Cardiovascular & Pulmonary Services

Helpline: (304) 367-7484

Cardiologists are highly skilled physicians, who specialize in the diagnosis and treatment of cardiac problems and conditions. When a possible cardiac condition exists, your family physician may refer you to a Cardiologist for a consultation and evaluation.

Cardiac Catheterization Using Your Wrist

Fairmont Regional Medical Center has provided expert cardiac care for the past decade and recently began an innovative service. For some patients, cardiac catheterization can be easily done using the radial artery in the wrist. Recovery under this procedure is much quicker, with less chance of bleeding. In procedures using the artery in the thigh for the insertion of the catheter, a patient must lie still for several hours to reduce risk of bleeding. Using the wrist means less time in recovery.

This procedure was initiated at FRMC thanks to efforts of Dr. Paul Alappat, cardiologist at FRMC. Dr. Alappat has now spearheaded this procedure in our region of West Virginia.

Electrocardiogram

Your physician has ordered an electrocardiogram for you at Fairmont Regional Medical Center in the EKG office. An EKG (ECG) is a simple, painless test that records the heart’s electrical activity. You will be asked to lie down on a bed and electrodes will be placed on your chest, forearms and legs. Wires will then be connected to the electrodes and then after stabilization the EKG will be printed and sent to a physician for interpretation.

An EKG shows:
• How fast your heart is beating
• Whether the rhythm of your heart beat is steady or irregular
• The strength and timing of electrical signals as they pass through each part of your heart
Doctors use EKG’s to detect and study many heart problems, such as heart attacks, arrhythmias, and heart failure. The test’s results also can suggest other disorders that affect heart function.

Ambulatory Monitoring

Your physician has referred you to the Cardiovascular Center at Fairmont Regional Medical Center for a 24 or 48 hour holter monitor. The basic purpose of a holter monitor is to provide a 24 hour EKG. Most EKG’s last about a minute which is perfectly fine for certain types of heart problems, but most heart irregularities cannot be determined this quickly and are related to other things such as activity, meal time, and emotional stress. These types of irregularities can, at times, be very dangerous if left undiscovered and untreated. The Cardiovascular Center staff will connect you to the monitor by applying electrodes to your skin and then attaching the monitor and placing over your shoulder, around your waist or in your pocket. 

Whenever a symptom such as palpitations, chest pain, dizziness, or shortness of breath is experienced, you will be instructed to push any one of the three buttons on the front of the monitor. You will be given a diary to take home to keep track of your activities and to record any symptoms you might have. Avoid getting the monitor or wires wet. Please maintain your normal everyday activities unless your physician has restricted you. You will return the monitor after the 24 hour period and the information obtained will be analyzed and then interpreted by a cardiologist. The final report will be sent to your physician.

30 Day Event Recorder

Your physician has requested a 30 day event monitor for you at Fairmont Regional Medical Center in the Cardiovascular Venter. The 30 day event recorder can capture events that occur over a 30 day period. Therefore, if your symptoms happen infrequently, there is a greater chance the heart irregularity may be detected. 

While the monitor is being worn, the patient can record their own EKG and transmit it to a 24 hour cardiac monitoring center from most telephones. The EKG’s are then forwarded to Fairmont Regional Medical Center where the Cardiovascular Center staff reviews the EKG strips and forwards it to the cardiologist for interpretation. 

When wearing the monitor if you have a symptom (chest pain, dizziness, etc.) you press the symptom/record button, the monitor saves your heart’s EKG activity that occurred about a minute before you pressed the button, and then continues to save the signal for about 30 seconds after the button press. This means that your physician can see what was happening with your heart BEFORE you had the symptom; this can be very important because symptoms are often felt AFTER the heart “event” occurs. In addition, the event monitor may also detect EKG abnormalities that you don’t feel.

The Cardiovascular Center staff will give you a pouch with all the supplies you will need for the 30 day period. The complete procedure will be reviewed; however, an instructional booklet is included. The staff will connect you to the monitor by applying electrodes to your skin and attaching the monitor with wires. You will be instructed on how to press the symptom button and also how to transmit your EKG information. 

