Our Services

All services performed by CKC are done or closely monitored by Dr. DiNardo. All of the non-invasive studies are done on out-patient basis in the office or at one of the hospitals we are affiliated with.

Invasive diagnostic studies are done in a hospital setting and patients are frequently discharged the same day. Most interventional procedures will require at least one overnight stay and are performed at one of the above mentioned hospitals. Appropriate instructions will be given at the time you make your appointment.

Non-Invasive Diagnostics:

ELECTROCARDIOGRAM (ECG)

An ECG is a record of electrical activity of the heart. During this test electrodes are placed on each arm and leg and six points on the chest. If the ECG is abnormal, it may mean or suggest different types of heart problems. The ECG can provide important information about the heart rhythm, a previous heart attack, increased wall thickness of the ventricles, signs of insufficient oxygen delivery to the heart muscle or an ongoing heart attack, and problems with conduction of electrical signals from one part of the heart to another. A normal ECG does not exclude heart disease.

STRESS TESTING (Exercise Stress Test)

The treadmill test is basically a continuous ECG monitoring during physical exertion with close attention to the blood pressure and heart rate. Its' major use is to detect significant coronary artery disease (blockages in coronary arteries). Frequently it is used as part of the evaluation of patients with chest pain and palpitations (irregular heartbeats). It also provides assessment of exercise capacity, circulation to the legs, and blood pressure and heart rate response to exercise. Although the regular treadmill test is extremely useful, it can occasionally miss coronary artery disease. Nuclear imaging or Echocardiography done in conjunction with exercise testing will improve the overall accuracy of the test and provide useful information in regard to the location and severity of the blockages.

NUCLEAR IMAGING STRESS TEST

This test uses the IV injection of a small amount of radioactive substance called "Cardiolite". A special camera is used to take pictures of the heart at "rest" and after "stress". This study provides more accurate and detailed information than that provided by a regular treadmill test. This test is frequently used to evaluate patients with chest pain or after an angioplasty to detect reblockage of the dilated artery and after coronary bypass surgery to assess the integrity and function of the bypass grafts.

If a patient cannot exercise, a "chemical stress test" will be used. This involves the use of an IV medication (instead of exercise) that increases the blood flow to the heart coronary vasodilators. This type of stress test is used for patients who cannot exercise such as those with severe lung disease, arthritis, prior leg amputation or stroke, etc.

STRESS ECHOCARDIOGRAM

This test combines the treadmill test and the echocardiogram. A resting echo is done and repeated immediately after the exercise. Both digitized studies are compared side by side.

ECHO-DOPPLER CARDIOGRAPHY

This a simple office test that uses ultrasound to image the heart. It is painless and entirely non-invasive. This test provides detailed analysis of the structure and function of the heart. The information provided includes size and thickness of the walls of the heart, the strength of the heart muscle as a pump, congenital anomalies of the heart, and detailed assessment of the heart valves for narrowing or leakage and presence of tumors or clots. It allows initial assessment and follow-up of prosthetic heart valves. In essence this study provides vital information that is necessary in most patients with known heart disease or patients with symptoms that suggest it.

HOLTER MONITORING

The Holter monitor is a continuous ECG recorded on audiotape over 24 hours. The patient is sent home with the attached monitor to record the heart rhythm for 24 hours. Patient is encouraged to perform their usual daily activities while wearing the monitor. A "diary" is given to the patients to write down any symptoms experienced during that period. Your cardiologist then will be able to match the symptoms with abnormal heart rhythms. This test is used to detect and document any cardiac arrhythmias or simply to determine the patients' heart rate over a 24 hour period.

CARDIAC CT ANGIOGRAPHY

A non-invasive test that utilizes CAT scan images to evaluate the plaque deposits within the heart arteries. The images are similar to that obtained by the heart catheterization without having to directly enter the vessels.

CAROTID DOPPLER

Ultrasound is used to provide 2-dimensional images of the blood vessels and Doppler is used to assess the velocities of blood flow in the neck arteries that supply blood flow to the brain (blockages may result in strokes). Data obtained can tell if circulation is normal or provide vital information about the severity of the blockages and composition of the plaques.

PERIPHERAL ARTERY DOPPLER

Ultrasound is used to provide 2-dimensional images of the blood vessels and Doppler is used to assess the velocities of blood flow in peripheral (leg) arteries that supply blood flow to the lower extremities. This study can determine if circulation is normal or provide information about the severity of the blockages. This study is used to evaluate patients with leg pain usually associated with walking and assist your physician in determining the problem and deciding appropriate treatment.

TILT TABLE TESTING

This test provides an assessment of the neural reflexes, which when abnormal, may cause patients to faint from a condition called Neurocardiogenic Syncope.

ANKLE-BRACHIAL INDEX

This is a blood pressure-doppler test to quickly assess adequacy of the peripheral circulation.

INVASIVE DIAGNOSTICS

CARDIAC CATHETERIZATION

This is an x-ray test that use radiographic contrast (dye) to visualize the coronary arteries and pinpoint the presence and severity of blockages and, more importantly, to determine the best treatment available. If the test reveals blockages, the patient will be offered one of three treatments: medications only, angioplasty or bypass surgery. This test is done on an outpatient basis. The patient is mildly sedated but awake during the procedure. This is the best test available to find and visualize the blockages of the coronary arteries.

RENAL ANGIOGRAPHY

This test is done in a similar manner to the cardiac catheterization and frequently can be done at the same time when requested. This test involves the injection of dye into the renal arteries. Blockages are identified and best treatment options are determined.

PERIPHERAL ANGIOGRAPHY

This test is also done in similar manner to cardiac catheterization and can be done at same time when requested. This test involves the injection of dye in the leg arteries. Blockages are identified and best treatment options are determined.