Diagnostic Testing

Diagnostic Test Results: Each diagnostic test differs in the time it requires to complete and be processed, reported, and reviewed. You will be notified promptly if an abnormal, significant test result is reported. Otherwise, patients are notified by phone or mail within 7-10 days of the test.

Please arrive 15 minutes prior to your scheduled appointment time in order to register. Please bring your insurance cards and information as well as a list of your current medications. If you are running more than 10 minutes late for your appointment, kindly call us so we can reschedule you. If you are unable to keep your appointment, please call us at least 24 hours in advance (978) 744-3499. After business hours: 978 740-5517 x 262. After you register, you will receive an explanation of the test and be asked to read and sign a consent form.

We are committed to providing you with the highest quality of care. North Shore Cardiovascular Associates Diagnostic Center at 331 Highland Avenue is ICANL, ICAEL, and ICAVL certified. ICANL accreditation is a voluntary process which is dedicated to promoting quality nuclear cardiology and nuclear medicine diagnostic evaluations in the delivery of health care by providing a peer review process of laboratory accreditation. For more information on ICANL, click here. ICAEL accreditation is a voluntary process which is dedicated to promoting quality echocardiographic diagnostic evaluations. For more information on ICAEL, click here. ICAVL accreditation is a voluntary process which is dedicated to promoting high quality noninvasive vascular diagnostic testing in the delivery of health care by providing a peer review process of laboratory accreditation. For more information on ICAVL, click here. At the 331 location we perform cardiac stress tests, both these routine stress tests and imaging stress tests, cardiac ultrasound tests, holter or event monitor tests. In addition, if you do have a pacemaker, we provide assessment and reprogramming as needed on an outpatient basis in our Pacemaker Clinic. Below you will find information about each type of test and how to prepare for it.

A stress test is a diagnostic study to evaluate your heart function during exercise. This test is often done to diagnose the presence of coronary artery disease or to obtain more precise information in patients with coronary artery disease. It can also be used to evaluate medical therapy in patients with known high blood pressure, diabetes, shortness of breath, high cholesterol or chest discomfort. There are routine stress tests and Imaging stress tests.

Routine Stress Test: A routine stress test is a treadmill test done to evaluate EKG and blood pressure as you exercise. No fasting is required prior to a routine stress test. Treadmill exercise time is different for each individual. It can be influenced by age, medications or physical conditions. You will never be asked to do anything you cannot do.

• It is okay to shower or bathe the morning of your test.
• Please do not use lotion on your body, arms or chest.
• Take medications as usual on the day of your test unless you are instructed otherwise by your Doctor.
• Wear comfortable clothing, loose fitting shorts, slacks or sweatpants are best. Sneakers or comfortable walking shoes, NO HEELS, boots or slip on shoes.
• No smoking at least 4 hours prior to the appointments.

Imaging Stress Test: This is a two-day test. This involves the injection of a harmless amount of radioactive imaging agent into the bloodstream through an IV. This material is absorbed into the heart muscle and shows if your heart muscle is receiving adequate blood supply under stress and/or rest conditions. The stress portion of the test is usually accomplished by walking on the treadmill. In the event you are unable to walk on the treadmill, your physician may choose to substitute a chemical agent to facilitate your exercise.

The total test time each day will be 1½ to 2 hours. Pictures of your heart will be taken using a special camera. You will be asked to lie down on a flat table. The camera will rotate around your chest. It is important that you lie very still. Results of the test will be read by the cardiologist and given to your doctor within 4-5 days.

• It is okay to shower or bathe the morning of your test.
• Please do not use lotion on your body, arms or chest.
• Do not eat or drink for 4 hours prior to your appointments.
• Do bring a muffin, bagel or sandwich to both appointments to eat after the tests.
• Do not drink caffeine or even "decaffeinated" products after midnight. These products interfere with the test and could result in your testing being cancelled.
• You may drink water.
• Take medications as usual on the day of your test unless you are instructed otherwise by your Doctor.
• If you are a diabetic, please call your doctor for any special instructions.
• If you use inhalers, please bring them with you to the test.
• Wear comfortable clothing, loose fitting shorts, slacks or sweatpants are best. Sneakers or comfortable walking shoes, NO HEELS, boots or slip on shoes.
• No smoking at least 4 hours prior to the appointments.

Abdominal Vascular Duplex: Ultrasound is used to evaluate the aorta and renal arteries. These vessels bring blood to your abdomen and kidneys. Gel will be applied to the abdomen. A transducer will be placed on the gel-covered areas to obtain images and evaluate blood flow in the arteries and/or veins. For the abdominal duplex only, you must fast (nothing by mouth) after midnight.

Ankle Brachial Index (ABI) and Pulse Volume Recording(PVR): An ABI is a fast, effective tool used in screening for peripheral artery disease.

