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Baylor Scott & White Texas Cardiac Associates Murphy

Baylor Scott & White Texas Cardiac Associates

Welcome to Baylor Scott & White Texas Cardiac Associates

 
 

Baylor Scott & White Texas Cardiac Associates is a group of North Texas’ leading cardiologists with the goal of providing advanced cardiac care and improving the level of cardiology services across the state. We are committed to offering patients optimum care through new and emerging technologies.

Our nuclear lab holds the high distinction of being accredited by the Intersocietal Commission for the Accreditation of Nuclear Cardiology Laboratories, and our echo lab also holds the high distinction of being accredited by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories.

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Pay Your Bill

We offer an easy, secure way to pay your HTPN bill online through MyBSWHealth.

Tools & Resources

Our services are designed with you in mind so managing your healthcare needs is as simple as possible.

  • Patient Forms
  • MyBSWHealth
  • Pay Your Bill
  • Financial Assistance
  • Accepted Insurance
  • Patient Resources
  • Media

Patient Forms

To ensure that your visit to our office is as convenient and efficient as possible, we are pleased to offer our registration forms online. The patient registration form may be completed electronically and printed for better legibility or completed manually.

New Patient Registration Forms

Authorization Forms

We do not release your medical information without your authorization.

MyBSWHealth

MyBSWHealth is an online tool where you can communicate with your providers, schedule an appointment, access and manage your family’s health.

Pay Your Bill

We offer an easy, secure way to pay your HTPN bill online through MyBSWHealth.

Financial Assistance

At Baylor Scott & White Health, we want to be a resource for you and your family. Our team of financial counselors is here to help. We encourage you to speak to a member of our team at any time – before, during or after care is received.

Accepted Insurance

Baylor Scott & White has established agreements with several types of insurances in an effort to make sure your health needs are covered.

Media

New mom raising awareness after surviving sudden cardiac arrest

She wants other mothers and mothers-to-be to learn from her mistakes and listen more closely to their bodies.

Medical Services

Baylor Scott & White Texas Cardiac Associates offers expertise and treatment options conveniently located near you.

  • Procedures
  • Coumadin Clinic​​
  • Pacemaker Clinic
  • Dobutamine Echocardiogram
  • Echocardiogram
  • Electrocardiogram
  • Exercise Echocardiogram (Stress Echo)
  • Exercise Stress Test
  • Exercise Thallium
  • Holter Monitoring
  • Nuclear Stress Test Instructions
  • Permanent Pacemaker Insertion
  • Transesophageal Echocardiogram
  • Cardiac Catheterization
  • Stents
  • Enhanced External Counterpulsation (EECP)

Procedures

We offer a range of in-office procedures, including:

  • Nuclear testing
  • Electrocardiograms
  • Anticoagulation Monitoring
  • ICD Interrogation and Management
  • Insertable Loop Recorder Interrogation and Management
  • Treadmill or bicycle exercise stress testing
  • Cardiac ultrasound imaging
  • 24-hour heart monitors
  • Ultrasound testing with exercise
  • Transesophageal imaging
  • Signal-averaged electrocardiograms
  • Pacemaker assessments
  • Pharmaceutical stress testing

In addition to procedures offered in our office, we also perform hospital-based procedures such as:

  • Balloon angioplasty
  • Cardiac stents
  • Excimer laser surgery
  • Transluminal extraction catheter
  • Rotablator
  • ICD, Pacemaker, and Insertable Loop Recorder Implant
  • Resynchronization Therapy
  • Electrophysiology Study
  • Ablation of SVT/VT/PVGs
  • Atrial Fibrillation Ablation (Including Cryoblation)
  • Tilt Table Testing

 

Coumadin Clinic​​

Coumadin is the brand name for Warfarin, a prescription anticoagulant (blood thinning) medication that prevents blood clots from forming in your blood vessels. If you take Coumadin for a cardiac condition, it is important to check the medication’s effectiveness on a regular basis.

At our Coumadin Clinic, we will obtain a blood sample using the finger stick method to check your Prothrombin Time (PT) and International Normalized Ratio (INR). These measurements check to ensure that the medication is doing its job to prevent clots without causing excessive bleeding. Results are immediate, and if your dosage needs to be adjusted, the doctor can do so that same day.

