In Office Procedures

PREOPERATIVE CLEARANCE

Healthcare providers have a responsibility to determine if a patient is a suitable candidate for any proposed surgical procedure or if any special precautions should be taken prior to and/or during surgery. Not only must a patient’s condition warrant the performance of a procedure, but, their overall health must allow for the surgery to be performed without undue risk of harm. It is, therefore, essential that healthcare providers ascertain a patient’s health status prior to the performance of surgical procedures. Preoperative testing (also commonly called “preadmission testing”) is integral to the necessary evaluation of a patient prior to undergoing surgery. A failure to properly and timely evaluate a patient to assess whether or not they are an appropriate candidate for surgery may constitute medical negligence or malpractice, and, can result in serious injury to a patient, or, even death.

ELECTROCARDIOGRAM

An electrocardiogram (ECG or EKG, abbreviated from the German Elektrokardiogramm) is a graphic produced by an electrocardiograph, which records the electrical activity of the heart over time. Its name is made of different parts: electro, because it is related to electrical activity, cardio, Greek for heart, gram, a Greek root meaning "to write". The abbreviation "EKG" is preferred over the more straightforward "ECG" in oral communication, because the latter may be misheard as EEG.

HOLTER MONITORING

In medicine, a Holter monitor (also called an ambulatory electrocardiography device), named after its inventor, Dr. Norman J. Holter, is a portable device for continuously monitoring the electrical activity of the heart for 24 hours or more. Its extended recording period is sometimes useful for observing occasional cardiac arrhythmias that would be difficult to identify in a shorter period of time. For patients having more transient symptoms, a cardiac event monitor which can be worn for a month or more can be used.

ECHOCARDIOGRAPY

An echocardiogram is a sonography of the heart. Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart. The latest ultrasound systems now employ 3D real-time imaging.

STRESS ECHOCARDIOGRAPY

For a stress echocardiogram, ultrasound images of your heart are taken before and immediately after walking on a treadmill or riding a stationary bike. If you're unable to exercise, a chemical can be injected into your bloodstream to make your heart work as hard as if you were exercising.

NUCLEAR STRESS TESTING

A nuclear exercise stress test is a diagnostic test used to evaluate blood flow to the heart. During the test, a small amount of radioactive tracer is injected into a vein. A special camera, called a gamma camera, detects the radiation released by the tracer to produce computer images of the heart.Combined with exercise, the test can help determine if there is adequate blood flow to the heart during activity versus at rest.

MUGA

A MUGA scan (Multiple Uptake Gated Acquisition Scan) is a nuclear medicine test to evaluate the function of the heart ventricles. It provides a movie-like image of the beating heart, and allows the doctor to determine the health of the heart’s major pumping chambers. The advantages of MUGA is that it is more accurate than an echocardiogram and it is non-invasive.

CAROTID AND VASCULAR ULTRASOUND

Ultrasound imaging, also called ultrasound scanning or sonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound exams do not use ionizing radiation (x-ray). Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.
Ultrasound imaging is usually a painless medical test that helps physicians diagnose and treat medical conditions.
Vascular ultrasound provides pictures of the body’s veins and arteries.
A Doppler ultrasound study may be part of a vascular ultrasound examination.
Doppler ultrasound is a special ultrasound technique that evaluates blood as it flows through a blood vessel, including the body’s major arteries and veins in the abdomen, arms, legs and neck.

PERIPHERAL ARTERY DISEASE SCREENING

Ankle-brachial index (ABI). This is one of the most common tests used to diagnose PAD. It compares the blood pressure in your ankle with the blood pressure in your arm. To get a blood pressure reading, your doctor uses a regular blood pressure cuff and a special ultrasound device to evaluate blood pressure and flow. You may walk on a treadmill and have readings taken before and immediately after exercising to capture the severity of the narrowed arteries during walking