Diagnostic Services

To effectively diagnose and treat various types of cardiac problems, Nyack Hospital offers some of the most technically-advanced services, facilities and technologies in the region, including:

Echocardiogram is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than x-ray image and involves no radiation exposure.

A trained sonographer performs the test, then your heart doctor interprets the results. An instrument that transmits high-frequency sound waves called a transducer is placed on your ribs near the breast bone and directed toward the heart. The transducer picks up the echoes of the sound waves and transmits them as electrical impulses. The echocardiography machine converts these impulses into moving pictures of the heart.

Echocardiogram works well for most patients and allows doctors to see the heart beating and to visualize many of the structures of the heart. Occasionally, your lungs, ribs, or body tissue may prevent the sound waves and echoes from providing a clear picture of heart function. If so, the sonographer may inject a small amount of material (contrast) through an IV to better see the inside of the heart. (Source:  MedlinePlus)

An electrocardiogram, also called an EKG or ECG, is a simple test that detects and records the electrical activity of the heart. It is used to detect and locate the source of heart problems.  Electrical signals in the heart trigger heartbeats. These signals start at the top of the heart in an area called the right atrium. The electrical signals travel from the top of the heart to the bottom. They cause the heart muscle to contract as they travel through the heart. As the heart contracts, it pumps blood out to the rest of the body.  An EKG shows how fast the heart is beating. It shows the heart’s rhythm (steady or irregular) and where in the body the heartbeat is being recorded. It also records the strength and timing of the electrical signals as they pass through each part of the heart.  An EKG is sometimes called a 12-lead EKG (or 12-lead ECG) because the electrical activity of the heart is most often recorded from 12 different places on the body at the same time. (Source:  NHLBI)

Holter Monitor
A Holter monitor is a machine that continuously records the heart's rhythms. The monitor is usually worn for 24 hours during normal activity.
Electrodes (small conducting patches) are stuck onto your chest and attached to a small recording monitor. You carry the Holter monitor in a pocket or in a small pouch worn around your neck or waist. The monitor is battery operated.
While you wear the monitor, it records your heart's electrical activity. You should keep a diary of what activities you do while wearing the monitor. After 24-hours, you return the monitor to your doctor's office. The doctor will look at the records and see if there have been any irregular heart rhythms.
It is very important that you accurately record your symptoms and activities so that the doctor can match them with your Holter monitor findings.
Holter monitoring is used to determine how the heart responds to normal activity.

The monitor may also be used:

  • When starting a new heart medicine
  • After a heart attack
  • To diagnose heart rhythm problems

It may be used to diagnose:

  • Atrial fibrillation/flutter
  • Multifocal atrial tachycardia
  • Paroxysmal supraventricular tachycardia
  • Palpitations
  • Reasons for fainting

    (Source:  MedlinePlus)

Pacemaker Implantation
A pacemaker is a small device that's placed under the skin of your chest or abdomen to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate.

Pacemakers are used to treat heart rhythms that are too slow, fast, or irregular. These abnormal heart rhythms are called arrhythmias.  Pacemakers can relieve some symptoms related to arrhythmias, such as fatigue (tiredness) and fainting. A pacemaker can help a person who has an abnormal heart rhythm resume a more active lifestyle.

Faulty electrical signaling in the heart causes arrhythmias. A pacemaker uses low-energy electrical pulses to correct faulty electrical signaling. Pacemakers can:

  • Speed up a slow heartbeat
  • Help end an abnormal and fast rhythm (only in implantable cardioverter defibrillator/pacemaker combination devices)
  • Make sure the ventricles contract normally if the atria are quivering instead of beating in a normal rhythm (a condition called atrial fibrillation)
  • Coordinate the electrical signaling between the upper and lower chambers of the heart
  • Coordinate the electrical signaling between the ventricles (cardiac resynchronization therapy used in heart failure)

Pacemakers also can monitor and record your heart's electrical activity and the rhythm of your heartbeat. Newer pacemakers can monitor your blood temperature, breathing rate, and other factors and adjust your heart rate to changes in your activity. (Source:  NHLBI)

Stress Testing
Stress testing provides your doctor with information about how your heart works during physical stress. Some heart problems are easier to diagnose when your heart is working hard and beating fast. During a stress test, you exercise (walk or run on a treadmill or pedal a bicycle) or are given a medicine to make your heart work harder while heart tests are performed.

During these tests, your heart is monitored using images or through dime-sized electrodes attached to your chest, arms, or legs. You may be asked to breathe into a special tube during the test. This will allow your doctor to see how well you’re breathing.

You may have arthritis or another medical problem that prevents you from exercising during a stress test. If so, your doctor can give you a medicine that makes your heart work harder, as it would if you were exercising. This is called a pharmacological stress test.

Doctors usually use stress testing to help diagnose coronary artery disease (CAD) or to see how serious this disease is in those who are known to have it. It’s sometimes used to assess other problems such as heart valve abnormalities or heart failure. (Source:  NHLBI)