Key Diagnostic Tools:

• Electrocardiogram (EKG/ECG): It’s a test that records the electrical activity of your heart through small electrode patches that a technician attaches to the skin of your chest, arms, and legs. EKGs are quick, safe, and painless. With this test, your doctor will be able to check your heart rhythm or diagnose a heart attack among other things.

• Echocardiography (TTE/TEE): Ultrasound assessment of valves, chambers, systolic/diastolic function, and pericardial disease. Echocardiography (or “echo”) is simply an ultrasound of your heart — completely painless, no radiation, and one of the most important tests in cardiology. We spread a little gel on your chest and glide a small wand (transducer) over it to create live moving pictures of your heart beating (transthoracic echo, or TTE — the usual one). It shows us the size and shape of your heart chambers, how strongly the muscle squeezes (systolic function) and relaxes (diastolic function), how well the four valves open and close, and whether there’s any fluid around the heart (pericardial disease). When we need even clearer images — for example, before valve surgery or if chest structures are in the way — we do a transesophageal echo (TEE): you’re comfortably sedated, and we pass a tiny ultrasound probe down the esophagus (right behind the heart) for super-sharp pictures. Think of it as a weather radar for your heart — it tells us exactly how everything inside is working and moving.

• Stress testing: Exercise or pharmacologic stress ECG, stress echo, nuclear myocardial perfusion imaging (SPECT/PET). Stress testing provides information about how your heart works during physical stress. Many heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise (walk or run on a treadmill or pedal a stationary bike) to make your heart work hard and beat fast. Tests are done on your heart while you exercise.

• Cardiac catheterization & coronary angiography: Invasive gold standard for coronary artery disease and hemodynamic assessment.Cardiac catheterization and coronary angiography is the gold-standard test to see exactly what’s happening inside your heart’s arteries and how well the heart is pumping. A thin, flexible tube (catheter) is gently inserted through a small needle stick in your wrist or groin and guided to the heart while you’re awake but comfortably relaxed. We then inject a safe contrast dye and take real-time X-ray movies (angiography) to spot any narrowings or blockages in the coronary arteries that supply blood to your heart muscle. At the same time, we can measure pressures inside the heart chambers to check for valve problems, heart failure, or other issues. It’s the most accurate way to know whether a blockage needs a stent, bypass surgery, or just medicine and lifestyle changes — and it’s very safe, takes about 30–60 minutes, and most people go home the same day.

• Holter/event monitors & implantable loop recorders: Long-term rhythm monitoring for syncope and palpitations. An event monitor is a portable device used to record your heart’s electrical activity when you have symptoms. It records the same information as an electrocardiogram (EKG), but for longer durations of time. Most of these devices can transmit the recorded information directly to your healthcare provider. Holter monitors record continuously, usually for about 24 to 48 hours. Event monitors are typically worn for 1-2 weeks but can be worn up to 1 month. It records when you activate it by documenting a symptom but can also automatically record an abnormal heart rhythm that is detected. These monitors can be very useful in diagnosing arrhythmias that are intermittent.

• Cardiopulmonary exercise testing (CPET): Objective measurement of functional capacity and differentiation of cardiac vs pulmonary limitation. ardiopulmonary Exercise Testing (CPET) is the single most accurate way to discover why you get short of breath or tired. You simply ride a stationary bike/treadmill that gradually gets harder for 8–12 minutes while wearing a lightweight mask; we monitor your heart, lungs, and muscles in real time. Unlike regular stress tests or lung tests done at rest, CPET watches the entire system under real-life effort and pinpoints the exact problem — heart, lungs, deconditioning, anemia, or something else — even when all other tests look “normal.” It’s completely safe (a cardiologist supervises the whole time) and will be offered in-office at Ambulatory Cardiovascular Center, one of the few private cardiology practices in New Jersey with a full metabolic cart, because the right diagnosis the first time truly changes lives.