Echocardiography

Your physician has requested that you have an echocardiogram at Fairmont Regional Medical Center. This test determines the size and shape of the heart, checks the thickness and movement of the heart wall, and looks at the heart valves and how well they work and the ability of the heart to pump blood.

There is no special preparation for this test. Once you arrive to the Echo Department you will undress from the waist up and put on a hospital gown. You will lie down on your left side on an exam table and the room will be darkened to help the sonographer to view the images on the machine. The sonographer will apply 3 electrodes to your chest along with electrode gel and hold an instrument over your chest, called a transducer, to obtain the images.

Pictures of your heart structures are seen on the TV screen and recorded on a disc for the cardiologist to review and interpret. You will occasionally hear sound coming from the ultrasound machine which is the blood passing through the valves of your heart. The sonographer may obtain a series of heart images by positioning the transducer at various angles to capture different parts of your heart. The sonographer may ask you to breathe in and out slowly or to hold your breath. The way your heart responds to these actions will be recorded. Please try to stay still during the test because movements can alter the results. After the exam is complete, the sonographer will clean the gel off of your chest and remove the electrodes. Please note that the cardiologist will review your test and a copy of the interpretation will be sent to your physician. The approximate time of the exam is 30 minutes.

Transesophageal Echocardiogram

Your physician has requested that you undergo a Transesophageal Echocardiogram at Fairmont Regional Medical Center. With this procedure a flexible tube is inserted into the mouth and down to the esophagus. The echocardiogram is then performed from within the esophagus with a special transducer so that there is no interference from the ribs, lungs or underlying tissue. This procedure allows for improved resolution of the images compared to the regular echocardiogram.

You will be told when to arrive at the hospital and will be sent to the Ambulatory Surgery Department. Since you may receive sedation for this procedure, you must be accompanied by a responsible adult to take you home afterwards since you cannot drive yourself. You must not have anything to eat or drink for 6 hours prior to the examination. You will be asked to sign an informed consent. An intravenous catheter will be placed in your arm so that you may receive the sedative. If you wear dentures, you will be asked to remove them. At this time you will be sent to the Cath Lab in Radiology where the back of your throat will be anesthetized with a spray or gel to suppress your gag reflex. A bite guard will be placed in your mouth. Your blood pressure will be monitored throughout the procedure along with your heart rhythm.

The cardiologist performing the examination will ask you to swallow as he inserts the tube. The doctor will then manipulate the tube so that proper images can be obtained. This part of the test usually lasts 15 to 20 minutes. After the test is completed, the tube will be removed and you will be taken back to Ambulatory Surgery for further observation (approximately 2 hours). Since your throat will still be numb, you cannot eat or drink anything for 2 to 3 hours after the exam. Any questions regarding this procedure should be referred to the physician who requested you have the exam. 

Approximate time for procedure:
Preparation 1 hour, exam 15 to 30 minutes and recovery 2 hours.

Graded Exercise Test (Cardiac Stress Test)

Your physician has requested that you undergo a graded exercise test at Fairmont Regional Medical Center’s Cardiovascular Center. A graded exercise test is performed to assess the heart’s response to stress or exercise. Other valuable information will also be obtained such as blood pressure levels and exercise capacity. 

In preparation for this test you are not to eat or drink anything the morning of the test. Please wear loose fitting, comfortable clothing and shoes that are appropriate for walking. Bring your morning medications with you. A staff member will take a brief history, explain the procedure and request you sign an informed consent. The next step will be to place electrodes on your chest so that you can be connected to the exercise test equipment.

While on the treadmill your EKG will be monitored continually along with periodic blood pressure measurements with the cardiologist present. The treadmill will be started out at a level that is easy to accomplish and will then be advanced in speed and elevation every few minutes. You will exercise until reaching a target heart rate (determined by the physician based on your age and physical status) or until you are unable to continue due to fatigue, shortness of breath, chest pain, irregular heart rhythms, or other symptoms. The test is designed to measure your fitness level, to determine the presence or absence of clinically significant heart disease, and/or evaluate the effectiveness of your current therapy. After reviewing the EKG tracings and your responses to exercise, the cardiologist will interpret the findings and an official report will be sent to your physician.

