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.
