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Equipment

What does a 24-hour Holter Monitor detect? | Cardiology

What is a holter monitor?

The Holter monitor is a small, battery-powered medical device that measures your heart’s activity, such as rate and rhythm. Your doctor may ask you to use one if they need more information about how your heart is working than a routine electrocardiogram (EKG) can provide.

A 24-hour Holter monitor is a continuous test to record your heart rate and rhythm for 24 hours. You wear a Holter monitor for 12 to 48 hours while going about your regular daily routine. This device has electrodes and electrical wires just like a regular EKG, but it has fewer leads. It can detect not only your heart rate and rhythm but also when you feel chest pain or symptoms of an irregular heartbeat or an irregular heartbeat.

The Holter monitor test is sometimes called a mobile ECG. There are different kinds of gadgets that can be utilized to gauge heart movement for longer time frames.

Why holter monitor?

In the event that you have signs or manifestations of a heart issue, for example, an unpredictable heartbeat (arrhythmia) or unexplained blacking out, your PCP may arrange a test called an electrocardiogram. An EKG is a short, non-invasive test that uses electrodes attached to your chest to check your heart’s rhythm.

However, sometimes, the EKG doesn’t detect any abnormalities in your heart rhythm because you are only connected to the device for a short time. If your signs and symptoms indicate that an irregular heartbeat may be causing your condition, your doctor may recommend that you wear a Holter monitor for a day or so. Over this time, the Holter monitor may be able to detect an irregularity in your heart rhythm that the EKG cannot detect.

Your doctor may also order a Holter monitor if you have a heart condition that increases your risk of developing an abnormal heart rhythm. Your doctor may suggest wearing a Holter monitor for a day or two, even if you don’t have any symptoms of an abnormal heartbeat.

How would I prepare for a holter monitor?

  • Your health care provider will explain the procedure and you can ask questions.
  • You do not need to fast (neither eat nor drink).
  • Depending on your medical condition, your healthcare provider may require another specific preparation.

What happens during a holter monitor?

Holter monitor is generally recorded on an outpatient basis. Procedures may vary depending on your condition and the practice of your healthcare provider.

In general, Holter screen recording follows this process:

  • You will be asked to remove any jewelry or other items that may interfere with the reading.
  • You will be asked to undress from the waist up so that the electrodes can be attached to your chest. The technician will ensure your privacy by covering you with a sheet or gown and only exposing the necessary skin.
  • The areas where the electrode stains are placed are cleaned, and in some cases, the hair may be shaved or trimmed so that the electrodes are closely attached to the skin.
  • Electrodes will be attached to your chest and abdomen. The Holter monitor will be connected to the electrodes by wires. The small screen box may be worn over your shoulder like a shoulder bag or around your waist or it may be attached to a belt or pocket.
  • Find out if you will have to change the batteries in the display. Make sure you know how to do this and that you have extra batteries on hand.
  • Once you are connected to the monitor and given instructions, you can return to your usual activities, such as work, housework, and exercise, unless your health care provider tells you otherwise. This will allow your healthcare provider to identify issues that may only occur with certain activities.
  • You will be asked to keep a diary of your activities while wearing the screen. Write down the date and time of your activities, especially if any symptoms, such as dizziness, heart palpitations, chest pain, or other previously encountered symptoms, occurred.

After the procedure

Once your observation period is over, you will return the device to your doctor’s office, along with the notes you kept while wearing a Holter monitor. Your doctor will compare data from the recorder and the activities and symptoms you noted.

What are the risks of a Holter monitor?

The Holter monitor is an easy way to assess heart function. The risks associated with a Holter monitor are rare. It can be difficult to keep the electrodes attached to your skin, and you may need extra tape. It can be uncomfortable when removing sticky electrodes and tape. If the electrodes are run for a long time, they may cause tissue breakdown or skin irritation at the application site. There might be different dangers relying upon your particular ailment. Make certain to talk about any worries with your medical care supplier before wearing the screen.

Certain factors or circumstances may interfere or affect the results of a Holter monitor. These include, but are not limited to:

  • Near magnets, metal detectors, high-voltage electrical wires, and electrical appliances such as razors, toothbrushes, and microwave ovens. Cell phones and MP3 players can also interfere with signals and they should be at least 6 inches away from the display box.
  • Smoking or using other forms of tobacco
  • Certain medications
  • Excessive sweating, which may cause the strings to loosen or fall off

Understanding the results

After the test period, the person returns to their doctor to have the screen removed. Provide any notes for the doctor to review and the doctor will consider screen readings and the person’s notes when making a diagnosis.

Holter monitor readings may reveal an underlying heart condition, new symptoms, and potential triggers. It may also help show the problems caused by medications. A person may have to wait for one to two weeks for the test results.

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Equipment

Types of Stress Testing Equipment | Cardiology

What is stress testing equipment?

A stress testing equipment (sometimes called a violence test) is a deliberately intensive or comprehensive test to determine the stability of a system, complex infrastructure, or a given entity. These are tests to observe results, often beyond normal operational capacity, to the point of failure. The reasons include:

  • To determine breaking points or limits of safe use
  • Planned features are being confirmed
  • The mathematical model is accurate enough to estimate breakpoints or safe use limits to verify
  • To test the constant operation of a component or system outside of standard use
  • To determine failure modes (how the system fails)

The word “stress” may have a more specific meaning in some industries, such as physics, so stress testing can sometimes have a technical meaning, in the example of a material fatigue test.

Alternate names

  • Stress test
  • Treadmill test
  • Stress EKG
  • Stress ECG
  • A nuclear stress test
  • Stress echocardiogram

What are the stress tests?

Stress testing equipment shows how well your heart can handle physical activity. Your heart beats faster and faster while you exercise. Some heart defects are easy to find when your heart is working hard. During a stress test, your heart will be monitored while you exercise on a treadmill or stationary bike.

If you are not healthy enough to exercise, you will be given medication that will make your heart beat faster and stronger, just like you exercise. If you have trouble completing the stress test at regular intervals, this means that the blood flow to your heart is reduced. Decreased blood flow is due to many different heart conditions, some of which are very serious.

Why do I need it?

Your doctor will use this stress testing equipment:

  • Find out if you have coronary heart disease and need more tests
  • Helps assess symptoms such as chest pain, shortness of breath, or palpitations to see if they are coming from the heart
  • Identify abnormal heart rhythms
  • Helps you develop a safe exercise program
  • See how well your heart valves are working

Types of stress testing equipment

Types of stress testing equipment are:

  • Exercise stress test
  • Stress test without exercise
  • Nuclear stress test

Exercise stress test:

During the stress test, the doctor aims to find out how tired the patient is by their heart rate, blood pressure, breathing, and various levels of physical activity. This test also includes an electrocardiogram (ECG or ECG) test. It is a simple test that records the electrical activity of the heart. This will help the doctor understand how well the heart is working.

The ECG shows how fast the heart is beating. It also analyzes the heart rate and measures the strength and timing of electrical signals as they pass through each part of the heart. The wires with the electrodes were attached to the patient’s chest, arms, shoulders, and legs. Eventually, the patient will need to suck into the mouthpiece.

Stress test without exercise:

If a person is unable to exercise as is involved in the stress test, the physician may use medications to induce the same process. A technician attaches electrodes to his chest, legs, and arms using adhesive patches.

They place the intravenous (IV) line in the patient’s hand and dispense medications through this line. The medications stimulate the heart and cause side effects similar to those experienced during exercises, such as redness or shortness of breath.