The procedure will take approximately one hour, including check-in, preparation and the actual procedure.

Graded Exercise Test with Myocardial Perfusion Imaging

Your physician has requested that you undergo a graded exercise test with myocardial perfusion imaging at Fairmont Regional Medical Center. The procedure is performed between the Cardiovascular Center where you have the graded exercise test and Nuclear Medicine Department where the imaging is conducted. The addition of the myocardial perfusion imaging will give your physician additional information than just undergoing a graded exercise test by itself. The myocardial perfusion scan gives the doctor a visual picture of your heart muscle which will aid in determining the presence or absence of cardiac disease.

Special Test Instructions:
• You may drink 1-2 glasses of water past midnight, but no other liquids
• Do not eat or smoke past midnight before the test
• Do not have caffeine or chocolate past 7pm the night before the test
• Do not take your morning medication but bring them with you
• If you are diabetic do not take your medication but bring them with you
• If you need pain or anti-anxiety medicine to help you lie down for the scan, please bring it
• You must be able to raise your left arm above head, and be able to lie very still
• Wear comfortable clothes and shoes. No metal on shirt or blouse. No underwire bra.
• Juice/water may be supplied, or you may bring a caffeine-free drink and low fat snack, if you like
• You may want to bring something to read or work on to help occupy your time because the test takes 4 to 5 hours
• Mid-way through the morning you will be able eat, drink, and take any medications. You will be given a 20% discount to eat in the hospital cafeteria, if you like

When you arrive at the Cardiovascular Center you will interviewed by a staff member to obtain pertinent medical history. After the test is explained to you by the staff member, you will be asked to sign the informed consent. Then your skin will be prepped and electrodes will be placed on your chest. An intravenous catheter will be placed in your arm by a registered nurse. The next part of the test occurs in Nuclear Medicine. A small amount of a radioactive isotope will be injected into your IV (don’t worry the isotope is not a dye). You will be given water to drink. There is a 60 minute wait time and then you will have your resting scan with the gamma camera. The technologist will try to make you comfortable on the table with your arms above your head, and with a pillow under your knees. This scan takes 8 minutes.

Approximately 2 hours from the first injection, you will have your stress test (either walking on treadmill or receiving a chemical agent). The exercise test in conducted in the Cardiovascular Center with a registered nurse or exercise physiologist and a cardiologist. A Nuclear Medicine technologist will inject more radioactive isotope in your IV and then the IV will be removed. At this point you may eat, drink and take your morning medicines while waiting for the second scan. If you would like to go to the cafeteria, staff will give you a 20% discount card. If you do not choose to go to the cafeteria, the Nuclear Medicine staff will provide a snack and a beverage to drink. 

30 to 60 minutes later you will then have your stress scan in Nuclear Medicine which takes 6 minutes. After test completion, your exercise test will be reviewed along with your scans and an official interpretation will be completed and sent to your physician generally within 1-2 working days.

THE RADIOISOTOPES ARE SPECIAL ORDER!!!
Please call to cancel or change your appointment if you can’t make it. Procedure will take approximately 4 -5 hours to complete.

Chemical Stress Test with Myocardial Perfusion Imaging

Your physician has requested that you undergo a chemical test with myocardial perfusion imaging at Fairmont Regional Medical Center. The procedure is performed between the Cardiovascular Center where you have the chemical stress test and Nuclear Medicine Department where the imaging is conducted. The addition of the myocardial perfusion imaging will give your physician additional information than just undergoing a chemical stress test by itself. The myocardial perfusion scan gives the doctor a visual picture of your heart muscle which will aid in determining the presence or absence of cardiac disease.