Pacemaker Clinic

A pacemaker is a small device that is implanted in the chest to help control cardiac arrhythmias, or abnormal heart rhythms (when the heart beats too fast or too slow). This device uses electrical pulses to help the heart beat at a normal rate and relieve some symptoms of arrhythmia, such as shortness of breath, fatigue, and fainting.

If you have a pacemaker, you need to have it tested approximately every three months to ensure it is functioning properly. At our Pacemaker Clinic, we will assess the battery life, check the pulse generator and leads, check for pocket erosion and extract diagnostic information from it. If any changes need to be made to your pacemaker, we will program it into the device.

 

Dobutamine Echocardiogram

Procedure

Your doctor has asked that you have a dobutamine echocardiogram (dobutamine echo) to measure your heart’s tolerance to work and the heart wall movement when it is working very hard. This test is a stress test of the heart using the medicine dobutamine to make it beat faster and harder. An echocardiogram is performed during the test. During the test, your heart rate is measured by an electrocardiogram (ECG), and your blood pressure is taken while you are being given the medicine. The test, which usually takes one and a half hours, is performed in our office.

Before The Test

  • You will be asked to sign a consent form after your doctor has explained the procedure and its risks to you.
  • You may be asked to refrain from eating or drinking (except water) for three hours before the test.
  • Some foods may affect the test results. You should refrain from tobacco usage (cigarettes, chewing tobacco) for three hours before this test.
  • If you are being tested as an outpatient, please bring a list of your medications or the prescription bottles with you. If you are unsure whether to take your medications, please consult your doctor.
  • Please avoid using body lotion or body powder on your chest the day of the test. Lotions and powders interrupt the signals the monitor is picking up from your heart.

During The Test

  • You will need to undress from the waist up; women will be given a hospital gown or a blanket with which to cover.
  • A staff member will place electrodes on your chest to monitor your heart rate. The skin may need to be lightly scraped and chest hair shaved on men to obtain clear test results.
  • Blood pressure cuffs will be used during this test. If your doctor has asked you to avoid using a blood pressure cuff on one or both arms, please inform the staff about this when you are getting prepared for the test.
  • A small intravenous catheter (IV catheter) will be placed in your hand or arm. The medicine given during the test will be given through this catheter. If you are an Inpatient and already have a catheter in your hand or arm, the staff nurse may first try to use this IV site.
  • You will first receive a resting echocardiogram. A trained technician will place a small instrument called a probe on the outside of your chest to obtain an image of your heart and its blood flow.
  • You will be asked to lie on your left side for the echo portion of the test. The technologist may ask you to change positions periodically.
  • You may hear a loud “whooshing” sound during the test. This sound occurs when the technologist is recording your blood flow.
  • Once this information is collected, the nurse or staff member will give you dobutamine, a medicine that quickens your heartbeat and increases your blood pressure. Lie quietly while this medicine is being given; however, if you have any discomfort or pain or shortness of breath, please let the staff know immediately. Sometimes this medicine can cause nausea; if you begin to feel bad, please tell the staff. Other medicines may be given to help you with symptoms or to assist doctors in obtaining additional information. Once the medicine is given, the technologist will perform another echo ultrasound procedure with you lying on your side. This study usually takes only 15 – 20 minutes; once the medicine is stopped, your heart rate and blood pressure should gradually slow down. Your heart rate and blood pressure will be monitored during this time.

Immediately After The Test

  • When the technologist has collected all the necessary data, the electrodes will be removed and you may get dressed.
  • Depending on your doctor’s request, the catheter may be removed by a nurse or technologist from the arm or hand. Light pressure will be applied to the site to decrease any bleeding. If you are on medications that keep your blood from clotting, please tell the nurse so that pressure can be held a little longer.
  • You will probably feel tired after the test. You should avoid heavy exercise or physical work for the remainder of the day. If you have any symptoms or discomfort after you have left the clinic, you should contact your doctor immediately.
  • Your test results will be sent to your doctor, who will explain them to you.

Echocardiogram

Definition

Similar to the monograms used during pregnancy, an echocardiogram uses a probe gently moved across the chest. This probe emits sound waves which are convened into moving images of the heart. These images are displayed on a screen and are stored on Digital echo storage. This test allows our doctors to learn how the heart functions at rest. It provides valuable information about the structure, size, and how well your heart is pumping.