Nuclear stress test:

If the first symptoms persist or worsen, the doctor may recommend a nuclear stress test. Provides a more detailed and accurate assessment of the patient’s heart. The procedure is the same, but the color is injected into the patient’s hand which shows the heart and blood flow in the image.

It also shows areas of the heart where blood is not flowing. This indicates stagnation. This can be captured by x-rays, or single-photon emission tomography (SPECT), or cardiac positron emission tomography (PET). Two sets of photographs are taken, each of which lasts between 15 and 30 minutes. The first is taken after exercise and the second when the body is at rest, the next day or the next day.

Risk factors for stress testing equipment

Stress testing equipment is generally considered safe, especially if it is performed in a controlled environment under the supervision of a qualified healthcare professional.

However, there are some rare risks:

  • Heart attack
  • Irregular heartbeat
  • Collapsing
  • Chest pain
  • Fainting

However, the risk of experiencing these reactions during the test is low because your doctor will examine you beforehand for problems. People who are at risk for these complications, such as those with advanced coronary heart disease, are rarely asked to be tested.

Results of stress testing equipment

If the information gathered from your stress testing equipment shows that your heart function is normal, you do not need additional testing. However, if the results are normal and your symptoms get worse, your doctor may recommend a nuclear stress test or other stress tests that includes an echocardiogram before and after exercise to increase blood flow to your heart.

These tests are more accurate and provide more information about your heart function, but they are also expensive. If the results of your stress test indicate that you may have coronary artery disease or show arrhythmia, your doctor will use the information to develop a treatment plan. You may need additional tests, such as a coronary angiogram.

If you take a stress test to decide on treatment for heart disease, your doctor will use the results to plan or change your treatment.

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Tests

Risk Factors, and Results of Electrocardiogram | Cardiology

What is an electrocardiogram (ECG)?

An electrocardiogram is commonly called an ECG or EKG and it is a simple test used to check the rhythm and electrical activity of your heart. Sensors attached to the skin are used to detect the electrical signals your heart produces each time it beats. A machine records these signals, and the doctor sees if they are abnormal.

The electrocardiogram can be ordered by a cardiologist or any doctor who thinks you have a heart problem, including your GP. This test can be done by a hospital, clinic, or healthcare professional who is specially trained in surgery by your GP. Despite the similar name, the electrocardiogram is not the same as the echocardiogram, which is a scan of the heart.

Natural electrical impulses coordinate the contractions of different parts of the heart, causing blood to flow. An electrocardiogram records these impulses to show the strength and timing of the electrical impulses as the heartbeats, the rhythm of the heartbeat (constant or irregular), and the passage through different parts of the heart. Changes in the ECG indicate heart conditions.

Why is an electrocardiogram done?

Your doctor may recommend an electrocardiogram to assess the health of your heart. This is a common part of checkups, especially for those over 40.

An electrocardiogram by itself does not diagnose all types of heart conditions or predict future heart problems. Provides important information about your heart health-related to your age, physical exam, medical history, and other tests.

  • Identify abnormal heart rhythms that cause blood to clot.
  • Identifying heart problems includes a recent or ongoing heart attack, abnormal heart rhythms (arrhythmia), coronary artery occlusion, damaged areas of the heart muscle (from a previous heart attack), inflammation of the broken heart, and shock around the heart.
  • Identify non-cardiac conditions such as electrolyte imbalance and lung and lung diseases.
  • Heart attack, the progression of heart disease, or recovery from the effect of certain medications or pacemakers.
  • Eliminate hidden heart disease in patients undergoing surgery.

When are ECGs needed?

In some cases, having this test is very important. If you have symptoms of high blood pressure or heart disease, chest pain, shortness of breath, irregular heartbeat, or large heartbeat, you may need an electrocardiogram. You may need screenings or tests for professional purposes or if you have a personal or family history of heart disease, diabetes, or other accidents and want to start exercising.

How the test is done

You will be asked to remove all clothing and jewelry from your waist (including women’s bras) to place electrodes on specific areas of the chest wall, arms, and legs. The electrodes are held in place by rubber bands, suction cups, or adhesive pads.

Sometimes it is necessary to shave the skin where the electrode recording patches are placed to easily detect the electrical signal and reduce discomfort when removing the patches. For a standard 12-bottle ECG, the electrodes are placed in 4 positions on the 4 extremities and 6 on the chest wall. Sometimes additional leads are added for a 15-lead electrocardiogram.

You will be prompted to remain normal when the machine is turned on, and typically a sample (usually 3-4 seconds) from each electrode site is recorded. The electrocardiogram is usually constantly monitoring and may ask you to hold your breath for a short time during the procedure (to stop chest wall movement that interferes with the signal). The machine captures the electrical activity of the wires and then produces a graph with an up and down row that looks a bit like a geographic map but indicates the activity of your heart.

Types of electrocardiogram

The types of ECG are:

  • Standard (resting) ECG: The electrocardiogram measures the electrical activity of your heart while you lie down or rest in a semi-reclined position. This is the most common type of ECG.
  • Stress test (exercise ECG or tape test): This usually involves taking an electrocardiogram on a treadmill while you exercise. Show how exercise affects your heart. Helps diagnose and diagnose coronary artery disease and other types of heart disease. Medications are sometimes given instead of mimicking the effect of exercise on the heart.
  • Holter monitor (24-hour ECG or ambulatory ECG): This includes the use of an electronic electrocardiogram recorder 24 hours a day. It records the electrical activity of your heart for 24 hours. It can help diagnose arrhythmias (irregular or abnormal heartbeats).
  • Cardiac event recorders record an electrocardiogram for an extended period, a year or more. Portable cardiac event recorders record the electrical activity of the heart when you have symptoms. Adjustable loop recorders are mounted under the skin on your chest. They constantly record the electrical activity of your heart.

Results of ECG

For most people, an electrocardiogram is just a series of lines. However, each line corresponds to an electrical signal sent from the heart. Doctors can read and understand these lines, which indicate the general condition of the heart.

The operating physician or healthcare professional places the electrodes on a person’s skin, usually around the chest, and at 10 different points on the extremities. Each beat sends an electrical impulse. These electrodes select this pulse and record the activity as a waveform on a graph.

All of these take place in the eyelid, so an EKG is very important. An ECG can capture all these little details and record them for the doctor to analyze.

Risk factors of ECG

Electrocardiograms (EKGs) are safe, non-invasive, painless, and accident-free tests. The electrodes (adhesive patches) that connect the sensors to your chest do not send electrical shocks. People who undergo stress tests have a higher risk of having a heart attack, but this is related to exercise, not the EKG.

You may develop a mild rash or irritation of the skin where the electrodes are placed. If paste or gel is used to place the electrodes, you may have an allergic reaction. This irritation usually disappears without the need for treatment, once the patches are removed.

Specialists who handle ECG

  • Cardiac surgeons specialize in the surgical treatment of the heart and its vascular conditions. They are also known as cardiothoracic surgeons.
  • Pediatric cardiologists and cardiologists are interns or pediatricians who specialize in diagnosing and treating diseases or situations of the heart and its blood vessels.
  • Emergency medicine specialists specialize in the diagnosis and treatment of sudden illness or injury and difficulties of chronic illness.
  • Interventional cardiologists are cardiologists who specialize in diagnosing and treating conditions and diseases of the heart and its blood vessels. They use catheter-based non-surgical procedures and imaging techniques.
  • Primary care providers include interns, family practitioners (family medicine physicians), pediatricians, geriatricians, physician assistants (PA), and nurse practitioners (NP). Primary care providers provide comprehensive health services and treat a wide variety of ailments and conditions.
  • Thoracic surgeons train in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. They are also known as cardiothoracic surgeons.
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Specialists

Cardiac Rehabilitation Specialist – Overview | Cardiology

Who is a cardiac rehabilitation specialist?

