Diagnostics

• PET/CT
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• Cardiac PET(Viability)
  Nuclear imaging is the branch of imaging involving the administration of trace amounts of radiopharmaceuticals within the body to produce diagnostic images along with the aid of special gamma cameras and computers. These images are used to assess organ function, and are an effective tool for early diagnosis, as the function of the organ is assessed at the molecular level.

  PET CT scan is a non-invasive nuclear imaging tool, which is used to assess blood flow to the organs and their function. As with many other nuclear imaging studies, a minute amount of radioactive tracer (Rubidium or 18F-FDG, depending upon the scan) is injected into the blood to assist a Gamma camera and computer with capturing images of the organ. At Owensboro Medical Practice, we offer both Cardiac PET and Oncology PET scans.

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• Oncology PET
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• Myocardial Perfusion Imaging (SPECT) Scan
  Cardiac SPECT or single photon emission computed tomography also known as myocardial perfusion imaging, is a non-invasive nuclear imaging study used to measure blood flow to the heart at rest and under stress. A radionuclide, such as Technetium is injected into the body, and images are taken with a Gamma camera and computers, which is similar to many other nuclear imaging studies. The blood flow to the heart is measured at rest and after exercise. For exercise, the patient may walk on a treadmill, which is known as a nuclear exercise stress test. If patients are unable to walk along a treadmill, then stress may be induced by a pharmacologic compound, such as Persantine or Adenosine, which causes a simulated response to stress caused by exercise within the body. This is known as a pharmacological nuclear stress test.
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• MUGA Scan
  A Multi-Gated Acquisition Scan (MUGA) scan, also known as Radionuclide Ventriculography (RNV), Radionuclide Angiography (RNA) or gated blood pool imaging, is a non-invasive nuclear imaging test used to measure the ejection fraction (EF) within your heart. EF is the capacity of the ventricle (lower chamber of your heart) to pump blood with each heartbeat. In this test, a minute amount of radioactive tracer is injected into your vein. A special gamma camera along with the use of a computer creates moving images of the heart that detects size, EF and wall motion of the heart.

  A MUGA may be used to detect or monitor Congestive Heart Failure (CHF). Oncologists may use this test to look for pre-existing heart conditions or to estimate the effects of chemotherapy on the heart.

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• HIDA Scan
  HIDA scan also known as Cholescintigraphy or commonly known as gallbladder scan is a non-invasive nuclear imaging tool is used to assess functions of gall bladder and liver.

  This procedure uses a radioactive tracer (Technetium) which is injected in vein. The tracer is then taken up by bile producing cells of liver from the blood stream and is excreted with bile into the gall bladder via bile duct and eventually into small intestine.

  HIDA scan is used to track the flow of bile from liver to gall bladder to small intestine and can help detect gall bladder inflammation (Cholecystitis), bile duct obstruction and congenital problems with bile duct. It can also help assess the progress after liver transplant.
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CT scan may be done with and without contrast. Contrast is a substance or medicine that helps to capture clearer image.  Before the scan, the patient may be given contrast either through a vein or by drinking it. This is so that desired body parts will be enhanced in the cross-sectional image. If you have allergic reaction to contrast agent, you may be given medication to reduce the allergic reaction.

Because a CT scan is non-invasive, it is a quick and painless procedure. The doctor might ask for a CT scan if they suspect a problem that cannot be detected through a normal physical examination. As CT scans provide detailed images of all types of tissue (especially hard tissue), doctors might use it to diagnose heart disease, cancer, internal damage (due to trauma), and musculoskeletal disorders. Its versatility and convenience makes CT imaging a reliable diagnostic tool.

• CTA
  A Computed Tomography Angiography (CTA) is an examination that uses x-rays to visualize the blood flow in arterial and venous vessels from all over the body including arteries serving the brain to those bringing blood to the lungs, kidneys, and arms and legs. CT combines the use of x-rays with computerized analysis of the images to produce a three-dimensional picture of the area being studied. The contrast material is injected intravenously before the scan. Because the contrast dye will be traveling through the patient’s blood vessels while the scan is being completed, the images produced will show blood flow. Owensboro Heart and Vascular can then use this image to more accurately diagnose and design a treatment plan to fit your unique needs. The physician can diagnose blood vessel related diseases such as aneurysms and congenital cardiovascular disease. CTAs can also help detect angiogenesis and blockages.
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• CT scan with and without contrast
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• Echocardiogram

  An echocardiogram is a test where ultrasonic (high frequency) sound waves are used to create moving images of the heart. The ultrasonic sound waves are produced by a transducer. They will travel to the heart and 'echo' back, which are then converted to moving images by a computer. With invention and addition of color Doppler technology to the echocardiogram, speed and direction of blood flow can be measured. By assigning different colors to direction of flow, abnormal blood flow patterns can be assessed.

