Ultrasound – This involves the use of high-frequency sound waves to create images of organs and systems within the body. The test is done in the ultrasound or radiology department. You will be lying down for the procedure. A clear, water-based conducting gel is applied to the skin over the area being examined to help with the transmission of the sound waves. A handheld probe called a transducer is moved over the area being examined. You may be asked to change position so that other areas can be examined. Some of the types of ultrasounds that we provide include.

  • Abdominal ultrasound
  • Breast ultrasound
  • Doppler ultrasound of an arm or a leg
  • Doppler/ultrasound of the heart (Echocardiogram)
  • Duplex ultrasound
  • Pregnancy ultrasound
  • Testicle ultrasound
  • Thyroid ultrasound
  • Transvaginal ultrasound
  • Vascular ultrasound

Doppler – Doppler ultrasound test uses reflected sound waves to see how blood flows through a blood vessel. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced blood flow through narrowing in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (Deep Vein Thrombosis, or DVT) that could break loose and block blood flow to the lungs (Pulmonary Embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (Fetus) to check the health of the fetus.

During Doppler ultrasound, a handheld instrument (Transducer) is passed lightly over the skin above a blood vessel. The transducer sends and receives sound waves that are amplified through a microphone. The sound waves bounce off solid objects, including blood cells. The movement of blood cells causes a change in pitch of the reflected sound waves (called the Doppler Effect). If there is no blood flow, the pitch does not change. Information from the reflected sound waves can be processed by a computer to provide graphs or pictures that represent the flow of blood through the blood vessels. These graphs or pictures can be saved for future review or evaluation.

Echocardiogram: An Echocardiogram is a test in which ultrasound is used to examine the heart. The equipment is far superior to that used by fishermen. In addition to providing single-dimension images, known as M-mode echo that allows accurate measurement of the heart chambers, the echocardiogram also offers far more sophisticated and advanced imaging. This is known as two- dimensional (2-D) Echo and is capable of displaying a cross-sectional “slice” of the beating heart, including the chambers, valves and the major blood vessels that exit from the left and right ventricle

An echocardiogram can be obtained in a physician’s office or in the hospital. For a resting echocardiogram (in contrast to a stress echo or TEE, discussed elsewhere) no special preparation is necessary. Clothing from the upper body is removed and covered by a gown or sheet to keep you comfortable and maintain the privacy of females. The patient then lies on an examination table or a hospital bed.

Sticky patches or electrodes are attached to the chest and shoulders and connected to electrodes or wires. These help to record the electrocardiogram (EKG or ECG) during the echocardiography test. The EKG helps in the timing of various cardiac events (filling and emptying of chambers). A colorless gel is then applied to the chest and the echo transducer is placed on top of it. The echo technologist then makes recordings from different parts of the chest to obtain several views of the heart. You may be asked to move form your back and to the side. Instructions may also be given for you to breathe slowly or to hold your breath. This helps in obtaining higher quality pictures. The images are constantly viewed on the monitor. It is also recorded on photographic paper and on videotape. The tape offers a permanent record of the examination and is reviewed by the physician prior to completion of the final report.

ECG (Electrocardiogram): An ECG is a test that measures the electrical activity of the heart. The heart is a muscular organ that beats in rhythm to pump the blood through the body. The signals that make the heart’s muscle fibres contract come from the sinoatrial node, which is the natural pacemaker of the heart. In an ECG test, the electrical impulses made while the heart is beating are recorded and usually shown on a piece of paper. This is known as an electrocardiogram, and records any problems with the heart’s rhythm, and the conduction of the heart beat through the heart which may be affected by underlying heart disease.

Tread Mill Test (TMT) It is common to find heart patients who have normal ECG. One must remember that the ECGs are taken at rest when the heart is beating at its lowest rate. Even with 90% blocks the patients can have a normal ECG. In such cases the patient would also agree that at rest there is no pain in the chest, the angina symptoms would only come when they increase the heart rate, while doing some physical exertion like walking.

This is the condition where we need a TMT test. The patients are to gradually increase their heart rate, thus increasing the blood requirement of the heart muscles. Simultaneously ECG records are taken. If there is a blockage of approximately more than 70% ECG shows changes, suggestive of Angina.

Patients have to physically exert for this test which uses a computerised machine. The level of the exercise is gradually increased according to a standard protocol called the Bruce’s Protocol. The continuous ECG monitoring during the exercise would reflect any blood and oxygen deficit in the muscles of the heart during exercise. The patient is asked to stop exercising as soon as ECG changes appear or any symptoms of chest pain or discomfort or breathlessness are felt.

TMT test is also called Exercise Stress Test, Computerised Stress Test or simply Stress test. This is the most easy, popular and common test performed on heart patients to determine the severity of the heart disease. Taken at an interval, this test can also show the improvement or deterioration of patient’s angina.

A negative TMT or Stress Test is declared when the patient can reach a certain heart rate without showing any ECG changes. This rate is called a target heart rate and is calculated by a formula (Target Heart Rate = 220 – age of patient). If this rate is reached by the patient without producing any ECG changes, though the TMT can be called negative, but it would not mean that the blockage is zero. It will only mean that the person performing the test probably has a blockage less than 70%.