A cardiac rehabilitation therapist also called a cardiac rehabilitation specialist, develops nutrition, exercise and education programs to promote wellness and fortify patients who have undergone heart surgery or who have chronic heart disease.

Cardiac rehabilitation has been shown to help patients live longer after developing heart disease. Our cardiac rehabilitation specialist teams develop customized programs that combine exercise and education to help patients safely recover from heart disease, heart surgery, or a cardiac event such as a heart attack.

Our cardiac rehabilitation specialist remains in close contact with the patients’ cardiologists and referring physicians. We inform the patients’ physicians of any concerns regarding their heart rate, heart function or blood pressure or if there is a reason to adjust their medications.

Members of the patient’s cardiac rehabilitation specialist may include:

  • Cardiologists
  • Exercise physiologists
  • Counsellors
  • Physical therapists
  • Dietitians

Responsibilities of a cardiac rehabilitation specialist

A cardiac rehabilitation specialist might be required to play out any or the entirety of the accompanying obligations:

  • Help the patient understand their condition

One of the most important things and responsibilities that a cardiac rehabilitation specialist takes on is helping the patient understand their condition and how their medical system will be structured. This includes helping them understand the changes they may need to make in their normal routine and what to expect moving forward.

  • Explain the course of treatment

The other main responsibility of the cardiac rehabilitation specialist revolves around explaining the course of treatment plans and helping them understand when a patient may be able to resume their normal activities.

Since patients may experience fatigue while suffering from heart and lung disease, the patient may be keen to know when they can return to normal life and not feel tired. The main responsibility is to educate them about what a recovery schedule looks like and how quickly they can expect to recover.

  • Provide counselling, coaching, and support based on patient concerns

As noted earlier, patients may have concerns related to their recent diagnosis and understanding of their medical condition. Cardiac rehabilitation specialists may be concerned about what their future will look like, how difficult the future will be and any concerns they might have about their treatment plan. A patient who understands his future care plan and remains positive about his future prospects, will stick to it closely and increase the chances of improving his overall well-being.

  • Identify risk factors

The other responsibility of the cardiac rehabilitation specialist is to determine any risk factors that may contribute to the patient’s disease. This includes things like high blood pressure, smoking, poor diet or obesity. There are other risk factors to be aware of that can contribute to a patient’s heart and lung risks and diseases.

If you can identify them, you can work on a treatment plan about reducing these risks and educating the patient about why they need to be avoided.

  • Educate the patient about their risk factors

Another responsibility of cardiopulmonary rehabilitation specialists is to educate the patient about his or her risk factors and how these risk factors might slow down his recovery or worsen it over time if changes are not made. Educating the patient about their risk factors also revolves around educating them about how these risk factors affect their commitment to the lifestyle changes needed to improve their health.

  • Identify potential interventions that may reduce health risks

When a patient has to drastically change his lifestyle to improve his well-being and lead a healthy life, these interventions are known as interventions. As a specialist in cardiopulmonary rehabilitation, the other primary responsibility is to determine which and all interventions can be used to help reduce their risks and relapse into an unhealthy lifestyle.

  • Educating the patient about key lifestyle changes

The other primary responsibility of the cardiopulmonary rehabilitation specialists is to educate the patient about some of the major lifestyle changes they will need to make to improve their wellness. This may include educating them about the foods they need to refrain from and the foods they should eat. Recommending how often they should do exercises based on their current routine and the benefits of participating in such activities. 

Why is this cardiac rehabilitation program important?

Cardiac rehabilitation specialist can save many lives. It can help prevent future heart problems, heart events, and related deaths. According to studies, people who go to cardiac rehabilitation have up to 30% fewer fatal heart conditions, and a 25% lower risk of death compared to people who receive standard treatment alone. Cardiac rehabilitation specialist can also reduce their chances of having a second heart attack or heart surgery.

People enrolled in this program usually have greater success when it comes to controlling other cardiovascular risk factors (for example, high blood pressure or cholesterol). This is because cardiac rehabilitation programs are comprehensive, fully patient-centred and providing them with the tools and information needed to make long-term health changes.

Other benefits include:

  • Less chest pain and in some cases, less medication to treat it
  • Preventing future hospitalization
  • Weight loss
  • Better nutrition and knowledge of how to make heart-healthy choices
  • Reducing stress and increasing emotional well-being

Who should take part in cardiac rehab?

Many people with a range of heart problems can benefit from a cardiac rehabilitation specialist. It is often recommended for people who have:

  • A recent heart attack
  • Stable pain in the chest also called angina
  • Heart failure
  • Cardiac procedures such as percutaneous coronary intervention (PCI), which includes an angioplasty or heart stent
  • Heart surgery, such as coronary artery bypass surgery or heart valve repair or replacement
  • Heart or heart-lung transplant

What is the cardiac rehab program?

Your cardiac rehabilitation program is designed to meet your needs. It is supervised by a cardiac rehabilitation specialist and a team of heart health providers. Your program may last from about a month and a half to over a year.

The goal of cardiac rehabilitation specialist is to help relieve symptoms and make your heart as healthy as possible. It may include your program:

  • Exercise program: This makes you fitter and helps your heart function better.
  • Classes to help you change your lifestyle and habits: For instance, classes and back to assist you with stopping smoking. Or you can take a nutrition class to learn how to eat better.
  • Stress management: You will learn how to manage stress to reduce your anxiety.
  • This will help you learn about your own condition and how to cope with it.
  • Occupational therapy: This is to help you prepare to return to work or to manage the normal activities of daily life.

After cardiac rehabilitation

After the cardiac rehabilitation program ends, you will generally need to continue the diet, exercise, and other healthy lifestyle habits that you have learned for the rest of your life to maintain the heart health benefits. The goal is that, at the end of the program, you are confident exercising on your own and enabling you to maintain a healthier lifestyle.

Results

Cardiac rehabilitation is a long-term maintenance program and you’ll generally need to continue the habits and skills you learned in the program for the rest of your life. After about three months, you will likely have developed your own exercise routine at home or at your local gym.

You can also continue to exercise at a cardiac rehabilitation centre, fitness centre, or club. You can also exercise with friends or family. You can remain under medical supervision during this time, especially if you have special health concerns.

Education about nutrition, lifestyle, and a healthy weight may continue, in addition to counselling. To get the most benefits from cardiac rehabilitation, make sure your exercises and lifestyle practices become lifelong habits.

In the long term, you can:

  • Gain strength
  • Learn heart-healthy behaviours, such as regular exercise and a heart-healthy diet
  • Stop bad habits and such as smoking
  • Control your weight
  • Find ways to manage stress
  • Learn how to deal with heart disease
  • Reduce your risk of coronary artery disease and other heart diseases

Often one of the most important benefits of cardiac rehabilitation is to improve your overall quality of life. If you stick to your cardiac rehabilitation program, you may drop out of the program and feel better than before. You have a heart condition or have had heart surgery.