Before The Test

  • You should allow one hour which includes preparation and the imaging portion.
  • Wear comfortable attire as you will be lying on an exam table, while the sonographer obtains your images.
  • There are no dietary restrictions for this test.
  • Bring your medication in their original containers with you to the test, so we may obtain an accurate list.

During The Test

  • You will be asked to lie on an examination table. To improve the quality of the pictures, a colorless gel is applied to the area of the chest where the transducer will be placed.
  • We will apply electrodes (small sticky patches) to your chest, so we can record the electrical activity of your heart. This is called an EKG.
  • The sonographer moves the transducer to various places over the left side of your chest. Pictures of your heart at rest are recorded on videotape.

Immediately After The Test

  • A written report will be sent to your referring physician.
  • Information gained from this test helps your doctor make an accurate diagnosis and develop a treatment plan that is best for you.​​

Electrocardiogram

Definition

An electrocardiogram or ECG is a graphic record of the electrical impulses of the heart. These impulses are conducted to the external surface of the body where they are detected by electrodes. It is important to realize that the ECG does not depict the actual physical state of the heart or its function, but rather the electrical activity. These impulses (or your heart rate) are normally discharged 60 to 100 times per minute.

Before The Test

  • There are no dietary restrictions prior to this test.
  • Please bring all of your current medications with you, or provide us with an accurate list. (Please, include dosage and number of times you take medication in a day). Certain cardiac medications can slow the heart rate, and it will be helpful to know if you are on any of this medication. In contrast, certain cold and sinus medicine can increase your heart rate, and this information will be valuable to your physician.
  • Do not wear a one-piece jumpsuit, as you will be asked to undress from the waist up. Women will be provided a half gown or cape to wear.

During The Test

  • A trained medical assistant (or nurse) will place several electrodes (small sticky patches) on your chest. Men may need to have areas of their chest shaved, to ensure that the electrodes stay in place.
  • The electrodes are connected by wires to an ECG machine.

After The Test

  • Immediately after the test, the physician can give you a complete interpretation.
  • If the test is abnormal or inconclusive, your doctor may order additional tests.

Exercise Echocardiogram (Stress Echo)

Definition

An exercise echocardiogram (also known as a stress echo) is a test that combines an ultrasound study of the heart with an exercise test. The test allows the doctor to learn how the heart functions when it has to work harder. This test is useful in diagnosing heart problems, such as coronary artery disease (blockages in the coronary arteries).

Before The Test

  • You should allow an hour to an hour and a half for this test.
  • Wear or bring comfortable attire and walking/running shoes.
  • Refrain from eating at least two hours before the test. This will prevent the possibility of nausea, which may accompany vigorous exercise after eating.
  • Make your last meal light and without tea, coffee or alcohol.
  • If you are currently taking any heart medication, check with your BSW Texas Cardiac Associates doctor. He or she may ask you to stop certain medications a day or two before the test. This can help obtain more accurate test results.
  • Before the test, you will be given an explanation of the test and you will be asked to sign a consent form. Feel free to ask any questions about the procedure.
  • Several areas on your chest and shoulders will be cleansed with alcohol and an abrasive pad will be used to prepare the skin for the electrodes (small sticky patches). Men may need to have areas of their chest shaved, to ensure that the electrodes stay in place.

During The Test

  • The test is divided into three parts. First, a resting echocardiogram is performed. Next, you will walk on a treadmill. Then another echocardiogram is performed while your heart is still beating rapidly after exercise.
  • Resting echocardiogram – You will be asked to lie on an exam table. To improve the quality of the pictures, a colorless gel is applied to the area of the chest when the transducer will be placed. Pictures of your heart are recorded on videotape.
  • Exercise test – You will walk slowly in place on a treadmill, on which the speed is increased to a faster pace and is then tilted to produce the effect of going up a small hill. The doctor will stop the test when you reach your peak heart rate when you get too tired or have significant symptoms.
  • After exercise echocardiogram – You will be asked to very rapidly return to the examining table, and lie once again on your left side. The sonographer will then record the second set of images while your heart is still beating rapidly. The BSW Texas Cardiac Associates doctor can then compare the two sets of images. This will be before and after exercise side by side to see how your heart responds to the stress of exercise.

