Patient Services

General Services:

  • Patient Forms - Download PDFs
  • Patient education programs
  • Patient education handouts
  • Hospital consultations
  • 24-hour coverage in case of emergency
  • Offices located near local hospitals
  • Pharmacy preceptor programs
  • Multilingual staff and impaired hearing sign language available
  • We bill all major insurance carriers


 

Nuclear Cardiology Services:


Judy Kowal, CNMT, ARRT
Mary Jo Buckley-Clark, CNMT, ARRT

The Consulting Cardiologists Glastonbury office performs nuclear stress testing procedures and MUGA tests.  We are an ICANL accredited facility with three board certified nuclear cardiologists. Patients who have testing done at our Glastonbury office will find a friendly educated staff that makes them feel at ease during their test.

Nuclear Stress Test:
A nuclear stress test is a stress test that provides the doctor with more information than a regular stress test gives.  This noninvasive test provides additional information about coronary blood flow by using an isotope (Cardiolite) which is administered into the patient's vein.  The patient will have an IV inserted prior to the stress test in order to inject the isotope at peak exercise.  Cardiolite does not cause any adverse reactions.  It will, in  very few patients, cause a metal taste in the mouth.

Individuals who cannot exercise on the treadmill due to physical impairement or other illness will be given Adenosine which mimics exercise.  Adenosine can have some side effects such as shortness of breath or nausea.  Some people do not feel any different when getting an adenosine stress test.  For patients that can exercise even a tiny bit on the treadmill during the adenosine procedure side effects will be less pronounced.

The nuclear stress test has two parts.  The stress part is the injection of Cardiolite during exercise or adenosine infusion.  The rest part is the injection of Cardiolite at rest.  Each part of the test takes about two hours and can be done in a single day or two different days depending on the patients weight and preference.  If both parts are done in 1 day there will be up to 4 hours between the two parts.  The patient will be able to leave between the two parts.  Usually the stress test is done first.

The patient will be informed of any medications to stop taking prior to the test.  Generally no medications are taken the morning of the test and beta blockers may be withheld for 48 hours prior to the test.  The patient will be given instructions in regards to medication prior to the test.  The patient should not have any caffeinated beverages for 24 hours prior to the test.  This includes coffee, tea, soda, chocolate and decaffeinated coffee tea or soda too.  There is caffeine in decaffeinated coffee tea and soda!  The patient can have milk, juice or water.  The patient will not be able to eat anything form midnight the night before the test until the test time.  If the patient is a diabetic they can have a light breakfast and juice.  The patient should discuss this with the person who is scheduling the test for detailed instructions.  Please wear comfortable clothes to walk on the treadmill.  This includes rubber soled shoes.  There are no restrictions prior to the resting part of the test.

After the stress test is completed the patient will have pictures of the heart taken with a special camera for about 20 minutes.  The patient will lay on a table with their arms up for this time and hold still while the pictures are being taken.  If the patient cannot put their arms over their head or stay still for 20 minutes please inform the staff prior to the test.  These same pictures will be taken after the resting injection as well.  There will be about 45 minutes in between the resting injection and the pictures.  The patient can leave the office if desired at this time.  The pictures will show the doctor the areas of the heart that may not be getting enough blood flow at stress and rest and comparison of blood flow at stress and rest will be made.

During the stress portion of the test the patient will be hooked up to an EKG machine and the heart will be monitored by the physician or nurse practioner who is performing the test. We will be looking for changes in the EKG or patient symptoms during the test.  The test will be stopped when the appropriate heart rate has been achieved, adenosine infusion is complete, patient has symptoms or when the patient requests to stop.  The patient is always in control of what happens to him or her.

A common question asked by our patients is "How long will I be on the treadmill?" This all depends on how long it takes the patient to get the heart rate up to where we need it. Generally patients will be on the treadmill for an average of 7 or 8 minutes. The adenosine stress test only takes approximately 5 minutes to infuse. Any side effects that the patient may feel will go away within seconds after the adenosine is stopped.

A nuclear cardiologist will interpret the test results later that day.  He will be looking for areas of the heart that may not be getting adequate blood flow.  Rarely, additional testing that may be needed including coronary angiography.  The patient will receive a call from our office in 3 days or less with the results.  

MUGA (Nuclear Ventriculography) Test:
The Glastonbury office also performs MUGA scans.  This test will show the doctor how well the patient's heart is pumping blood out to the rest of the body.  This is unlike the Cardiolite stress test which shows the blood flow to the heart muscle itself.

There are no food or medication restrictions prior to this test.  It will take approximately 1and a half hours to complete.  The patient will receive two injections.  The first is called pyrophosphate and it gives the red blood cells a positive charge.  The second injection is given 20 minutes after the first and is a negatively charged radioisotope that attaches to the red blood cells.  The test will show how well the left and right ventricles of the heart are functioning.

After receiving both injections the patient will have pictures of their heart using a special camera.  The patient will lye down for about 40 minutes with their arms above their head and hold still during the picture taking.  The patient will be hooked up to an EKG during the pictures. 

The doctor will interpret the results that afternoon and the patient will get a call from our office in 1 to 3 days regarding the results. 

For additional information, please refer to the following websites:
http://www.icanl.org
http://www.asnc.org
http://www.cardiolite.com
http://www.adenoscan.com


Echocardiography (ECHO):

During ultrasound or ECHO, harmless sound waves are bounced off your heart, then beamed back and converted to images on a screen. These images are used to see the structures and movement of the heart's valves and chambers. A Doppler ECHO may be used in the same way, bouncing sound waves off the heart chambers and blood vessels to view blood flow patterns and valves.

During an ECHO, a small device will be lubricated with gel and the technician will hold it to your chest. You may be asked to lie in different positions. After obtaining the necessary information, the results are then sent to your doctor.

This test takes approximately one hour and is performed in our Hartford and Glastonbury offices.


Chip Hulten


Pacemaker Clinic:

The follow-up of pacemakers over the telephone is performed in a regular and convenient fashion to determine that the device is both functioning appropriately and has adequate battery reserve.


 


Peripheral Arterial Disease and ABI Testing:

Peripheral arterial disease (P.A.D) occurs when there is a build up of cholesterol and plaque in the arteries of the lower extremities, causing decreased blood flow to the legs and feet. Signs and symptoms of peripheral arterial disease may include pain in the legs during walking that is relieved by rest, pain during rest, wounds on the legs that are difficult to heal, or color changes in the skin. The groups most as risk for P.A.D include men and women over the age of 70. Those over the age of 50 who have a history of high blood pressure, high cholesterol, diabetes, or smoking are also at an increased risk.

The first test for P.A.D. is often a non-invasive screening method called an Ankle-Brachial Index, or an ABI. This test detects blockages in the legs by measure segmental blood pressure measurements and pulse volume recordings. During the test blood pressure cuffs on the arms and legs are inflated for short periods of time while the patient is lying still on an exam table. Sometimes the test also involves light exercise, such as walking on a treadmill or performing toe raises for a short period of time. These tests are performed in our Glastonbury office. Patients should wear comfortable clothing, including shorts and sneakers. They also should not use any tobacco products 30 minutes prior to arriving at the office for their test.

P.A.D. Examination Brochure


 


Clinical Services:

Other services include: stress tests, holter monitor, 30-day event monitor, warfarin (coumadin) clinic and EKG's.