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Tests

4 Types and Procedures of Stress Test | Cardiology

What Is a stress test?

Doctors use a stress test, also known as an exercise test or a treadmill test, to see how well a patient’s heart works during physical activity.

A stress test can also help a doctor advise patients on the best type of physical activity for them. A stress test usually involves walking on a treadmill or riding a stationary bike while monitoring the patient’s breathing, blood pressure, and heartbeat.

Some patients, such as those with arthritis, will not be able to do the activities involved in a stress test during exercise. Instead of exercising, the patient can take medication to make the heart work harder, as might happen during exercise.

Types of stress tests

We recommend different types of stress tests based on your general health and symptoms. Our doctors and imaging specialists are experienced in performing stress tests and interpreting the results.

1. Cardiopulmonary exercise test (CPET):

This comprehensive test assesses how well your heart and lungs are working together to deliver oxygen-rich blood to your body. It also shows how well your muscles are using oxygen while you exercise at increased levels. CPET can evaluate:

  • Reasons for shortness of breath
  • Fitness level and ability to exercise, especially after a heart attack or heart surgery
  • Lung function

The CPET test is similar to the exercise stress test but it also measures lung function, including:

  • The amount of oxygen your body uses during exercise
  • Your breathing pattern
  • The amount of carbon dioxide you produce

We use this test not only to identify many types of heart and lung disease but also to:

  • Monitor people who already have these conditions and check for disease progression
  • Measure how well treatments are working
  • Determine if the exercise restrictions are due to a heart or lung problem

2. Exercise stress test

This test uses an EKG during exercise to assess blood flow to your heart. We do a stress test while exercising on the treadmill or stationary bike at a gradually increasing rate. We use this test to raise your heart rate so we can detect heart problems affecting blood flow.

The exercise stress test only measures the electrical activity of your heart, not the lung function like CPET. We use this test to:

  • Determining safe levels of exercise after a heart attack or heart surgery
  • Diagnosing and determining the severity of coronary heart disease and other types of heart disease
  • Diagnose an arrhythmia
  • Find out what causes symptoms that only appear during exercises, such as shortness of breath, fainting or an irregular heartbeat
  • Treatment planning guidance, such as medications, cardiac catheterization (minimally invasive heart procedures), surgery or implantation

3. Pharmacologic stress test

This stress test assesses the blood flow to your heart using an EKG but does not involve any physical activity. We recommend a drug stress test for people who are unable to exercise due to physical limitations such as arthritis, joint or back conditions, injury or disability. For this test, you receive medication to stimulate your heart and make it beat harder and faster as if you were exercising.

Use the drug stress test to:

  • Determine safe levels of physical activity if you have a heart attack or heart surgery
  • Diagnosing many types of heart disease and determining their severity
  • Guiding decisions about treatment options, such as medication, cardiac catheterization (minimally invasive heart procedures), surgery or implantation
  • Evaluate how well your treatment increases blood flow to the heart

4. Nuclear stress test

This type of stress test includes a radioactive dye and imaging studies to show blood flow to the heart, both at rest and when the heart rate is elevated. As with other types of stress tests, we record the electrical activity of your heart with an EKG.

During a nuclear stress test, you receive an injection of a radioactive dye through an intravenous (IV) line. The dye travels through the bloodstream and your heart. While you’re still at rest, we scan your heart with a special camera that captures the radioactive dye to show blood flowing into and through your heart.

In the second part of the test, you start exercising on a treadmill or stationary bike. If you are unable to exercise, we can give you medicine to increase your heart rate. Then we check more images of your heart to capture blood flow to the heart during increased activity.

Nuclear stress tests show which parts of the heart are receiving enough blood and which ones are not. The tests provide details that can indicate heart disease and severity and show tissue damage from a previous heart attack.

Why stress test is done?

Your doctor may recommend a stress test to:

  • Diagnose coronary artery disease: Coronary arteries are the main blood vessels that supply your heart with blood, oxygen, and nutrients. Coronary artery disease develops when these arteries are damaged or sick – usually due to a buildup of plaques containing cholesterol and other substances (plaques).
  • Diagnose heart rhythm problems (arrhythmias): Arrhythmias occur when the electrical impulses that coordinate your heart’s rhythm do not work properly, causing your heart to beat too fast, too slowly or irregularly.
  • Guide treatment of heart disorders: If you’ve already been diagnosed with heart disease, an exercise stress test can help your doctor know how well treatment is working. It can also be used to help create a treatment plan for you by showing how much exercise your heart can handle.
  • Your doctor may use a stress test to help determine the timing of heart surgery, such as valve replacement. In some people with heart failure, results of a stress test may help a doctor determine whether you need a heart transplant or other advanced treatments.

Your doctor may recommend an imaging test, such as a nuclear stress test or an echocardiogram stress test if an exercise stress test doesn’t determine the cause of your symptoms.

By what means should I prepare for the exercise stress test?

  • Do not eat or drink anything except water for the 4 hours before the test.
  • Do not drink or eat anything containing caffeine for the 12 hours before the test.
  • Do not take the following heart medications on the day of the test, unless your doctor tells you otherwise or if medication is needed to treat chest discomfort on the day of the test:
    • Isosorbide dinitrate(for example, Isordil, Dilatrate SR)
    • Isosorbide mononitrate(for example, ISMO, Imdur, Monoket)
    • Nitroglycerin(for example, Deponit, Nitrostat, Nitro-Bid)
  • If you are using a breathing inhaler, bring it to the test.

You may also be asked to stop taking other heart medications on the day of the test. If you have questions about your medications, ask your doctor. Do not stop taking any medication without first consulting with it.

During the stress test

You will slowly start exercising on a treadmill or stationary bike, then gradually increase the speed of the treadmill or resistance bike until your heart works at the target heart rate for your age. Most often, the stress test includes an electrocardiogram to measure the electrical activity of your heart while you exercise on a treadmill or on a stationary bike. Your doctor may also measure the blood oxygen level, blood pressure, heart rate.

During the test, you’ll exercise for 10 to 15 minutes. And we have better stress test equipment. Your primary care physician will stop the test on the off chance that you give any indication of a heart issue, in the event that you are too worn out to even consider continuing the test.

If you are not able to exercise, your doctor will give you the medication for over 10 to 20 minutes through an intravenous (IV) line into a blood vessel.

Your doctor may also take pictures of your heart during or immediately after a stress test to see how well blood flows through your heart and how well your heart pumps blood when it beats. These images can be taken by echocardiogram or by injecting a radioactive dye into a vein, which is called a nuclear heart scan. The amount of radiation in the dye is safe for you and those around you. However, if you are pregnant, this test should not be performed due to the risks it may pose to your unborn baby.

If your doctor also wants to know how well your lungs are working, you may be asked to wear a mask or mouthpiece to measure the gases you breathe in during the stress test.

Following up after an exercise stress test

After the test, you will be given water and asked to rest. If your blood pressure rises during the test, the nurse may continue to monitor your blood pressure.

A couple of days after the test, your primary care physician will survey the outcomes with you. The test can reveal an irregular heartbeat or other symptoms that indicate coronary artery disease, such as blocked arteries.

If your doctor determines that you may have coronary artery disease or other heart problems, he may begin treatment or order further tests, such as a nuclear stress test.

Risk factors

These tests are usually safe. Sometimes, exercise or medication that increases the heart rate can cause symptoms such as chest pain, dizziness, or nausea. You will be monitored closely throughout the test to reduce the risk of complications or to treat any health problems quickly.