After The Test

  • The doctor conducting the test can give you results before you leave. A complete interpretation will be sent to your referring physician.
  • If the test is abnormal or inconclusive, then additional tests may be ordered.
  • The information gained from the stress echo helps your doctor make an accurate diagnosis and develop a treatment plan that is best for you.

Exercise Stress Test

Definition

This test, typically involving the patient walking on a treadmill while attached to an electrocardiogram, measures a patient’s ability to exercise and the electrical waves of the heart during exercise. This test can help detect heart problems that may not be apparent at rest.

Before The Test

  • You should allow one hour, which includes preparation for the test, the exercise portion, and the recovery period.
  • Wear or bring comfortable attire and walking/running shoes.
  • Refrain from eating at least two hours before the test. This will prevent the possibility of nausea, which may accompany vigorous exercise after eating.
  • Make your last meal light and without tea, coffee or alcohol.
  • If you are currently taking any heart medication, check with your​ BSW Texas Cardiac Associates doctor. He or she may ask you to stop certain medications a day or two before the test. This can help get more accurate test results.
  • Before the test, you will be given an explanation of the test and you will be asked to sign a consent form. Feel free to ask any questions about the procedure.
  • Several areas on your chest and shoulders will be cleansed with alcohol and an abrasive pad will be used to prepare the skin for the electrodes (small sticky patch). Men may need to have areas of their chest shaved, to ensure that the electrodes stay in place.

After The Test

  • After the exercise portion of the test is over, you will still be monitored for another 5 to 10 minutes while you recover. The medical assistant or nurse will remove the electrodes and cleanse the electrode sites.
  • The doctor conducting the test can give you results before you leave. A complete interpretation will be sent to your referring physician.
  • If the test is abnormal or inconclusive, then additional tests may be ordered.
  • The information gained from the exercise test helps your doctor make an accurate diagnosis and develop a treatment plan that is best for you.

Exercise Thallium

Definition

A thallium scan is a test that uses a radioactive substance (known as a tracer) to produce images of the heart muscle. When combined with an exercise test, the thallium scan helps determine if areas of the heart do not receive enough blood.

Purpose

The exercise, thallium test is especially useful in diagnosing coronary artery disease, the presence of blockages in the coronary arteries. These are the arteries that supply oxygen to the heart muscle. Tracers, other than thallium, can be used for this type of scan. Your BSW Texas Cardiac Associates doctor will decide if your situation warrants a different type of tracer.

Before The Test

IF YOU ARE NURSING OR IF YOU THINK YOU MAY BE PREGNANT, INFORM THE TCA DOCTOR OR NUCLEAR TECH BEFORE THE EXAMINATION.

  • You will receive a specific instruction sheet that pertains to the type of tracer your physician plans for you to have. If you have any questions, please ask your doctor, or the nuclear tech will be happy to assist you.
  • You may be asked to fast (not eat or drink anything) for three to four hours or longer prior to your exam. If you cannot fast, or are diabetic, ask your BSW Texas Cardiac Associates doctor or nurse for special instructions.
  • You will be instructed not to have food or drink prior to the test that contains caffeine. For example, coffee, tea, colas (even “caffeine-free”), and chocolate foods all contain different amounts of caffeine.
  • Be sure to notify our office nurse or nuclear tech of all the medicines you are taking. Some medicines may affect the test results.
  • Wear loose, comfortable clothing that is suitable for exercise. You should also wear comfortable walking shoes or tennis shoes.
  • Before the test, you will be given an explanation of the test and you will be asked to sign a consent form. Feel free to ask any questions about the procedure.

