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 Preventive Care
Echocardiogram:
Echocardiogram is a cardiac ultrasound performed either in doctor's office or in a hospital. It provides the accurate measurement of the heart, a two dimensional cross-sectional view of the heart, his chambers and valves. The Doppler examination examines the flow across the valves, as well as the partitions of the heart.

How is it done?
A cardiac gel is applied to the chest wall and the transducer is used to image the heart. This test does not emit any radiation and therefore is safe in pregnancy. The patient is examined in different positions to optimize the views of the cardiac chambers.

Pump – EF: Echocardiogram provides the information about the pump of the heart. Therefore, it is valuable in identifying patients with heart disease, especially after heart attack, and in patients with congestive heart failure. This is described as EF %. Normal EF is 55 to 65%. When the reduction in EF occurs below 40%, significant amount of the pump action is lost. Echocardiogram is used in monitoring the therapy for optimization of her cardiac pump on annual basis.

Valve Function: Echocardiogram evaluates the structure and the function of the heart valves. It can identify the valves being normal, scarred from rheumatic fever or other infections, thickened. It also identifies whether the valves are getting tight ( Stenotic)or developing leakage ( Regurgitation). This test also evaluates the function of prosthetic valve. With this test, the patient is surveyed. Mitral valve prolapse also diagnosed. Patient should heart murmurs are evaluated and need for antibiotics prior to dental procedures is assessed.

Chamber size: The size of the cardiac chambers is accurately measured along with the thickness of the walls. This information assists their physician in managing and monitoring the therapy.

Other Reasons: Echocardiogram is also valuable in identifying fluid around the heart called Pericardial Effusion. This condition can be quite serious and compromises the patient's pump. Besides this, it is valuable in the diagnoses of infections of the heart, tumors of the heart, congenital heart disease and pulmonary hypertension and pulmonary embolism (high-pressure within the lungs and development of lung clots).

How long does it take?
It takes about 20 to 30 minutes for each test. It is better to have last meal about two hours prior to the test. The report is communicated to your physician within 48 hours.
If you have any questions, or confusion in relation to this test, please contact your physician for further advice.
 
Nuclear Cardiology Imaging:
According to the American Society of nuclear Cardiology
“Heart disease is the leading cause of death in the western world. Each year in the U.S.A, more than 500,000 men and women die from coronary artery disease. During the past two decades, major strides have been made in the diagnosis and treatment of heart disease. Nuclear Cardiology has played a pivotal role in establishing the diagnosis of heart disease and in the assessment of disease extent and the prediction of outcomes in the setting of coronary artery disease”.
The nuclear cardiology imaging is a noninvasive procedure used for the assessment of myocardial blood flow and the efficiency of the myocardial pump.
The myocardial perfusion images are performed at rest, as well as on exercise or post chemical infusion for the delineation of myocardial perfusion. The chemical test uses dipyridamole or adenosine intravenously in place of treadmill exercise test. Sestamibi or Myoview, an imaging agent is injected intravenously for the study. A specialized device, a nuclear imaging Gama camera, is deployed for acquisition of the images. With the dual head camera like ours, it takes 16 minutes for each set of pictures. Overall, you are required to be in the facility for approximately 3 hours.
Complications may occur rarely in only one case out of every 1,000 to 2,000 cases. These complications are rare skin rashes, large fluctuations in blood pressure, irregular heart beats (arrhythmias) and difficulty breathing or asthma-like reactions.

What are my instructions?
  • Do not eat anything for three hours prior to the test

  • If you going to undergo a chemical test, you must avoid caffeine products like coffee, tea and soda at least for 12 hours prior to the test. If you're taking any Aminophylline products for shortness of breath, that must be discontinued as well.

  • Beta-blockers like Toprol, atenolol, propanolol, Ziac should be avoided for 24 hours before the test

  • If you are diabetic taking insulin injections, take only half of the usual dose of insulin. You may take orange juice on the morning of the test, if needed.

