Thursday, September 16, 2010

USA new york hospitals


 Cardiology

Advanced Diagnostics

An acute or chronic heart condition can become evident during a routine annual physical exam or through a specific set of symptoms, and expert diagnosis is crucial in determining the most appropriate course of treatment. Patients at NewYork-Presbyterian are examined by world-class physicians who provide a full range of diagnostic services for adults and children with heart disease.
As one of the nation's largest clinical and research institutions, NewYork- Presbyterian has access to the most advanced diagnostic equipment, often years before other hospitals. Our state-of-the-art diagnostic services include:
Cardiac catheterization, when making an accurate diagnosis must rely on more invasive procedures. NewYork-Presbyterian?s cardiac catheterization laboratories offer coronary angiography for the detailed evaluation of the extent of anatomic blockages in the coronary arteries as well as intravascular and intracoronary ultrasound, in which detailed images of the heart and coronary arteries are created using sound waves.
At NewYork-Presbyterian, we are now also evaluating the functional significance of arterial blockages, using a tool called fractional flow reserve (FFR). This involves placing a tiny catheter across a blockage, to measure the difference in pressure before and after the use of a drug that challenges the heart's ability to function. It allows us to see the effects of a narrowed vessel in real time.
Electrocardiographic tests, considered the first diagnostic tools for evaluation of anatomic changes and arrhythmias, use an electrocardiogram (ECG) to assess the electrical activity produced by the heart. In addition to the resting 12-lead ECG, the electrical activity of the heart can be examined over 24 hours, by using portable ambulatory recorders. Event recorders can be used over even longer time periods to detect infrequent rhythm irregularities. The ECG can also be examined during exercise testing.
Electrophysiological studies that allow physicians to expertly diagnose irregularities in heart rhythm. These studies are useful for defining the origin and risk of supraventricular and ventricular tachycardias and in designing the appropriate therapy for these conditions.
Advanced imaging techniques such as
  • Echocardiography, a noninvasive procedure that produces a graphic image of the heart's movement, valves, and chambers using high-frequency sound waves.
  • Magnetic Resonance Imaging (MRI), which creates high quality images of the heart throughout its pumping cycle. MRI is also important to help distinguish heart muscle that is irreversibly damaged from muscle that can be restored to some degree of function.
  • Nuclear imaging techniques such as single photon emission computer tomography (SPECT), positron emission tomography (PET), and MUGA scans, which evaluate not just how organs appear but how well they are functioning.

Tilt table testing for evaluation of patients with syncope (fainting). Syncope is a sudden loss of consciousness due to a transient drop in blood pressure. At NewYork-Presbyterian, physicians with expertise in the diagnosis and treatment of syncope use the most advanced techniques to determine whether syncope is being caused by an underlying cardiac arrhythmia.