Special Test Instructions:
• If you are taking Theophylline or any medication containing Theophylline, it should be held for at least 12 hours prior to testing
• You must also avoid any caffeine or caffeine containing drugs for 24 hours prior to testing
• You may drink 1-2 glasses of water past midnight, but no other liquids
• Do not eat or smoke past midnight before the test
• Do not have caffeine or chocolate past 7pm the night before the test
• Do not take your morning medication but bring them with you
• If you are diabetic do not take your medication but bring them with you
• If you need pain or anti-anxiety medicine to help you lie down for the scan, please bring it
• You must be able to raise your left arm above head, and be able to lie very still
• Wear comfortable clothes with no metal on shirt or blouse and no underwire bra
• Juice/water may be supplied, or you may bring a caffeine-free drink and low fat snack, if you like
• You may want to bring something to read or work on to help occupy your time because the test takes 4 to 5 hours
• Mid-way through the morning you will be able eat, drink, and take any medications. You will be given a 20% discount to eat in the hospital cafeteria, if you like

When you arrive at the Cardiovascular Center you will interviewed by a staff member to obtain pertinent medical history. After the test is explained to you by the staff member, you will be asked to sign the informed consent. Then your skin will be prepped and electrodes will be placed on your chest. An intravenous catheter will be placed in your arm by a registered nurse. The next part of the test occurs in Nuclear Medicine. A small amount of a radioactive isotope will be injected into your IV (don’t worry the isotope is not a dye). You will be given juice and water to drink. There is a 60 minute wait time and then you will have your resting scan with the gamma camera. The technologist will try to make you comfortable on the table with your arms above your head, and with a pillow under your knees. This scan takes 8 minutes.

Approximately 2 hours from the first injection, you will have your chemical stress test utilizing with either Lexiscan or Dobutamine. The chemical test is conducted in the Cardiovascular Center with a registered nurse and a supervising cardiologist. The chemical agent will either be injected or infused via an IV solution. A Nuclear Medicine technologist will inject more radioactive isotope in your IV. If you receive Lexiscan you will be given a caffeinated beverage to drink shortly after the injection. This will help to alleviate any side effects of the chemical agent. The IV will then be removed.

At this point you may eat, drink and take your morning medicines while waiting for the second scan. If you would like to go to the cafeteria, staff will give you a 20% discount card. If you do not choose to go to the cafeteria, the Nuclear Medicine staff will provide a snack and a beverage to drink. 30 to 60 minutes later you will then have your stress scan in Nuclear Medicine which takes about 6 minutes. After test completion, your exercise test will be reviewed along with your scans and an official interpretation will be completed and send to your physician generally within 1-2 working days.

THE RADIOISOTOPES ARE SPECIAL ORDER!!!
Please call to cancel or change your appointment if you can’t make it. Procedure will take approximately 4 -5 hours to complete.

Vascular Laboratory

Carotid Ultrasound:
Your physician has referred you to Fairmont Regional Medical Center’s Vascular Laboratory for a carotid ultrasound. This procedure uses ultrasound waves to obtain images of the blood flow in your carotid arteries which will indicate any plaque build-up within the artery. The technologist will need to access your neck so it is helpful if you wear loose fitting clothing. Upon arrival you will be asked a brief history and then be positioned on an exam table. Ultrasonic gel will be placed on your neck and a transducer connected to the ultrasound machine will be moved up and down both sides of the neck. The procedure will be INFINITI PACS and viewed by the interpreting physician. You may hear sounds coming from the machine throughout the procedure. The sounds are the blood rushing through your arteries. Once the exam is complete the gel will be wiped off of your neck. 

The physician will interpret the test and the report will be sent to your physician, generally within 2 to 3 days. The procedure usually takes 20 to 30 minutes.

Peripheral Arterial Doppler:

Your physician has requested that you undergo a peripheral arterial Doppler at the Vascular Laboratory at Fairmont Regional Medical Center. This examination utilizes sound waves and blood pressure readings to evaluate the circulation in your arteries generally looking for a blockage.

Upon arrival to the Vascular Laboratory you will be asked a brief history and then be instructed to remove your clothing from the area to be examined. The technologist will position you on an exam table and then apply gel to a probe and listen and take pictures of the arterial signals at various locations. Next, a series of blood pressure cuffs will be placed on the extremity to be examined and readings will be taken and recorded. In most cases both sides will be checked. 

