Diagnostic Services
Guided by a patient's symptoms such as shortness of breath, chest pain or irregular heart rhythm, cardiologists have a variety of tools available to identify the cause of heart-related problems, including:

Stress testing
These testing procedures include an electrocardiogram (EKG), which monitors the electrical activity of the heart. During a stress test, specialists measure the changes in the heart during exercise.

Nuclear stress testing
When a more complete study of the patient's condition is necessary, patients may undergo advanced forms of stress testing. During this procedure a patient is injected with a precise amount of Cardiolite and the heart is scanned at rest and after strenuous exercise. The heart muscle absorbs the Cardiolite, which in turn creates an image on the scan. Blank spots in the image may reflect previous heart damage, points out Campbell. After exercise, additional spots on the scan indicate blockage of the vessel that supplies that area with blood.

Echocardiography
This diagnostic ultrasound test allows cardiologists to look at the heart without using x-rays or surgery. Echocardiography is used to track blood flow through the heart. Color-coded images produced by ultrasound provide extremely detailed information about the function and condition of the valves and walls of the heart, revealing possible abnormalities undetectable using other techniques.

Electrophysiology study
The electrophysiology study is a test that maps the electrical conduction system in the heart. It can help identify the cause of symptoms related to heart rhythm disturbance, assess abnormally slow or fast heart rates, or assess the effectiveness of medications that are taken to regulate a disturbance in the heart rhythm.

Cardiac catheterization
This procedure uses a special fluid, visible by x-ray, to locate blockages in the arteries that supply oxygen and nutrients to the heart muscle.

MRI imaging
This technology provides high-quality, cross-sectional images of the heart and major blood vessels without x-rays or other radiation. During this procedure, the patient is exposed to short bursts of a powerful magnetic field that create shifts in the nuclei of the body's atoms. This creates a detectable radio signal that a computer converts into an image based on the strength of signals produced by different types of tissue.

PET scanning
Position emission tomography, also known as PET, is a diagnostic technique based on the detection of positrons (positively charged particles) that are emitted by substances injected into a patient's body. Pet scanning produces three-dimensional imagines that reflect the metabolic and chemical activity of the tissues being studied.

Holter monitoring
Patients wear this portable, 24-hour, electrocardiographic monitoring device which detects intermittent irregular heart beats or palpations.

Interventional Procedures
Depending on the results of the diagnostic tests, cardiologists may recommend changes in diet or physical activity, prescribe medication, recommend one or more of the following cath lab interventional procedures, or refer the patient to a cardiovascular surgeon for bypass surgery:

Angioplasty, coronary stent implant and rotational atherectomy
These high-technology procedures help restore blood flow in heart vessels without open-heart surgery. During angioplasty, a wire is passed directly to the blocked part of the patient's coronary artery, and a tiny balloon passes over the wire and is inflated to clear the blockage. In many cases, open-heart surgical repair of the coronary arteries can be postponed or avoided completely. Coronary stent implant is similar to angioplasty, but in addition, a coronary stent (a small mesh-like wire tube) is placed in the blocked or narrowed coronary artery to help keep it open. Once permanently placed, this device acts like a pipe or scaffold to hold the artery open. Rotational atherectomy (rotoblator) is used for certain types of blockages in the coronary arteries. This procedure involves the insertion of a catheter that has a high-speed, rotational "burr" that breaks up blockages into very small fragments that can pass, harmlessly, into the circulation. Angioplasty may be performed after atherectomy, depending upon the results.

Pacemaker implants
When the heart's natural pacemaker fails, an artificial pacemaker can be implanted. Once implanted, the pacemaker will emit a series of electrical signals, which result in regular contractions of the heart and normal blood flow through the circulatory system.

Implantable cardiac defibrillator (ICD)
An ICD is a light-weight electronic device implanted under the skin. It monitors heart rhythm and slows down or halts excessively rapid heart rates. Some of these rhythms, if untreated, would cause fatal outcomes within minutes. The procedure for insertion of the ICD is very similar to that of a pacemaker.

Radio frequency catheter ablation
This procedure, which is performed at the same time as an electrophysiology study, is done to treat fast heart rates. During an ablation, a catheter is guided into the heart to locate and eliminate the source of the irregular rhythm.

Cardioversion
Another procedure performed to correct a heart arrhythmia is the cardioversion. Used to correct atrial fibrillation, cardioversion involves sending an electrical shock to the heart. The shock briefly interrupts the heart, disrupts the arrhythmia and restores the heart to a normal rhythm.