The radioactive dye used for a nuclear stress test is safe for most people. In rare cases, it may cause an allergic reaction. Also, a nuclear stress test is not recommended for pregnant women, as the dye may be harmful to a fetus.

Results

If the information gathered during the exercise stress test shows that your heart function is normal, you may not need any other tests. However, if the results are normal and symptoms continue to worsen, your doctor may recommend nuclear or other stress tests that include an echocardiogram before and after exercise or taking medications to increase blood flow to your heart. These tests are more exact and give more data about your heart work, yet they are likewise more costly.

If the stress test results indicate the possibility of coronary artery disease or an irregular heartbeat, your doctor will use the information to create a treatment plan. You may require extra tests, for example, a coronary angiogram. If you have a stress test to help determine a treatment for heart disease, your doctor will use the results to plan or change your treatment.

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Procedures

Overview of lumbar puncture (spinal tap) | Neurology

What is a lumbar puncture (spinal tap)?

A lumbar puncture (spinal tap) is acted in the lower back, in the lumbar locale. During a lumbar puncture, a needle is inserted between the two lumbar bones (vertebrae) to remove a sample of cerebrospinal fluid. This is the liquid that encompasses the cerebrum and spinal rope to shield them from injury.

A lumbar puncture can help analyze genuine contaminations, for example, meningitis. Other central nervous system disorders, such as Guillain-Barré syndrome and multiple sclerosis, or cancers of the brain or spinal cord. A lumbar puncture is now and again used to infuse sedation or chemotherapy drugs into the cerebrospinal liquid.

Why is a spinal tap performed?

A spinal tap may be performed to rule out an infection such as meningitis or encephalitis as a cause of epileptic seizures.

Besides used to treat epilepsy, the cerebrospinal fluid test can help diagnose disorders of chronic inflammatory demyelinating polyneuropathy, the central nervous system that may include the brain, spinal cord, or their covering (the meninges). Examples include meningitis, multiple sclerosis, Guillain-Barré syndrome, or idiopathic headache.

CSF contains glucose (sugar), proteins, and different substances found in the blood. The fluid test will show the number and types of white blood cells, glucose level, types and levels of proteins, and the presence of bacteria, fungi, or abnormal cells.

A spinal tap may also be performed:

  • Measurement of pressure around the brain and spinal cord
  • Relieve pressure in the head
  • Spinal anaesthesia
  • Inject the dye for an X-ray diagnostic test
  • Injection medications (such as baclofen)

NOTE: A cerebrospinal fluid test may not be necessary if a spinal tap is done to inject the drug.

What are the benefits of a lumbar puncture?

A lumbar puncture can help your PCP precisely analyze or preclude certain ailments, including some dangerous ailments. The sooner they diagnose the diagnosis, the faster you can get appropriate treatment. Some conditions, such as bacterial meningitis, can be fatal if you don’t get them treated quickly enough.

A lumbar puncture can likewise enable your PCP to give you a few sorts of prescriptions.

What are the risks of a lumbar puncture?

A lumbar puncture is generally safe, but there may be some risks. According to our clinic, up to a quarter of people who have a lumbar puncture develop a headache afterwards. Lying down for a few hours after the procedure may reduce your risk of headaches.

Other potential risks include pain or pain in the lower back and bleeding near the puncture site. You may feel some pain and numbness going down your legs. In rare cases, people have brainstem herniation, which is the movement of brain tissue from its normal position in your skull. This is uncommon.

Before having a lumbar puncture

Your primary care physician or medical caretaker ought to clarify what will occur and why you need a lumbar puncture.

A few days or weeks before the test:

  • You may have a CT scan or an MRI scan – to make sure you need a lumbar puncture and that it is safe to have one.
  • Tell the hospital if you are taking blood-thinning medications (anticoagulants) – such as warfarin

On the day:

  • You can eat, drink and accept prescription as would be expected
  • You will be drawn closer to sign a consent structure
  • You will usually need to undress and wear a hospital gown before the procedure – you may also want to use the toilet

How is the LP procedure performed?

Usually, patients lie on their side for the procedure. Often times, the procedure is performed while the patient is seated and leaning slightly forward.

After nearby sedation is infused into the lumbar district, a long needle is embedded between the bones of the spine (vertebrae) into the spinal waterway. (The needle is most usually positioned between the third and fourth lumbar vertebrae.)

Your cerebrospinal fluid pressure may then be measured and the cerebrospinal fluid (CSF) removed for testing.

What happens after a lumbar puncture?

This helps reduce the occurrence of headaches. It will allow you to roll from side to side as long as your head is not raised. If you need to urinate, you may need to do so in a bedspread or urinal during the time you need to stay flat.

You will be asked to drink additional fluids to replace the fluids after the operation. This replaces the cerebrospinal fluid that was withdrawn during a spinal tap and reduces the chance of a headache. After you recover, you may be taken to your hospital room or discharged home. If you go home, your healthcare provider will usually advise you to rest for the rest of the day

Once you are at home, notify your service provider of any abnormalities, such as:

  • Numbness and tingling in the legs
  • Blood or pain at the injection site
  • Inability to urinate
  • Headache

In the event that the migraine endures for in excess of a couple of hours after the technique, or when the position changes, contact the Neuroradiology group with the telephone number on your release directions.

You may be required to restrict your activity for 24 hours after the procedure. Your healthcare provider may give you other specific instructions about what to do after the lumbar puncture.

Spinal tap results

The CSF samples are sent to a laboratory for analysis. Lab technicians check a number of things when examining spinal fluid, including:

  • General look: The cerebrospinal fluid is usually clear and colourless. If it is cloudy, yellow, or pink, this may indicate abnormal bleeding. Green spinal fluid may indicate an infection or the presence of bilirubin.
  • Protein (total protein and presence of certain proteins): High levels of total protein – more than 45 milligrams per deciliter (mg / dL) – may indicate the presence of an infection or other inflammatory conditions. The specific laboratory qualities may fluctuate from the clinical office to the clinical office.
  • White blood cells: The cerebrospinal fluid usually contains up to 5 white blood cells (mononuclear leukocytes) per microliter. Increasing numbers may indicate infection. Specific laboratory qualities may differ from the clinical office to the clinical office.
  • Sugar (glucose): A low level of glucose in your cerebrospinal fluid may indicate an infection or other condition.
  • The presence of microscopic organisms, infections, parasites, or different microorganisms can show disease.
  • Cancer cells: Abnormal cells in the cerebrospinal fluid – such as a tumor or immature blood cells – can indicate certain types of cancer.

Lab results are combined with information obtained during the test, such as cerebrospinal fluid pressure, to help determine a possible diagnosis. A healthcare professional generally gives you results in a few days, but it may take longer. Ask when you expect to receive your test results.

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Overview of Electrocardiogram (ECG) Test | Cardiology

What is an electrocardiogram (ECG)?

An electrocardiogram is commonly called an ECG or EKG and it is a simple test used to check the rhythm and electrical activity of your heart. Sensors attached to the skin are used to detect the electrical signals your heart produces each time it beats. A machine records these signals, and the doctor sees if they are abnormal.

The ECG can be ordered by a cardiologist or any doctor who thinks you have a heart problem, including your GP. This test can be done by a hospital, clinic, or healthcare professional who is specially trained in surgery by your GP.

