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Outpatient Services
Cardiac Services
Cardiac Rehabilitation
Stress Exercise ECG Testing
Echocardiogram
EKG ( electrocardiogram)
For information about any of these services phone (585) 798-8060.
Cardiac Rehabilitation
Medina Memorial’s Cardiac Rehab services offer medically supervised and individualized exercise programs for people who have had a heart attack, heart surgery or have experienced other heart problems. Our Cardiac Rehab staff assist each patient in setting goals and monitoring progress. A cardiac rehab nurse specialist works with each patient and closely monitors electrocardiogram tracings and blood pressures during exercise sessions. Educational sessions are designed to help patients gain a better understanding of their illness and its treatment, and to regain confidence as they experience physical improvements and learn more about the illness.
What Are The Benefits of Cardiac Rehabilitation?
Patients participating in rehabilitation programs tend to have improved outcomes in managing their condition. Patients are more apt to stick with their drug regimens, and hospital re-admissions tend to be reduced. Furthermore, programs that involve individual and/or family counseling can help to address the common issues that arise as a result of heart disease. These issues range from sexual concerns to increased tension within the family.
Research has shown the following benefits from cardiac rehabilitation:
- Decreased risk of a recurrence of the heart problem
- Decreased risk of death due to heart disease
- Decreased risk of future heart attack
- Fewer episodes of reduced blood flow to the heart (cardiac ischemia)
- Increases strength and stamina
- Increases the efficiency of the heart
- Less of a need for heart-related medications
- Lowers heart rate and blood pressure
- Lower levels of both “bad” low-density lipoprotein (LDL) cholesterol and fats in the blood (triglycerides)
- Relief from depression, fear and anxiety
- Improves self-confidence and well-being
- Better chance of avoiding disability and returning to work
- Slowed development, or even reversal, of hardening of the arteries (atherosclerosis)
- Assists in weight control
- Increases knowledge of cardiac diseases, diet and risk factors
How Do I Enter The Program?
Patients must be referred to the program by a physician.
How Long Are The Cardiac Rehab Sessions?
Class sessions are 90 minutes in length and are held three days a week in the cardiac rehab room located on the hospital's first floor.
For more information call Mary Dunham, RN at 798-8060.
Stress Exercise ECG Test
An exercise ECG test allows doctors to learn how well your heart functions when it is made to work harder. This test can help detect heart problems that may not be apparent at rest. Other terms used to describe an exercise ECG test are stress test, exercise test and treadmill test.
The exercise ECG test is done while you walk on a treadmill. During the test an electrocardiogram (ECG or EKG) records the electrical activity of your heart.
What Does It Show?
Doctors can see how well your heart functions during exertion by studying what happens during the exercise test.
- How long were you able to exercise? Generally, people with a healthy heart and in good physical condition are able to exercise longer.
- Did you have significant symptoms?
- It is normal to feel tired and short of breath during strenuous exercise. However, if you develop chest pain or become extremely short of breath this may indicate a heart problem.
- What happened to your heart rate and blood pressure? The heart rate and blood pressure normally rise during exercise. An abnormal heart rate (too fast or too slow) or a fall ion blood pressure may indicate heart disease.
- What did the ECG show? Certain changes in the ECG tracing may indicate that the heart muscle is not getting enough oxygen-rich blood. Sometimes, the ECG during exercise shows abnormal heart rhythms (called arrhythmias).
- The exercise test is especially useful in diagnosing blockages in the coronary arteries (the vessels that carry blood to the heart). When the coronary arteries are blocked or narrowed, the heart muscle may not be getting enough oxygen during exercise. This often results in symptoms of angina (chest pain) and abnormal changes on the ECG.
Preparing For The Test
Do not eat or drink for 3-4 hours prior to the test. This will prevent the possibility of nausea, which may accompany vigorous exercise after eating. (If you are diabetic and take medications for diabetes, get special instructions from your doctor).
If you are currently taking an heart medications, check with your doctor. He or she may ask you to stop certain medications a day or two before the test. This can help get more accurate results.
Wear loose, comfortable clothing that is suitable for exercise. Men usually don’t wear a shirt during the test, and women generally wear a bra and a lightweight blouse or a hospital gown. You should also wear comfortable walking shoes or sneakers.
Before the test you will be given an explanation of the test and you’ll be asked to sign a consent form. Feel free to ask any questions about the test.
Several areas on your chest and shoulders will be cleansed with alcohol and an abrasive lotion to prepare the skin for the electrodes. Men may need to have areas of their chest shaved to ensure that the electrodes stay in place.
What Happens During The Test?
The exercise ECG test can be performed in the doctor’s office or at the hospital. A trained technician or nurse will place several electrodes (small sticky patches) on your chest and shoulders to allow recording of the ECG during exercise. The electrodes are connected by wires to an ECG machine. A cuff will be put on your arm to monitor your blood pressure. (If you are having a Cardiolite® exercise test, an intravenous line will be placed in your arm. See the information at the end of this section)
You will be shown how to step onto the treadmill and how to use the support railings to maintain balance. The treadmill starts slowly, and then the speed and incline are increased gradually.