   

  A transthoracic echocardiogram (TTE) is the most commonly used echocardiogram, and involves placing an ultrasound transducer on the chest to produce images.

   

  A transesophageal echocardiogram (TEE) is another type of echocardiogram which is described separately.

   

  At times, Saline Bubble Study may be ordered to detect intra-cardiac shunt like PFO (Patent Foramen Ovale), ASD (Atrial Septal Defect) or VSD (Ventricular Septal Defect). During the echocardiogram, a vigorously shaken sterile saline solution is injected in a vein and the patient is asked to perform a valsalve maneuver). Normally the bubbles would enter heart through right atrium and then right ventricle. But with intracardiac shunt defect, the bubbles would travel from right atrium to left atrium and be seen coming out of left ventricle.

   

  A full echocardiogram gives detailed information on measurements of valves and all 4 heart chambers. At times, only ejection fraction (EF) information is needed for CHF (Chronic Heart Failure) patients and patients going through cardiotoxic chemotherapy. That’s when a Limited Echocardiogram may be performed.

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• TEE
  A transesophageal echocardiogram or TEE utilizes the insertion of a transducer attached to the tip of a thin tube, or endoscope into the esophagus to visualize the heart, as the esophagus provides optimal viewing. Use of a TEE study provides better and clearer images of the heart and its structures for this reason. TEE can be used as an effective alternative to TTE, if images produced by the TTE are obstructed or unclear due to obesity, bone structure or scarring on the chest wall and certain lung diseases. TEE can be especially useful when evaluating disease of the left upper chamber of the heart (aorta) or valve infection, as these areas are not as clearly visible in a TTE. It is also a useful in detection of abnormal masses inside or outside the heart, identification of clots and causes of strokes and ministrokes, and looking for aortic dissection in a critically ill patient when CT and MRI are not feasible diagnostic options.
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• Stress Echocardiogram

  A stress echocardiogram also known as ‘Stress echo’ is a simple, painless, non-invasive test used to determine how well your heart and blood vessels are functioning.

   

  Patients with coronary artery disease may not show symptoms at rest. When applied the stress of exercise, the heart pumps more blood. The arteries that are open will dilate to allow more blood but the arteries with blockage will have less blood flow. This difference in the amount of blood flow will produce symptoms like chest pain and discomfort.  

   

  The stress echo can either be ‘Exercise stress echo’ or ‘Dobutamine stress echo’.

   

  During exercise stress echo, the patient will be asked to exercise on a treadmill or a stationary bike. The patient will be asked to stop the exercise when the target heart rate for the age is reached or when the patient develops some symptoms that the provider may think are too risky to continue the test. An echocardiogram is done before the exercise (at rest) and later after exercise.

   

  In case of patients who are not able to exercise due to various physical limitations, the stress may be induces by a medication like Dobutamine and the test is then known as 'Dobutamine stress echo'.Dobutamine is adrenaline like substance which when injected mimics exercise and makes the heart beat faster. An echo cardiogram is done before and after the dobutamine injection.

   

  Stress Echo is used to determine:

  • how well your heart tolerates any activity
  • the progress of known heart valve disease
  • to decide the amount of safe exercise before starting a cardiac rehabilitation program after a heart surgery
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• Vascular Ultrasound

  A vascular ultrasound is a noninvasive ultrasound, also known as a duplex that is used to examine the circulation in the blood vessels. A vascular ultrasound can be used to evaluate arteries and veins in nearly any part of the body, including blood vessels in the neck, abdomen, arms and legs. Some examples of vascular ultrasounds are ankle brachial indexes (ABI), radial brachial indexes (RBI), venous and carotid.

  With invention and addition of color doppler technology to the ultrasound, speed and direction of blood flow can be measured. By assigning different colors to direction of flow, abnormal blood flow patterns can be assessed. 

  Hence vascular ultrasound can be used to assess vascular occlusion (blockage), narrowing of blood vessels (stenosis), bulging of arteries (aneurysms) and DVT.

   

  Arterial and venous duplex exam is a very simple, non-invasive and painless test; it incorporates Doppler ultrasound along with traditional ultrasound.

  Traditional ultrasound uses sound waves to take images of arteries and veins which will show stenosis (narrowing) and occlusion (blockage) of the arteries and veins. Whereas Doppler ultrasound uses the sound waves to detect the flow of blood in arteries and veins.  Being a combination of both the traditional and Doppler ultrasound, duplex exam shows the location, the type and the severity of the vascular disease. Some of the commonly used duplex ultrasounds are carotid duplex, renal duplex, and mesenteric duplex along with other vascular ones.

