A new piece of medical imaging equipment promises to improve Barton Memorial Hospital’s ability to screen people for heart disease, the United States’ leading cause of death.
The machine uses ultrasound technology to give doctors high-quality moving images of patients’ hearts and information about the condition of coronary arteries that carry blood and oxygen.
Doctors traditionally have initially screened people for heart disease with an electrocardiogram, or EKG. Patients exercise on a treadmill to elevate their heart rates and doctors monitor electrical activity for signs that indicate a problem with the heart or its arteries.
“The only problem with the EKG, particularly in women, is it’s just not very accurate,” said Dr. David Young, of Barton Cardiology. “It’s only what we call 65 percent sensitive, which means 35 out of 100 cases we could be missing. So we’ve tried to add additional testing on the treadmill to make it more accurate. One of the ways you can do that is with ultrasound.”
The echocardiogram and stress echo test are simple and non-invasive. Combined with the EKG, they also boost the sensitivity of screening efforts to more than 85 percent.
“We’re excited about this,” Young said. “We got the latest and best ultrasound machine. We trained with probably 30 to 40 patients for five weeks. We’re getting ready to ramp back up, do a few more practice sessions and then we’re ready to go.”
The device will be used to screen people who are at an intermediate risk of heart disease and help determine if they need to be referred to another hospital for an angiogram, a test Barton Memorial Hospital does not offer. The “gold standard” for detecting coronary artery disease, an angiogram involves injecting dye into the bloodstream and taking an X-ray of the heart to look for artery blockages.
Patients who undergo a stress echo test first get an ultrasound of their heart at rest. They then exercise on the treadmill. When their heart rate is adequately elevated they lay down on a bed while a cardiac sonographer uses a transducer to collect ultrasound images of their heart on four image planes.
Collecting images can be tricky and must be done within 60 seconds. The ultrasound device cannot see through extensive breast or fat tissue, or through air, so getting images of the heart, which is in close proximity to the lungs, can be difficult when patients are breathing heavily.
“You can detect all kinds of abnormalities just by a resting ultrasound of someone’s heart,” Young said. “You can detect the thickness of the heart muscle, the status of heart valves, the size of various chambers, all of which can give a vast amount of information about someone’s cardiac history.”
Community fundraising by the Barton Foundation last winter raised money to purchase the machine and a specialized treadmill that interfaces with it, which cost about $180,000. A local cardiology patient also offered a major financial gift toward the purchase.
It’s part of an effort to improve cardiology care at the South Lake Tahoe community hospital.
“That’s what our big role has been here,” said Young, a cardiologist who has been with the hospital for two-and-a-half years. “For a long time there was no one here, so if you had an inkling of a cardiac problem you were referred down the mountain. This is one more piece of the wheel in bringing comprehensive care to the city.”