Your blood pressure will be checked every few minutes, and the ECG will be carefully watched for abnormal changes. You will be instructed to report any symptoms, such a chest pain, shortness of breath, leg fatigue, or dizziness.
The test may end when you become too tired to continue or if you experience significant symptoms. Other times, the test may be stopped when you reach your peak heart rate or when your ECG shows abnormal changes.
After the exercise portion of the test is over, you will be helped to a chair or bed. Your blood pressure will be monitored for another 5 to ten minutes while you recover. The technician will remove the electrodes and clean the areas where they were attached. (If you are having a Cardiolite® test, there are additional steps. See the information at the end of this section)
How Long Does It Take? You should allow 45 minutes to one hour, which includes preparation for the test, the exercise portion, and the recovery period.
Is The Exercise Test Safe? The exercise test is generally safe. A small amount of risk does exist, however, because it stresses the heart. Possible rare complications include abnormal heart rhythms and a heart attack. Experienced staff are available to handle any emergency.
The Results
The doctor conducting the test may be able to give you preliminary results before you leave. A complete interpretation may take several days. If the test is abnormal or inconclusive, your doctor may order additional tests.
The information gained form the exercise test helps your doctor make an accurate diagnosis and develop a treatment plan that’s best for you.
Cardiolite® Exercise Testing
Your doctor may want you to have a nuclear medicine exam, called Cardiolite® imaging, along with your exercise test. If this is so, the following is performed in addition to the exercise testing described above.
An intravenous (IV) line will be placed in your arm before your exercise on the treadmill. This line will be used to inject a small amount of Cardiolite into your blood stream approximately one minute before the end of exercise. Cardiolite® is a radioactive material used to get pictures of your heart using a special camera. The amount of radiation you will be exposed to is comparable to that from an x-ray or CAT (CT) scan. It is cleared from your body by natural processes. Millions of nuclear medicine exams of various types are performed each year. The IV line will be removed soon after the test is completed.
About one-half hour after the injection the technologist will begin taking pictures. This is called imaging. For this part of the exam, you will be asked to lie flat on your back on an imaging table. Imaging begins with the camera placed close to your chest. During imaging, the camera will take pictures at various angles. It will take 15-30 minutes to complete the imaging portion of the exam. It is important for you to remain very still while the pictures are being taken.
If you are pregnant, suspect you may be, or are a nursing mother, discuss this with your doctor before undergoing the procedure.
Adverse patient reaction to Cardiolite® is rare. You may briefly notice a metallic taste a few seconds after injection has occurred. Other side effects have occurred rarely.
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Echocardiogram
An echocardiogram is a test that uses ultrasound waves to examine the heart. It is a safe and painless procedure that helps doctors diagnose a variety of heart problems. 
How Does It Work?
During the test, a transducer ( a small microphone-like device) is held against the chest. The transducer sends ultrasound waves that reflect (echo) off the various parts of the heart. A computer uses the information coming from the transducer to construct an image of the heart. The image is displayed on a television screen, and it can be recorded on videotape or printed on paper.
What Does It Show?
The echocardiogram provides doctors with important information about the heart, such as:
Size of the heart. The echocardiogram is useful for measuring the size of the heart chambers and thickness of heart muscle.
Pumping strength. The test shows whether the heart is pumping at full strength or is weakened. It can also help determine whether the various parts of the heart pump equally.
Valve problems. The test shows the shape and motion of the heart valves. It can help determine if a valve is narrowed ort leaking and show how severe the problem is.
Other uses. The test is also used to detect the presence of fluid around the heart, blood clots or masses inside the heart, an abnormal holes between heart chambers.
Exercise echocardiogram. An echocardiogram is sometimes performed during or immediately following an exercise test. It helps doctors to determine how well the heart pumps when it is made to work harder.
What Happens During The Test?
The echocardiogram can be performed in the doctor’s office or at the hospital. No special preparation is necessary for this test (If you are scheduled for an exercise echocardiogram, however, you will be given special instructions.
You will be asked to remove clothing above the waist, and put on a hospital gown or a sheet to help keep you warm and comfortable. You will the n lie on an examining table.
Electrodes (small sticky patches) and wires will be attached to your chest and shoulders to record your electrocardiogram (ECG or EKG). The ECG shows your heart’s electrical activity during the test.
Next you will lie on your back or on your left side. To improve the quality of the pictures, a colorless gel is applied to the area of the chest where the transducer will be placed.
A technician moves the transducer over the chest to obtain different views of the heart. He or she may ask you to change positions. You may also be asked to breathe slowly or hold your breath in order to get a better picture.
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EKG ( electrocardiogram)
EKG ( electrocardiogram)
An electrocardiogram (EKG or ECG) is a recording of the heart's electrical activity as a graph or series of wave lines on a moving strip of paper. This gives the physician important information about the heart. For example, it can show the heart's rate and rhythm. It can also detect decreased blood flow , enlargement of the heart or the presence of either current or past heart attacks.
EKGs are quick, safe, and painless tests that are routinely done if a heart condition is suspected. Depending on what the results show, in combination with the patient's medical history and a physical exam, the physician may order further tests or a combination of medications and lifestyle changes.
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