During The Test

  • The test has two parts: the exercise imaging portion and the rest imaging portion.
  • Several electrodes (small sticky patches) will be placed on your chest to obtain an electrocardiogram (ECG). This will record your heart’s electrical activity.
  • An intravenous (IV) line will be started in a vein in your arm. This will allow injection of the radioactive tracer during exercise.
  • Depending on the type of exam that is ordered, you will be exercising several minutes on a treadmill. If you cannot walk on a treadmill, then a prescribed medication will be injected over a several-minute period. In either case, the purpose is to increase the workload being placed on your heart.
  • You will be instructed to report any symptoms, such as chest pain, shortness of breath, or dizziness. Try to exercise for as long as you are able to, as this will increase the accuracy of the test.
  • Tell the nuclear technician when you are almost to the point when you can no longer exercise. At this point, the tracer will be injected into the intravenous line. You will be asked to continue to exercise for another minute or so after the injection.
  • Imaging portion: You will then lie flat on a special table under a scanning camera. Several pictures of the heart will be taken at various angles. You should remain still while the pictures are being taken. This part can take up to 20 minutes.
  • After this initial set of pictures, you will be asked to return in 2 to 4 hours to have additional pictures taken without repeating the exercise. These images are compared to the images obtained during the first part of the test. The technician will give you specific instructions regarding when to return, and what food you can eat.

After The Test

  • No sedation is given during this test; therefore, you will be able to drive home directly after the test.
  • The BSW Texas Cardiac Associates ​doctor conducting the test may be able to give you preliminary results before you leave. However, a complete interpretation usually takes several days.
  • In addition to being called, a copy of your test results is sent to your referring physician.
  • This test generally provides more information than an exercise stress test. This will help your doctor make an accurate diagnosis and develop a treatment plan that is best for you.

Holter Monitoring

Definition

Holter monitoring is a continuous recording of your ECG, usually for 24 hours, while you go about your usual daily activities. It is especially useful in diagnosing abnormal heart rhythms. The Holt er monitor itself is a small, portable cassette recorder, worn on a strap over the shoulder. Several electrodes (small sticky patches) are placed on your chest and connected by wires to the recorder.

Purpose

  • To detect abnormal heart rhythms that may not occur during a standard ECG test.
  • To assess recurring symptoms such as dizziness, fainting, and palpitations.
  • To evaluate the effectiveness of treatments, such as medications and pacemakers, that can help control abnormal heart rhythms.

Before The Test

  • Wear a loose fitting blouse or shirt, with the buttons in the front.
  • Do not use lotions or bath oil on your skin. This will prevent the electrodes from sticking on your skin for 24 hours.
  • There are no dietary restrictions.
  • Ask your physician if you are to take your medication as ordered.

During The Test

  • Several areas on your chest will be cleaned with alcohol and an abrasive pad, to ensure good electrode contact. Men may need to have areas of their chest shaved.
  • Please inform the medical assistant or nurse if you are allergic to cloth or paper tape. This will be used to help secure the electrodes on your skin.
  • The electrodes are connected by wires to the recorder. The nurse or medical assistant will check the system to make sure it is working properly.
  • You can do anything you would normally do, except take a bath or shower while the monitor is on. Do not get the electrodes, wires, or recorder wet.
  • The nurse will show you a button on the recorder to press if you have a symptom that you want the physician to, especially note. When you press this button, it marks the tracing for the doctor. This will help the doctor correlate your symptoms with your ECG tracing.
  • Try to sleep on your back, with the recorder positioned at your side so that the electrodes are not pulled off.
  • You will keep a diary (or log) in which you enter your activities, any symptoms you experience, and the time at which the symptoms occurred. The diary is very important because it enables the doctor to correlate your activities and symptoms with the ECG tracing. DON’T FORGET TO BRING THE DIARY BACK WHEN YOU RETURN THE RECORDER!

After The Test

  • Once you return the monitor, the cassette is analyzed by a computer and scanned by a technician. The report is printed for the BSW Texas Cardiac Associates doctor to review.
  • The information gained will help your BSW Texas Cardiac Associates doctor make an accurate diagnosis and develop a treatment plan for you. A full report will be sent to your referring physician.

Nuclear Stress Test Instructions

When To Come

  • On the morning of your stress test, you will need to be in the office at least 20 minutes before the scheduled time of your test.
  • You must give the office at least 24 hours notice of a cancellation, if not you will be billed for the cost of the nuclear doses. The drugs used in testing are ordered specifically for you.
  • Also if you are more than 15 minutes late, your appointment will be rescheduled. If you foresee not being on time please call ahead of time. If you are unable to keep your appointment, you may cancel by calling 972.475.7500, Monday through Friday, 7:00 a.m.– 5:00 p.m.
  • No family member will be allowed to come back during your nuclear stress test.

