Cardiology

This branch of cardiology focuses on the heart’s electrical system, using electrophysiology studies to test for the cause of abnormal heart rhythms, known as arrhythmias. 

Also called EP studies, these tests use thin catheters inserted into a blood vessel that leads to the heart. The catheter places specialized electrodes inside the heart to send signals that measure electrical activity.
 
EP studies can help your heart specialist see:

• Where an arrhythmia is coming from
• The effectiveness of certain medicines to treat arrhythmia
• Whether to treat a problem by catheter ablation, where tiny scars are created to block irregular electrical signals and restore a typical heartbeat
• If a pacemaker or implantable cardioverter defibrillator would benefit your condition
• If you are at risk for serious or life-threatening heart problems

More About Arrhythmia
A heart rhythm disorder, known as arrhythmia, occurs when the electrical impulses in the heart that keep it beating or pumping “in rhythm” are not working correctly. 
How to know if you have a rhythm disorder? You may experience the following symptoms:

• Lightheadedness
• Dizziness
• Fainting
• Chest pain
• Shortness of breath
• Fluttering in your chest
• Heart racing

This branch of cardiology is an important diagnostic tool for emergency physicians and critical care physicians caring for patients in shock and following trauma to the chest, and those presenting with chest pain and shortness of breath.

The heart specialist uses an echocardiogram (echo), a noninvasive test that transmits high frequency sound waves (ultrasound) to take pictures of a patient’s heart. The test is also called a diagnostic cardiac ultrasound.

The types of echocardiograms are:

• Transthoracic echocardiography
• Stress echocardiography
• Transesophageal echocardiography
• Three-dimensional (3D) echocardiography

The test helps determine:

• The size and shape of the heart and its walls
• How the heart moves during heartbeats
• Its pumping strength
• If heart valves are working correctly
• If blood is leaking backward through the heart valves (regurgitation)
• If the heart valves are too narrow (stenosis)
• If a tumor or infectious growth is around the heart valves
• Problems with the outer lining of your heart (the pericardium)
• Problems with the large blood vessels that enter and leave the heart
• Blood clots or abnormal holes in the chambers of the heart

Interventional cardiology is a subspecialty within cardiology where minimally invasive and nonsurgical procedures, such as a catheter, are used to diagnose and treat a variety of heart and vascular diseases, including:

• Coronary Artery Disease
• Heart Valve Disease
• Congenital Heart Disease
• Vascular Disease

Procedures may include:

• Cardiac Catheterization: A procedure that uses dye and X-rays to see how blood flows through the heart. First, a thin hollow tube (catheter) is inserted through an artery in the wrist or groin area and is navigated into the heart. Once the catheter is in place, dye is injected into the catheter and X-ray images are taken to see how the dye moves through the vessels of the heart.
• Angioplasty: A catheter-based procedure where narrowed or blocked blood vessels that supply blood to the heart (coronary arteries) are opened by inflating a balloon. If a blockage is found during a cardiac catheterization, this procedure is used to restore blood flow.
• Atherectomy: A device is inserted through a catheter and uses a rotating burr to clean vessels.
• Coronary Stents: During an angioplasty or an atherectomy procedure it may be determined that a coronary stent is needed. This is a tiny mesh tube placed into an artery in the heart and expanded to hold it open.
• Thrombectomy: This is a device inserted through a catheter that is used to remove blood clots.
• Alcohol Septal Ablation: A technique in which a small amount of alcohol can be directed into a coronary artery to destroy muscle mass that is obstructing blood flow to the heart.
• PFO/ASD: A small disk like device is inserted through a catheter used to close a hole between two heart chambers. This is a treatment for congenital heart disease.
• Radial Cardiac Catheterization: This is a special type of cardiac catheterization where the catheter is inserted through the radial artery in the wrist and navigated into the heart. This procedure reduces the time needed for a patient to lie flat after the procedure and also reduces the chances of bleeding.

Nuclear cardiology studies use noninvasive techniques to assess myocardial blood flow, evaluate the pumping function of the heart as well as visualize the size and location of a heart attack. Among the techniques of nuclear cardiology, myocardial perfusion imaging is the most widely used.

With nuclear imaging, unlike other imaging methods that can see how organs appear, the test evaluates how organs function. A small and safe amount of radioactive dye, known as a tracer, is used through intravenous injection. A special camera follows solution in different parts of the body and images of the heart are produced.

The scans show how well the blood flows to your heart and can detect if you've had a heart attack.

Myocardial perfusion imaging (MPI), also known as a nuclear stress test, is the most common nuclear cardiology procedure.