  Arterial and venous duplex ultrasound can help diagnose Peripheral Arterial Disease (PAD), Deep vein thrombosis (DVT), Aortic Aneurysm and other vascular disorders. Sometimes it is also used for venous mapping for cardiac bypass surgery.
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• Pelvic Ultrasound
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• Penile Ultrasound
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• Other Ultrasound
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• X-Ray
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• Bone Density
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• ECG or EKG
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• Holter and Event Monitor
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• 7 day continuous Telemetry monitor
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• Exercise Stress Test (Treadmill)
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• Tilt Table Test
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• SHAPE
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• Cardiac Cath
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• Coronary Angiography
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• Carotid Angiography
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• IVUS
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• TEE
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• FFR
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• Cardiac Calcium Score
  A calcium score checks for the buildup of calcium or plaque on the walls of the arteries of the heart. This test is used to check for the early stages of heart disease and determine the severity.
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• Vascular Screening

  Peripheral artery disease or P.A.D. develops when your arteries become clogged with plaque or fatty deposits that limit blood flow to your legs. 1 in every 20 Americans over the age of 50 had P.A.D., a condition that raises the risk for heart attack and stroke.

  P.A.D. does not always present with symptoms. So it is very important to get screened. At Owensboro Heart and Vascular, we offer 3 simple, no- invasive tests for vascular screening-

  Carotid Artery Ultrasound, ABI- Ankle Brachial Index and Abdominal Aortic Ultrasound.

  Carotid Artery Ultrasound

  Providing assessment for stroke risk, Carotid Artery Ultrasound visualizes the presence of plaque and assesses if the plaque affects blood flow to the brain.

  ABI-Ankle Brachial Index

  ABI screening evaluates for adequate circulation through the arteries in your legs. It is determined by a ratio between the systolic pressure in your arms and the systolic pressure in your legs.

  Abdominal Aortic Ultrasound

  Abdominal aortic ultrasound measures the diameter of your abdominal aorta in 2 dimensions. An aneurysm is indicated if focal dilatation is present measuring greater than 3 centimeters.

  PAD does not always present with symptoms. So it is very important to get screened. Get your screening for early detection and prevention.

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• Full Body Scan
  The full body scan is a quick and painless scan of the torso – excluding the head and lower extremities – to screen the most important organs (unlike a normal CT scan which only examines desired parts of the body). A CT scanner is used for this procedure so much of the preparation and methods are the same. To prepare for the scan, the patient will be asked to drink a contrast liquid one hour prior to the scan. The scan itself only takes a few minutes and the patient remains fully clothed. The full body scan can detect such things as heart disease (calcified plaque built up in the coronary arteries); tumors in the lungs, ovaries, liver or other organs of the body which may be cancerous; kidney stones, cysts, and many other abnormalities. Used mainly as a preventative procedure, a full body scan can detect early-stage cancer and heart disease, sometimes before patients have even shown symptoms.
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• Virtual Colonoscopy
  A virtual colonoscopy (also known as VC or CT colonography) is an imaging procedure which uses x-rays and computers to produce 2 and 3-dimensional images of the colon and the rectum. Prior to the scan, the bowels need to prepared; then, the patient will lie on an examination table as the CT scanner takes cross-sectional images of the colon to produce a 3-dimensional image. In comparison to a normal colonoscopy, a VC is much less invasive: in a regular colonoscopy, the physician inserts a tube with a camera attached to the end into the colon. The procedure is used to diagnose colon and bowel disease, including polyps, diverticulitis and cancer. If patients report symptoms such as abdominal pain, irregular bowel habits, and bleeding from the rectum, a physician will order a VC. A VC can detect polyps and irritated tissue as well.
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• Body Composition Analysis
  When it comes to weight loss, everyone talks about BMI. BMI tells only a small part of the story. It serves as a good starting point on the road to weight loss and improved health. The more accurate method to determine health risks related to obesity is through a body composition analysis, or BCA. A BCA reading will not only give you your weight and BMI, but more importantly provides a thorough breakdown of your body’s fat, muscle, and water percentages. The general rule is that the higher your fat percentage, the higher your health risk, especially if most of that fat is sitting around your waist. We have a BCA scale that will provide you with a personalized report that can show you exactly where you fall on the health risk scale. 
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• Bone Density
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• ANSAR (Autonomic Nervous System Monitor)
  This is a painless and non-invasive diagnostic tool to evaluate your autonomic nervous system functioning. An ANSAR test can be the key in identification of many medical abnormalities, such as cardiovascular disease, diabetes, chronic fatigue syndrome and many others.
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• PFT
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• 24 Hour BP monitor
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• Endothelial Function Test 
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