What Will Happen

  1. An I.V. will be started and you will be injected with a radioactive tracer called Tc99m Myoview.
  2. After being injected with Myoview there will be a 30-45 minute waiting period.
  3. A resting scan will be done on your heart. This takes approximately 18 minutes.
  4. After the rest scan, you will be hooked up to the EKG machine and will walk on the treadmill until you reach your target heart rate: at that time you will be injected with another dose Myoview and will walk approximately 60 seconds more. If you cannot walk on the treadmill you will be having a pharmacological stress test with Lexiscan.
  5. After the treadmill or pharmacological portion of the stress test, you will be given a snack and some juice or coffee and asked to wait for a period of time. You will then have your stress scan which can last 18 minutes.
  6. The full test can take up to 3-4 hours.

What To Wear

  • Wear comfortable shoes and clothing. Please do not wear bras with underwire.
  • It is very cold in the nuclear department. Please bring a jacket or sweater that contains no metal.​

Your Medications

  • Please review the list of medications below. If you are taking any of the medications, please DO NOT TAKE THEM THE NIGHT BEFORE OR THE MORNING OF THE TEST, unless instructed otherwise.
  • PLEASE TAKE ALL OTHER MEDICATIONS THAT ARE NOT LISTED
Acebutolol Cardizem Inderal Nadolol Timolide
Atenolol Carteolol Inderide LA Normadyne Timolol
Bepridil Cartrol Isoptin Penbutolol Toprol
Betapace Carvedilol Isradipine Pindolol Trandate
Betaxolol Coreg Kerlone Propanolol Vascor
Bisoprolol Corgard Labetolol Sectral Verapamil
Blocadron Corzide Levatol Sotalol Verelan
Breviloe Dilacor XR Lopressor Tenoretic Visken
Bystolic Diltiazem Lopressor HCT Tenormin Zebeta
Calan Esmolol Metoprolol Tiazac Ziac

Do's And Don'ts

  • NO CAFFEINE 24 HOURS PRIOR TO YOUR STUDY. NO coffee, tea, chocolate, soft drinks containing caffeine, or decaffeinated beverage (decaffeinated beverages still contain caffeine.) Caffeine may alter your scan results, therefore making them unreliable.
  • Stay hydrated! Please drink a few glasses of water before your exam.
  • You may eat a light breakfast up to 4 hours prior to the test, after that only water. A light breakfast means no meat or eggs.
  • No smoking 8 hours prior to your test ​
  • Insulin-dependent diabetics that are scheduled after 10:00 a.m. may take half of your diabetic medications. ​

Consents/Risks

  • There are risks and hazards with any procedure. Associated with these tests, including but not limited to, cramping of muscles, stumbling or falling on the apparatus, dizziness, fainting, abnormal change in blood pressure, change in heartbeat and/or heart rhythm, chest pain, or heart muscle injury.
  • If you are pregnant or think you might be pregnant, you must notify the office. This test may not be appropriate to a patient who is pregnant since its administration could be dangerous to an unborn fetus.
  • Consents will be signed at the time of the test.

Products That Contain NO Caffeine

  • Celestial Seasonings Herbal Tea (all varieties)
  • Celestial Seasonings Herbal Iced Tea (bottled)​
  • Lipton Soothing Moments Peppermint Tea
  • 7-UP or Diet 7-UP
  • Barqs Diet Root Beer
  • Caffeine-free Coca-Cola or Caffeine-free Diet Coca-Cola
  • Caffeine-free Pepsi or Caffeine-free Diet Pepsi
  • Minute Maid Orange Soda
  • Mug Root Beer
  • Sprite or Diet Sprite
  • Stonyfield Farm Cappuccino Yogurt

Permanent Pacemaker Insertion

Procedure

A permanent pacemaker is a battery operated device that is placed under the skin, usually in the left upper chest. Small wires connect the pacemaker to the heart. The device is approximately the size of a half-dollar and about 1/2 inch in thickness. The pacemaker is able to sense your heart’s rate and the time between beats. If your heartbeat is not regular or is too slow, the pacemaker sends a small amount of electricity to the heart to speed up the heart or make it beat more regularly. The insertion, which usually takes about 2 hours, is performed in a special room in our clinic.