Despite the similar name, the ECG is not the same as the echocardiogram, which is a scan of the heart.

Natural electrical impulses coordinate the contractions of different parts of the heart, causing blood to flow. An ECG records these impulses to show the strength and timing of the electrical impulses as the heartbeats, the rhythm of the heartbeat (constant or irregular), and the passage through different parts of the heart. Changes in the ECG indicate heart conditions.

Purpose of electrocardiogram

Your doctor may recommend an EKG to assess the health of your heart. This is a common part of checkups, especially for those over 40.

An EKG by itself does not diagnose all types of heart conditions or predict future heart problems. Provides important information about your heart health-related to your age, physical exam, medical history, and other tests.

  • Identify abnormal heart rhythms that cause blood to clot.
  • Identifying heart problems includes a recent or ongoing heart attack, abnormal heart rhythms (arrhythmia), coronary artery occlusion, damaged areas of the heart muscle (from a previous heart attack), inflammation of the broken heart, and shock around the heart.
  • Identify non-cardiac conditions such as electrolyte imbalance and lung and lung diseases.
  • Heart attack, the progression of heart disease, or recovery from the effect of certain medications or pacemakers.
  • Eliminate hidden heart disease in patients undergoing surgery.

When are ECGs needed?

In some cases, having this test is very important. If you have symptoms of high blood pressure or heart disease, chest pain, shortness of breath, irregular heartbeat, or large heartbeat, you may need an electrocardiogram. You may need screenings or tests for professional purposes or if you have a personal or family history of heart disease, diabetes, or other accidents and want to start exercising.

How is the electrocardiogram test done?

You will be asked to remove all clothing and jewelry from your waist (including women’s bras) to place electrodes on specific areas of the chest wall, arms, and legs. The electrodes are held in place by rubber bands, suction cups, or adhesive pads.

Sometimes it is necessary to shave the skin where the electrode recording patches are placed to easily detect the electrical signal and reduce discomfort when removing the patches. For a standard 12-bottle ECG, the electrodes are placed in 4 positions on the 4 extremities and 6 on the chest wall. Sometimes additional leads are added for a 15-lead ECG.

You will be prompted to remain normal when the machine is turned on, and typically a sample (usually 3-4 seconds) from each electrode site is recorded. The ECG is usually constantly monitoring and may ask you to hold your breath for a short time during the procedure (to stop chest wall movement that interferes with the signal). The machine captures the electrical activity of the wires and then produces a graph with an up and down row that looks a bit like a geographic map but indicates the activity of your heart.

Types of electrocardiogram (ECG)

The types of an electrocardiogram are:

  • Standard (resting) ECG: The ECG measures the electrical activity of your heart while you lie down or rest in a semi-reclined position. This is the most common type of ECG.
  • Stress test (exercise ECG or tape test): This usually involves taking an ECG on a treadmill while you exercise. Show how exercise affects your heart. Helps diagnose and diagnose coronary artery disease and other types of heart disease. Medications are sometimes given instead of mimicking the effect of exercise on the heart.
  • Holter monitor (24-hour ECG or ambulatory ECG): This includes the use of an electronic ECG recorder 24 hours a day. It records the electrical activity of your heart for 24 hours. It can help diagnose arrhythmias (irregular or abnormal heartbeats).
  • Cardiac event recorders record an ECG for an extended period, a year or more. Portable cardiac event recorders record the electrical activity of the heart when you have symptoms. Adjustable loop recorders are mounted under the skin on your chest. They constantly record the electrical activity of your heart.

Risk factors for electrocardiogram (ECG)

Electrocardiograms (EKGs) are safe, non-invasive, painless, and accident-free tests. The electrodes (adhesive patches) that connect the sensors to your chest do not send electrical shocks.

People who undergo stress tests have a higher risk of having a heart attack, but this is related to exercise, not the EKG.

You may develop a mild rash or irritation of the skin where the electrodes are placed. If paste or gel is used to place the electrodes, you may have an allergic reaction. This irritation usually disappears without the need for treatment, once the patches are removed.

Procedure for electrocardiogram (ECG)

It is not necessary to limit food or drink before performing the ECG test. Always tell your doctor what medications you are taking before receiving the electrocardiogram and if you have any allergies to the adhesive tapes used to attach the electrodes.

When an ECG test is to be performed, the upper garment will need to be removed so that the electrodes adhere to the chest and extremities. (For women, wearing a special blouse with pants or a skirt can easily penetrate the chest.) If necessary, the selected sites can be shaved.

Electrodes (sensors) are attached to the chest, arms, and legs with suction cups or sticky gel. These electrodes detect the currents generated by the heart; they are measured and recorded by an electrocardiograph.

There are three main types of the electrocardiogram:

  • Resting ECG: You lie down for this type of ECG. No movements are allowed during the test, as electrical impulses generated by other muscles can interfere with those generated by your heart. This type of ECG usually takes 5 to 10 minutes.
  • Ambulatory ECG: If you have an ambulatory ECG or Holter, you must wear a portable recording device for at least 24 hours. Usually, you can turn it on when the monitor is connected. These types of ECG symptoms may not appear intermittently (stop-start) and on the resting ECG and are used to ensure that your heart is working properly in people recovering from a heart attack. Record your symptoms in a journal and note when they occur so that your own experience can be compared to an ECG.
  • Cardiac stress test: This test is used to record your ECG when you are riding an exercise bike or running on a treadmill. This type of ECG takes 15 to 30 minutes to complete.

Results of electrocardiogram

For most people, an electrocardiogram is just a series of lines. However, each line corresponds to an electrical signal sent from the heart. Doctors can read and understand these lines, which indicate the general condition of the heart.

The operating physician or healthcare professional places the electrodes on a person’s skin, usually around the chest, and at 10 different points on the extremities.

Each beat sends an electrical impulse. These electrodes select this pulse and record the activity as a waveform on a graph.

All of these take place in the eyelid, so an EKG is very important. An ECG can capture all these little details and record them for the doctor to analyze.

Specialists who handle electrocardiogram

  • Cardiac surgeons specialize in the surgical treatment of the heart and its vascular conditions. They are also known as cardiothoracic surgeons.
  • Pediatric cardiologists and cardiologists are interns or pediatricians who specialize in diagnosing and treating diseases or situations of the heart and its blood vessels.
  • Emergency medicine specialists specialize in the diagnosis and treatment of sudden illness or injury and difficulties of chronic illness.
  • Interventional cardiologists are cardiologists who specialize in diagnosing and treating conditions and diseases of the heart and its blood vessels. They use catheter-based non-surgical procedures and imaging techniques.
  • Primary care providers include interns, family practitioners (family medicine physicians), pediatricians, geriatricians, physician assistants (PA), and nurse practitioners (NP). Primary care providers provide comprehensive health services and treat a wide variety of ailments and conditions.
  • Thoracic surgeons train in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. They are also known as cardiothoracic surgeons.
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Polysomnography (Sleep Study) Procedure | Neurology

What is Polysomnography?

Polysomnography, also called a sleep study, is a test used to diagnose sleep disorders. Polysomnography records cerebrum waves, blood oxygen level, pulse, and breathing, just as eye and leg developments during the examination.

Polysomnography is usually done in a sleep disorders unit within a hospital or a sleep centre. The test records your sleep patterns at night. Polysomnography is sometimes performed during the day to accommodate the shift workers who usually sleep during the day.