  • If for some reason you are unable to keep your appointment, please call our office for cancellation to avoid surcharge. Please call 508 943-6612 Extension 121


Who should avoid the test?
Any person, who is allergic to the material used for the test should avoid it. This test should not be taken by anyone who is pregnant. The risk of radiation exposure to the patients is negligible.

Why should I do this test?
Standard exercise test performed on treadmill are not very reliable especially in female patients. Nuclear imaging study is far more predictive of underlying heart disease, than standard exercise tolerance test. This test however has its own limitations including false positive and negative test and should be reviewed in the context with the clinical picture.

Who should undergo this test?
  • Female patients with symptoms of chest pain.

  • Follow up of CAD and CABG (angioplasty and bypass surgery.)

  • Abnormal baseline EKG with chest pains

  • After heart attack.

  • Before any major surgery in a patient with heart disease

 
Colonoscopy:
The colon is a large intestine measuring about 5 feet in length extending from small intestine to the anus. The main purpose of the colon is to store undigested food waste and absorb water to eliminate the waste.
Colonoscopy is the Endoscopic examination of the colon for the detection of polyps, ulcers, tumors of the colon. Carcinoma of the colon is the second most common cause of cancer death in the developed world.
Cancer is seen rarely before the age of 50 other is a family history of colon cancer. Most of the time: Cancer occurs past the age of 50 and the lifetime risk for colon cancer is 1 in 20 in Men and 1 in 30 in women. The risk increases manifold with the family is to colon cancer in both sides of the family.

Preparation and Procedure:
In order to have a good colonoscopic evaluation, the colon must be clean prior to the test. This is achieved with the liquid diet, one to two days prior to the test. This may include broth, tea coffee soda and soups. You may be asked to go on GOLYTELY and or be given a laxative a night before. Make sure that your physician is aware of the medications you're taking especially aspirin, Coumadin, or diabetic medications or insulin. You may need antibiotics therapy prior to the test if required.
The test usually takes 30 minutes and is well tolerated. Often the medications are given to make you comfortable. You may have abdominal gas or cramps. Complications are very rare, however the most feared complication is perforation of the colon. If you received any medication for sedation, you will not be able to drive after the test.
The findings of the examinations are reviewed by the gastroenterologist with you in the time of examination. If any biopsies are taken, they are reviewed with you on your subsequent to visit with the physician.

Who should have it done?
  • Any one past 40 years of age with family history of colon cancer.

  • Past the age of 50.

  • History of Colon polyps.

  • IBD like Crohn’s disease and Ulcerative Colitis .

 
Mammogram:
Breast cancer is the most frequently diagnosed cancer and is the second-leading cause of death among in females in USA. Current data suggests that 13.2% ( 1 in 8) of the women born today will be diagnosed with breast cancer at some time of the life. As we get older, women's chance all of being diagnosed with breast cancer, also increases significantly as shown below.
    Age 30-39 Risk of Breast Cancer 0.44%
    Age 40-49 Risk of Breast Cancer 1.46%
    Age 50-59 Risk of Breast Cancer 2.73%
    Age 60-69 Risk of Breast Cancer 3.82%

Self breast examination with mammograms performed on a scheduled basis is the most effective way to detect the breast cancer and early-stage. The mammograms may be false negative in 20% of the cases, especially in younger female age group. False-positive mammograms are also seen in younger patients, and they need to be followed with other tests to confirm the diagnosis. Self breast examination alone is not adequate.
The risk of breast cancer increases as women gets older. The several factors increase the chance of developing breast cancer as outlined below.
  • Personal history of breast cancer

  • Family history of breast cancer

  • Genetic alteration ( less than 10% of all breast cancer)

  • Menstrual history. Menstrual cycles before age 12 and menopause after age 55 have a higher risk of developing breast cancer.

  • Reproductive history. First child after the age of 30 or those who never had a child long-term use of hormones

  • Radiation therapy

  • Obesity in a postmenopausal woman

 
 

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