Before The Test

  • You will be asked to sign a consent form after your doctor has explained the procedure and the risks to you.
  • Most patients are not allowed to eat or drink anything after midnight prior to the surgery. Please ask your nurse.
  • You may be asked to remove dentures, glasses, and jewelry, and to wear a hospital gown.
  • You will need to empty your bladder before you go for the procedure.
  • Tell your doctor or nurse if you are allergic to iodine, x-ray dye, or other medications.
  • You may be given some medicine to help you relax. You will not be put to sleep; you will be awake, but drowsy.

During The Test

  • You will be lying on a hard table surrounded by x-ray equipment and will be connected to a heart monitor.
  • A numbing medicine will be given.
  • The permanent pacemaker will be inserted just under the skin through a small incision.
  • Your heart rate, blood pressure, and breathing will be monitored.

Immediately After The Test

  • You will probably be returned to your same room.
  • Your heart rate and blood pressure will be monitored.
  • You will be able to eat and/or drink as soon as you are awake.
  • Before you go home, you will be given information regarding your and follow-up care from the nurses in the pacemaker lab.

Transesophageal Echocardiogram

Definition

A transesophageal echocardiogram is an ultrasound of the heart. It uses sound waves that are bounced off the heart, reflected back and converted to images on the screen. A trained cardiologist will pass a flexible tube through the mouth and into the esophagus to obtain more information about your heart. This gives clearer pictures of the values, structures, and size of the heart as opposed to an echocardiogram done from outside the chest wall.

Purpose

The images reflect the structure of the heart and the function and movement of the valves and heart chambers.

Before The Test

  • If done as an outpatient we advise you to have someone drive you to the hospital and take you home. You may receive sedation.
  • Do not eat for several hours before the test (your BSW Texas Cardiac Associates doctor will instruct you as to the exact amount of time).
  • If you accidentally do eat, please notify the lab, as your test may need to be rescheduled.

Day Of The Test

  • You will be asked to sign a special permit after the test has been explained to you.
  • Electrodes will be attached to your chest to monitor your heart.
  • The oxygen in your blood will be monitored using a monitoring device attached to a finger.
  • An intravenous (IV) line will be started so that medications can be given to you.
  • You will be asked to lie on your left side.
  • A “numbing medicine” will be sprayed into the back of your throat.
  • Medications to induce drowsiness will be given through an IV line.
  • Once sedated, a tube will be passed down the patient’s throat into the esophagus.
  • Images are then taken of the heart.
  • The test lasts approximately 15 minutes.

Immediately After The Test

  • The patient begins to wake up shortly after the scope is removed.
  • Liquids are given once throat is no longer numb (your BSW Texas Cardiac Associates doctor will instruct you as to the exact amount of time).
  • The patient is observed until the doctor approves your return to the hospital room or leaving the hospital.

Reactions

  • Most patients notice a mild sore throat after the procedure.
  • A cardiologist will review the study and inform you or your doctor of the results.

Cardiac Catheterization

Cardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart, usually from the groin or the arm.
Alternative Names: Catheterization – cardiac; Heart catheterization

How The Test Is Performed

You will get medicine before the test to help you relax.
The healthcare provider cleans a site on your arm, neck, or groin and inserts a line into one of your veins. This is called an intravenous (IV) line. A larger thin plastic tube called a sheath is placed into a vein or artery in your leg or arm. Then longer plastic tubes called catheters are carefully moved up into the heart using live x-rays as a guide.

Then the doctor can:

  • Collect blood samples from the heart
  • Measure pressure and blood flow in the heart’s chambers and in the large arteries around the heart
  • Measure the oxygen in different parts of your heart
  • Examine the arteries of the heart
  • Perform a biopsy on the heart muscle

If you have a blockage, you may have angioplasty and a stent placed during the procedure.
The test may last 30 – 60 minutes. If you also need special procedures, the test may take longer. If the catheter is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding.
You will be told how to take care of yourself when you go home after the procedure is done.

How To Prepare For The Test

You should not eat or drink for 6 – 8 hours before the test. The test takes place in a hospital and you will be asked to wear a hospital gown. Sometimes, you will need to spend the night before the test in the hospital. Otherwise, you will come to the hospital the morning of the procedure.
Your healthcare provider will explain the procedure and its risks. A witnessed, signed consent form for the procedure is required.
Tell your doctor if you:

  • Are allergic to seafood or any medications
  • Have had a bad reaction to contrast dye or iodine in the past
  • Take any medicines, including Viagra or other drugs for erectile dysfunction
  • Might be pregnant

How The Test Will Feel

The study is done by trained cardiologists with the assistance of trained technicians and nurses.
You will be awake and able to follow instructions during the test.
You may feel some discomfort or pressure where the catheter is placed. Some people have some discomfort from lying still during the test or from lying flat on your back after the procedure.

