material that helps arteries in your neck, brain, arms, legs, heart, intestines or kidneys show up better on a CT scan.
This exam can detect the earliest signs of heart disease and offers a faster, less-invasive alternative to cardiac catheterization in people who are at lower risk of blocked arteries.
Cardiac catheterization inserts a catheter—a thin flexible tube—into a blood vessel in your wrist or groin and threads it up to your heart. A doctor uses real-time X-ray images to guide the catheter. This procedure can check for blockages in the coronary arteries, take a tissue sample for testing, or measure pressure, blood flow and oxygen levels.
You may receive cardiac catheterization as part of an interventional cardiology procedure that uses minimally invasive techniques to treat heart conditions.
Vascular tests can check blood vessels throughout your body for problems such as blockages, narrowing or aneurysms. Most vascular diagnostics use noninvasive, painless ultrasound.
Cardiac Genetic Testing
If one of your relatives has a cardiovascular disease, you may face a higher risk of heritable heart and vascular conditions. Genetic testing and counseling at UNC Medical Center can guide you in taking steps to protect your health.
Lipid Clinic & High Cholesterol Treatment
Work toward healthy cholesterol levels and start reducing your risk of heart disease through the Lipid Clinic program at North Carolina Heart & Vascular. You’ll meet with a clinical pharmacist who specializes in lipids and can teach you about managing cholesterol medications, developing healthy lifestyle habits, and quitting smoking. Ask your cardiologist for a referral to this program.
If you have very high cholesterol levels and certain medical conditions, you may qualify for plasmapheresis. This blood-washing technique, available at UNC Medical Center, can dramatically lower cholesterol in a few three-hour sessions—thus reducing your risk of serious heart conditions.