If claudication is suspected (pain in legs while walking), you may be asked to walk on a treadmill for a short period of time and then the blood pressures would be repeated for comparison before and after walking. The report will be sent to INFINITI PACS and the interpreting physician will review it and send a report to your physician, generally within 2-3 days. The approximate time for this procedure is 30 to 45 minutes.

Venous Duplex/Doppler Scan:

Your physician has requested that you undergo a venous duplex exam at the Vascular Laboratory of Fairmont Regional Medical Center. This test can be performed on the arms or the legs and uses ultrasound waves to obtain images that will show information about the blood flow in the veins. Usually the reason for the test is to look for a blood clot in the deep venous system.

Upon arrival to the Vascular Laboratory you will be asked a brief history and then be instructed to remove your clothing from the area to be examined. Next you will be positioned on an examination table and gel will be placed on your skin. A transducer will move up and down the extremity to be examined. You may hear noises coming from the ultrasound machine and this is the blood flowing through the veins. The technologist will instruct to “bear down” and possible flex your foot. They may press down on your extremity with the transducer and at times squeeze your arm or leg. These maneuvers allow the technologist to evaluate the blood flow more thoroughly. Both extremities may be done for comparison. After the exam is complete the gel will be wiped off.

After the review, the physician will prepare a report and it will be sent to your physician usually within 2-3 days. Approximate time of the procedure is 30 minutes.

Renal Artery Duplex Ultrasound:

Your physician has requested that you undergo a renal artery duplex scan at the Vascular Laboratory of Fairmont Regional Medical Center. This test will show if there is a blockage in your renal artery that could cause uncontrolled hypertension along with other medical problems. You must not eat or drink anything after midnight before the morning of the exam. 

Upon arrival to the Vascular Laboratory you will be asked a brief history and then be instructed to remove your clothing from around your abdomen and be positioned on an exam table. The technologist will place ultrasound gel on both sides of your abdomen and you will be asked to turn from side to side. The ultrasound waves will allow the technologist to record images of the renal arteries and measurements will be taken of the blood flow in various locations. At times you will be asked to hold your breath. Once the exam is completed the gel will be wiped off of your skin. The INFINITI PACS for the interpreting physician to review.

Once the physician interprets the test, a report will be sent to your physician generally with 2-3 days. The approximate time for the exam is 30-45 minutes.

Respiratory Services:

Pulmonary Function Test
Your physician has requested that you undergo a Pulmonary Function Test at Fairmont Regional Medical Center. This test will measure how well your lungs are functioning. Before the test you must avoid smoking for at least 4 hours. Please avoid a heavy meal before your testing and wear loose fitting, comfortable clothing. If you are on medications (orally or inhaled) for your breathing, please avoid taking them for 12 hours prior to your testing. The test may take anywhere from 45 minutes to 2 hours depending on what your physician has requested.

The therapist will ask you to breathe as deeply as you can into a mouthpiece connected to a machine. A clip will be placed on your nose so that you can only breathe through your mouth. The therapist will be giving you instructions or “coaching” you throughout the procedure in order to obtain the best test possible. The therapist may give you a bronchodilator and repeat certain parts of the test. During the test you may get short of breath or become tired. If you need to take a break, just let the therapist know. Please report any signs of dizziness, chest pain, fast heartbeat, nausea or severe shortness of breath or wheezing.

Once the test is completed, you can return to normal activity. The Pulmonologist will interpret the test and a report will be sent to your physician generally within 2 to 3 days.

6 Minute Walk (Simple Stress Test)

Your physician has requested that you have a 6 Minute Walk Test to qualify you for oxygen usage at home. You can eat and take your medicines as usual before the test. The Respiratory Therapist will check your oxygen saturation on room air and then if necessary will have you walk on a flat surface and re-check the oxygen saturation to determine if the level had decreased. If the oxygen level meets insurance requirements, you may be placed on oxygen and then walk again.