Why The Test Is Performed

In general, this procedure is done to get information about the heart or its blood vessels. It may also be done to treat some types of heart conditions, or to find out if you need heart surgery.
Your doctor may perform cardiac catheterization to diagnose or evaluate:

  • Cardiac amyloidosis
  • Causes of congestive heart failure or cardiomyopathy
  • Coronary artery disease
  • Heart defects that are present at birth (congenital)
  • High blood pressure in the lungs (pulmonary hypertension)
  • Problems with the heart valves

The following procedures may also be done using cardiac catheterization:

  • Repair of certain types of heart defects
  • Open a narrowed (stenotic) heart valve
  • Open blocked arteries or grafts in the heart (angioplasty with or without stenting)

Stents

Stenting is a minimally invasive procedure that is used to help keep arteries from narrowing after they have been opened during a balloon angioplasty. The procedure is used to treat carotid artery disease, renal vascular disease, myocardial infarction (heart attack) and other vascular conditions.

Stents are tiny sections of wire mesh tube, flexible and expandable, that fits inside an artery and reinforces its walls. Some stents are treated with a time-released drug that prevents the artery from becoming blocked or closed again.

Prior to stenting, a catheter – a thin, flexible tube – is inserted into an artery in the groin and threaded through the body to reach the blockage. A very small balloon at the catheter tip is inflated and the artery is reopened. The stent is then inserted through the catheter and put in place inside the artery. Stenting is a catheter-assisted procedure to treat vascular disease.​

Enhanced External Counterpulsation (EECP)

Enhanced external counterpulsation (EECP) improves the flow of healthy, oxygenated blood to the heart by opening or forming small blood vessels, which create natural bypasses around narrowed or blocked arteries.

What Is EECP?

Enhanced external counterpulsation (EECP) is a noninvasive procedure in which a set of inflatable cuffs (similar to blood pressure cuffs) mechanically compress the blood vessels in your lower limbs. This increases the blood flow and oxygen back to the heart, reducing the work that the heart has to do. It also improves circulation and strengthens the cardiopulmonary system. EECP does not have the risks or recovery time associated with surgery. It is FDA-approved, Medicare-approved and usually covered by insurance.

Why Would You Have EECP?

EECP is the only non-invasive treatment for coronary artery disease, angina, and congestive heart failure. The procedure reduces or eliminates angina, increases energy and helps patients return to a more active lifestyle. EECP is used to treat patients with:

  • Chronic stable angina (lack of blood to the heart that causes severe chest pains)
  • Coronary artery disease
  • High blood pressure
  • Congestive heart failure
  • Heart attack

This procedure is particularly effective for those who:

  • Have had coronary angioplasty, stents or coronary artery bypass graft surgery, but their heart disease symptoms have returned
  • Are not candidates for surgery because of other medical conditions
  • Do not want to undergo surgery
  • Have diabetes
  • Have small vessels (often women)
  • Rely on medications

What To Expect During EECP

Preparing for Your Procedure

Prior to your treatment, you’ll meet with your doctor to discuss your medical history, the medicines you take and any questions you have about the procedure. Wear tight-fitting, seamless cycling pants or athletic tights to prevent chafing, one of the main adverse side effects of this treatment.

During Your Procedure

  • You lie comfortably on a special bed.
  • A series of blood pressure cuffs are placed around your legs.
  • An EKG triggers the cuffs to inflate and deflate in sync with your own heartbeat, pumping healthy blood throughout your body and taking a load off your heart.
  • During the heart’s resting phase, when it normally receives its supply of blood, the cuffs inflate, pushing oxygen-rich blood toward your heart.
  • Just before your heart begins pumping again, the cuffs rapidly deflate and blood leaves your heart without the muscle having to work as hard.
  • Most patients relax during the treatment by reading, listening to music, or even sleeping.
  • Each treatment takes about 60 minutes.
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