In addition to helping diagnose sleep disorders, polysomnography can be used to help adjust your treatment plan if you have already been diagnosed with a sleep disorder.

Why do I need a polysomnography?

A doctor can use polysomnography to diagnose sleep disorders. The symptoms of sleep apnea, which is a disorder in which breathing constantly stops and starts again, is often evaluated during sleep. Symptoms include sleep apnea:

  • Daytime sleepiness despite rest
  • Constant and loud snoring
  • Periods of holding your breath during sleep, followed by inhalations for air
  • Frequent bouts of awakening during the night
  • Sleep without rest

Polysomnography can likewise enable your PCP to analyze the accompanying rest issues:

  • Sleep-related seizure disorders
  • Periodic limb movement disorder or restless legs syndrome, which involves uncontrolled bending and extending of the legs during sleep
  • REM sleep behaviour disorder, which involves the realization of dreams during sleep
  • Chronic insomnia, which involves difficulty falling asleep or staying asleep

The National Heart, Lung, and Blood Institute (NHLBI) warns that if sleep disorders are not treated, they may increase your risk:

  • Heart disease
  • Stroke
  • High blood pressure
  • Depression

There is also an association between sleep disturbances and an increased risk of injuries associated with falls and car accidents.

How do you prepare for the sleep study?

You may be advised to avoid drinks or foods containing alcohol or caffeine during the afternoon and evening hours before polysomnography. Liquor and caffeine can adjust your rest examples, and they may intensify indications of some rest problems.

A nap in the afternoon before a sleep study is discouraged. You will usually be asked to shower or shower before your sleep study. However, do not apply lotions, gels, cologne, or make-up before the test, as they can interfere with the use of the electrodes.

Polysomnography procedure

People usually arrive at a sleep centre in the evening to stay overnight to monitor their sleep patterns.

The environment is usually set up in a style similar to a hotel room, with a private bathroom and little noise or light to distract the individual. The room is equipped with a video camera to capture the movement and behaviour of the individual during his sleep, in addition to an audio system that allows any sounds to be monitored. This also allows for communication with technicians, if needed, for example, if the patient needs to go to the bathroom at night.

After the individual is ready to sleep according to their nighttime routine, a sensor will be placed on the scalp, temples, chest, and legs. The sensors are associated with the registering framework, through long wires that permit the person to move unreservedly in the bed. A blood oxygen level monitor is also placed on the patient’s finger or ear to monitor changes.

It’s normal to have a harder time falling asleep more than usual in an unfamiliar environment, but this will not affect the results as each stage of sleep will eventually arrive, even if bedtime is longer.

Depending on the purpose of polysomnography, there may be other specific machines involved in the study. For example, a positive airway pressure (PAP) machine can help improve breathing for individuals with sleep apnea. In the morning, the sensors are removed and the individual can leave the sleep centre and continue normal daily activities immediately.

Are there any risks?

Polysomnography usually does not carry any risks.

Nonetheless, now and again, an individual may respond to the cement that connects the sensors to their body. If they are concerned about this, they should talk to the technician beforehand.

What do the results of a polysomnogram mean?

One of your roles as a sleep technologist is to record sleep stages and recorded events and plan them for your doctor’s review. Your observations during the study are crucial in helping the sleep doctor identify specific conditions, which means you need to take notes such as disturbances during the various stages of sleep, which are identified by brain waves and eye movements, which may indicate REM sleep behaviour disorder or narcolepsy. . You may also notice changes in heart rate and breathing along with changes in blood oxygen levels that indicate sleep apnea.

Other observations may include repetitive leg movements that may indicate periodic limb movement disorder or unusual movements and noises during sleep that indicate the potential for REM sleep. There are many possibilities that can only be discovered through the strong combination of skilled sleep technologists and information gathered by electrodes and sensors connected to patients.

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Types, Purpose, and Risks of Electromyography | Neurology

What is electromyography?

Electromyography (EMG) is a diagnostic procedure that evaluates the health of the muscles and the nerve cells that control them. These nerve cells are called motor neurons. These transmit electrical signals that cause muscles to contract and relax. An EMG translates these signals into graphs or numbers, which helps doctors make a diagnosis.

An EMG is often prescribed by a doctor when someone shows signs of a muscle or nerve disorder. These symptoms can include tingling, numbness, or unexplained weakness in the limbs. EMG results can help the doctor diagnose the disorders of the muscle and neurological connection between nerves and muscles.

Some doctors may prescribe electromyography as an electrodiagnostic test.

Types of electromyography

There are two types of EMG: Superficial EMG and intramuscular EMG. Surface EMG assesses muscle function by recording surface muscle activity on muscle on the skin. Surface electrodes can only provide a limited estimate of muscle activity.

Purpose of electromyography

If a nerve or muscle disorder is doubted, the doctor may suggest electromyography. These symptoms can include:

  • Tingle
  • Numbness
  • Muscular weakness
  • Muscle pain
  • Some types of organ pain

Electromyography results are often necessary to confirm or rule out several conditions:

  • Muscle disorders, muscular dystrophy, or polymyositis
  • Diseases that interrupt the function of the nerve and the muscle, such as myasthenia gravis
  • Nerve disorders outside the spinal cord (peripheral nerves) such as carpal tunnel syndrome or peripheral neuropathy
  • Disorders affecting motor neurons in the brain or spinal cord, amyotrophic lateral sclerosis, or polio
  • Defects that affect the nerve root, such as a herniated disc in the spine

Before the electromyography

  • Your doctor will explain the procedure to you and welcomes any questions on the same.
  • Generally, fasting is not required before the test. In some cases, cigarettes and caffeinated beverages like coffee, tea, and cola are restricted before the test.
  • Tell your doctor about all the medicines you are taking (prescription and over-the-counter) and herbal medicines.
  • Tell your doctor if you have a pacemaker.
  • Wear clothing that allows access to the area to be examined or easily removed.
  • Avoid using lotions or oils on your skin for a few days before your procedure or the day of the test.
  • Depending on your medical condition, your doctor may request specific preparation for others.

During the electromyography

The electromyography can be performed on a patient basis or as part of your hospital stay. The steps may vary depending on your health problem and the practices of your healthcare provider. Talk to your healthcare provider about what to do during your exam.

EMG is performed by a healthcare provider who specializes in neurological disorders. This is usually a neurologist or physical therapist. EMG often occurs after a neural conduction study.

Generally, electromyography tests follow this procedure:

You will be asked to remove clothing, jewellery, hairpins, glasses, headphones, or other metal objects that may interfere with the test.

  • You will be given a gown to wear before the test.
  • Your position is adjusted before the test.
  • A neurologist finds the muscles that need to be studied.
  • The skin is cleaned with an antiseptic solution. Next, a clean, fine needle is inserted into the muscle. A metal plate is placed under you.
  • Multiple needles may be required to perform the test. You may feel some pain when placing the electrode. But it is often painless.
  • If the test is painful, tell the examiner as it may lead to complications.
  • You will be asked to relax and then do some full-strength muscle contractions.
  • The electrical activity of the working muscles is measured and displayed on the monitor. An audio amplifier can also be used to check the appearance and sound of electrical power. If the recorder is connected to an audio amplifier, you may hear a snowflake on the tin roof as you contract your muscles.

After the electromyography

After testing, the electrodes are removed. You may be given pain relievers. Warm compresses can be placed on the affected area immediately after the test.