You will lay on an exam table or reclining in a chair for this exam. The examiner will ask you questions regarding your health history and medications. Blood pressure cuffs will be placed on the ankles and upper arms. When inflated, the cuffs will provide blood pressure readings as well as waveforms. This test will determine if there are areas of blockage within the arteries. To further evaluate the leg arteries, additional pressure measurements will be done after a brief walk on the treadmill. PVR utilizes the same technique to analyze the wave forms of blood pressure at various levels in the leg to determine the exact site of blockages.

Ultrasound Technology: Ultrasound uses high frequency sound waves too high to be heard by humans. It is a safe and harmless method to diagnose many medical conditions (the same technology used to take pictures of the fetus in a pregnant woman). Ultrasound is used in echocardiography and vascular exams in our laboratory.

Echocardiography: There are no special preparations for an echocardiogram. It is a safe, painless diagnostic procedure, which uses ultrasound to take moving pictures of the heart. The pictures we take will enable us to measure the size of each of the four chambers, to study the appearance and motion of the heart valves and to assess how effectively the heart muscle contracts, moving the blood through the heart and out to the lungs and the rest of the body.

Doppler echocardiography is used to judge the speed, amount and direction of the blood flowing through the parts of your heart and great vessels. This test determines if there is any narrowing or leaking of the valves or if there are holes between the pumping chambers. When this Doppler ultrasound examination is performed, you will hear a swishing sound as the instrument processes the information.

Abdominal Vascular Ultrasound: Abdominal Vascular Ultrasound is an important tool used in the diagnosis of blood vessel conditions. Ultrasound uses sound wave frequencies too high to be heard by humans as a safe and harmless method to diagnose many medical conditions.

The technologist will perform your procedure by applying a hypoallergenic water-based gel to the area to be evaluated. Then a small microphone-like device called a transducer is passed over the gel-coated area to be examined. This produces an image on the screen of the ultrasound machine. Ultrasound is also used to measure the blood flow in specific blood vessels. Noises might be heard while the technologist listens to the blood flow. Upon completion of the exam, a physician reviews and interprets all of the images and blood flow measurements.

Carotid Duplex: Ultrasound is used to evaluate the carotid arteries located in the neck. These vessels bring blood to the brain. Gel will be applied to the skin of the neck. A transducer will be placed on the gel-covered areas to obtain images and evaluate the blood flow in the arteries.

Your technician will place electrodes on your chest and attach a small recording monitor that can be carried in a pocket or a small pouch worn around your neck. Your physician has scheduled this test in order to learn whether your heart has a slow, fast or irregular rhythm. A Holter monitor is a continuous recording of your hearts' rhythm during normal activity, usually 24 hours. An event monitor is similar to a Holter monitor, but you will wear for a longer period of time. You press a button to record a symptom as you are experiencing it.

The following tests are performed at North Shore Medical Center's Salem Hospital.

This test is ordered if you have been experiencing fainting spells. The tilt table test produces syncope (fainting spells) under controlled conditions, which enables your physician to diagnose whether you have a condition called vasovagal syncope.

• Do not eat or drink anything after midnight.
• Take medications as usual on the day of your test unless you are instructed otherwise by your Doctor.
• The complete procedure may take 1 - 2 hours.
• You will need to designate a driver to pick you up after your test is completed.

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We conduct EP (electrophysiology) studies on patients who have experienced heart palpitations, dizzy spells and blackouts, or who have been diagnosed with an arrhythmia. Your physician has ordered this test to learn how electrical impulses are flowing through your heart. Normally, electricity flows through the heart in a regular pattern. Your physician wants to diagnose what is causing the rhythm disturbance in your heart. During the EP study, specially trained physician will provoke a disturbance in order to observe which areas of your heart tissue are related to your arrhythmia. You will be given local anesthesia and a sedative to help you remain as comfortable as possible. A flexible, narrow catheter will be inserted into a blood vessel in your groin or neck. The electrophysiologist will thread the catheter wire up into your heart. Electrodes at the catheter tip will gather data and a variety of electrical measurements. Once the damaged site or sites are confirmed, the electrophysiologist may administer different medications or electrical impulses to determine their ability to halt the arrhythmia and restore normal heart rhythm.

• Take medications as usual on the day of your test unless you are instructed otherwise by your Doctor.
• The complete procedure may take 2 hours.
• You will remain still for 4-6 hours after the procedure.
• You will need to designate a driver to pick you up after your test is completed.
• You will receive discharge instructions prior to going home.

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This procedure is used to learn whether the blood vessels giving blood to your heart muscle are narrowed or blocked, how well your heart is pumping, if your heart valves are working properly, if you were born with any heart defects, and if your heart has been damaged by disease. This procedure is not painful. You will receive a local anesthetic at the catheterization site. A flexible tube called a catheter will be placed into a blood vessel in your groin or am. This catheter will be guided toward your heart. Dye will be injected into each coronary artery while an x-ray camera takes pictures.

• Take medications as usual on the day of your test unless you are instructed otherwise by your Doctor.
• The complete procedure may take 1 - 2 hours.
• You will need to designate a driver to pick you up after your test is completed.
• You will receive discharge instructions prior to going home.

Click here for more information.