Some muscle aches last a day or more after the test. Tell your healthcare provider if you have any symptoms at the injection sites:

  • Increased pain
  • Sensitivity
  • Inflammation
  • Pus

Your healthcare provider may give you other instructions after the test based on your specific situation.

Risks factors of electromyography

Both EMG and NCS are low risk. With EMG, there is a risk of infection or bleeding where the electrodes are inserted. If you are taking anticoagulants (blood thinners) or have hemophilia, inform the neurologist who performs this procedure in advance. A disorder that prevents blood from clotting.

If you are testing the chest muscles with EMG, there is a small risk of air entering the space between the chest wall and the lungs, causing pneumothorax (lung collapse).

If you have NCS, tell your neurologist ahead of time if you have a pacemaker or cardiac defibrillator because you are about to receive mild electrical shocks. Care must be taken in this case.

Results of electromyography

Your doctor can review the results with you after the procedure. However, if another healthcare provider requests an EMG, you may not know the results until you schedule your next appointment with your doctor.

If your EMG shows any electrical activity in your muscles at rest, you may have:

  • Muscle disorder
  • A disorder that affects the nerves that connect to the muscle.
  • Inflammation from injury
  • If your EMG shows abnormal electrical activity during muscle contraction, you may have a neurological disorder such as a herniated disc or ALS, or carpal tunnel syndrome.

Depending on your results, your doctor may discuss additional tests or treatments with you.

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Overview of Electronystagmography (ENG) | Neurology

What is Electronystagmography (ENG)?

Electronystagmography (ENG or electrocardiogram) is used to evaluate people with vertigo (a false sense of spinning or movement that can cause vertigo) and some other disorders that affect hearing and vision. Electrodes are set at areas above and underneath the eye to record electrical activity.

By measuring changes in the electrical field within the eye, ENG can detect nystagmus (rapid, involuntary eye movement) in response to various stimuli. If nystagmus does not occur upon stimulation, there may be a problem within the ear, the nerves supplying the ear, or certain parts of the brain. This test may also be used to distinguish lesions in different parts of the brain and nervous system.

Purpose of an ENG

ENG detects disturbances in the parts of the inner ear responsible for steering, posture, and balance, as well as in the nerves that connect your brain to your eyes and ears.

Your doctor may recommend this test if you have any of the following symptoms:

  • Severe or persistent dizziness
  • Vertigo (meaning the room is spinning)
  • Problems with balance
  • Unexplained hearing loss

Your doctor may also perform ENG if you have any of the following conditions:

  • Usher syndrome: A genetic disorder that affects vision, balance, and hearing
  • Acoustic neuroma: A benign tumor of the auditory nerve (vestibular-cochlear)
  • Labyrinthitis: Inflammation of the inner ear
  • Meniere’s disease: A problem of the inward ear that influences equalization and hearing
  • Any suspected lesion on your inner ear

What are the risks of an ENG test?

There is very little risk of Electronystagmography (ENG). A few people may encounter wooziness or sickness during the test. Electronystagmography (ENG) ought not to be utilized in the event that you have a pacemaker. The device may interfere with the pacemaker function.

Rapid changes to the posture needed for the test may worsen back or neck problems. The test for calories in water may cause mild discomfort. If you have previously been diagnosed with a perforated tympanic membrane, you should not have a portion of water calories on the ENG test.

There may be various risks depending upon your specific affliction. Talk about any worries with your medical services supplier before the strategy. Certain factors or circumstances may interfere with ENG. These include:

  • Earwax
  • Impaired vision
  • Frequent blinking
  • Certain medicines, those are sedatives, tranquilizers, and anti-vertigo medicines

How to prepare for the test?

Before the tests, you’ll likely be asked to do the following:

  • Tell your doctor about the medications you are taking: It may ask you to stop taking it 72 hours before the test.
  • Abstain from caffeine and alcohol: No drinking or coffee for 48 hours before the completion date.
  • No food: Most doctors recommend avoiding eating at least 4 hours in advance.
  • Clean your ears: Ear blockage and earwax can distort the results, so a medical assistant may wash the ear canals before the procedure if they are not clear.
  • Prepare a trip afterwards: Usually, this is good advice for many medical procedures, just in case you do not want to drive.

The test can be distorted if you have double vision or blink a lot. Also, you shouldn’t have an Injex device if you have a pacemaker for your heart. You can usually go home after your recovery, although the test can also be taken during a hospital stay. The test takes up to 90 minutes.

What happens during an electronystagmography?

So now it’s time for ENG. You might be a little hungry, you might be tired, and you might be nervous. What can you expect? In fact, the procedure includes several tests. Prior to beginning, your primary care physician will clean your brow, sanctuaries, and cheeks with liquor. Then, you attach the electrodes to those areas using a paste.

In some testing facilities, instead of electrodes, you may be provided with a binocular camera that looks like virtual reality glasses. The tests performed with this system are known as videography or VNG. These devices capture your eye movements on video and can measure them just like electrodes.

The tests include:

  • The calibration test: Utilizing just your eyes, you will be gotten some information about 6 to 10 feet away or think to and fro between focuses on a divider. This test measures visual impairment, a condition in which your pupils have difficulty judging distances to targets.
  • The tracking test: Also known as the nystagmus test, it is similar to the sobriety test offered by the police. But in Muhandis, you are usually sitting or lying down. (Nystagmus is a condition in which your eyes are out of your control.) In this test, you try to stare at a steady light, directly in front of you or at an angle, without moving your eyes around you.

There are two related tracer tests:

  • The first is the pendulum tracking test. In it, you are tracking a light that moves back and forth like a pendulum without moving your head.
  • The other is the optokinetic test, in which you track multiple moving objects without turning your head. Things may move at high speeds and enter and leave your field of vision.

The positional test: Now is the time to move your head. Often your doctor will ask you to perform what is called the Dex-Halpike maneuver. While sitting at a table, you will turn your head to one side and quickly lie down with your head – supported by your doctor – about 20 degrees below the surface of the table. You’ll remain there for 30 seconds, at that point sit upstanding once more. You will repeat it with your head on the other side. Your doctor will notice the effect on your eyes.

The water caloric test: While lying down, your doctor will inject a stream of cold or warm water into one ear, then the other. (Air is sometimes used.) If you are not vertigo, your eyes should reflexively twitch. Your doctor may not perform all of the tests. On the off chance that you have neck or back issues, she may recommend something different.

After the electronystagmography test

  • Once the test is finished, your provider will remove the electrodes and wash off the electrode paste. Do not rub your eyes to prevent spreading the electrode paste.
  • Your provider will monitor you for any signs of weakness, dizziness, and nausea. You may need to rests or sit for a couple of moments to recuperate.
  • Your healthcare provider will tell you when to start any medications you stopped taking before the test. Your healthcare provider may give you other instructions after the procedure, depending on your specific situation.
  • You may also have vertical videography (VNG). This is a test that likewise identifies eye development. But it uses video cameras instead of electrodes.

Results

If your ENG test results are abnormal, it could indicate a problem with your inner ear or the area of the brain responsible for controlling the movement of your eyes.

Other diseases or injuries to the auditory nerve can cause vertigo, including:

  • Vascular disorders that cause bleeding in the ear
  • Ear tumors
  • Genetic disorders
  • Damage to the inner ear
  • Ototoxic drugs
  • Multiple sclerosis
  • Viral infections such as chickenpox, measles, and influenza
  • Movement disorders
  • Chemical poisoning