Updates

NGDC News

Physician Spotlight

Roberto M. Villanueva, M.D., F.A.C.P

Roberto M. Villanueva, M.D., F.A.C.P

Cardiology Services

Cardiology Services

We offer the following on-site services:

Electrocardiograms

An electrocardiogram, also called an EKG or ECG, is a simple test that detects and records the electrical activity of the heart. It is used to detect and locate the source of heart problems. Electrodes will be placed on your arms, legs and chest. Wires will be attached to the electrodes and to the EKG machine. The electrical activity created by your heart is processed by the EKG machine and then printed on a special graph paper. It takes a few minutes to apply the EKG electrodes, and one minute to make the actual recording. The EKG will be interpreted by your physician.

Echocardiograms

An echocardiogram, also called an echo, is a safe, non-invasive procedure used to diagnose cardiovascular disease. It uses high-frequency sound waves (ultrasound) to see all four chambers of the heart, the heart muscle, the heart valves, the great blood vessels entering and leaving the heart, as well as the sack around the heart. Echocardiography allows doctors to visualize the anatomy, structure, and function of the heart.

  • The test is performed by placing a probe called a transducer on your chest at different locations to image different parts of the heart. Doppler is used to evaluate the flow of blood through the chambers of the heart.
  • The images made during the echocardiogram are interpreted by a cardiologist, who will send a report to your doctor.
  • There is no prep for an echocardiogram.
  • Allow 30 to 45 minutes for your appointment.

Treadmill Stress Testing

A treadmill stress test is a procedure that uses a treadmill to stress your heart in order to evaluate your heart function. A physician typically orders a stress test to determine if you have coronary artery disease.

  • Electrodes will be placed on your chest to enable continuous monitoring of your EKG during the procedure. Your blood pressure will also be monitored throughout the test.
  • You will be asked to walk on a treadmill. The speed and incline will increase gradually every two to three minutes until an adequate heart rate is achieved or you are too tired to continue.
  • You will continue to be monitored until your heart rate and blood pressure return to normal.
  • A cardiologist will review your electrocardiograms and blood pressures for any abnormal responses to exercise.
  • The cardiologist overseeing your test will send a report to your doctor with his findings.
  • The test will take approximately one hour, including preparation time and monitoring afterward. You may resume your normal activities after the test unless you are told otherwise.

Prep:

  • Have nothing to eat or drink for 3 hours before your test.
  • If you take Corgard, Inderal, Tenormin, Visken, Sectral, Lopressor, Trandate, Toprol or Tenoretic, you may be asked to hold one dose prior to your test. Take all other medications unless told otherwise by your physician. Diabetics should hold their sugar medications if unable to eat.
  • Wear loose fitting slacks or shorts and athletic shoes.
  • Do not apply lotions, oils or powder to your skin the day of your test.
  • Avoid coffee, tea, soft drinks, smoking and alcohol the day of your test

Stress-Echocardiogram

A stress echocardiogram is a procedure that uses a treadmill stress test and an echocardiogram (ultrasound) combined to evaluate heart function. A physician typically orders a stress-echo to determine if you have coronary artery disease.

An echocardiogram is performed at rest focusing on the heart's wall motion. Another echocardiogram will be performed immediately following exercise and the two will be compared side by side. The heart muscle will not squeeze properly if it does not get sufficient blood supply due to narrowing of the coronary arteries. An echocardiogram can detect this and other abnormalities with a high degree of accuracy, thereby giving the physician a better assessment of your heart’s condition.

  • Electrodes will be placed on your chest to enable continuous monitoring of your EKG during the procedure. Your blood pressure will also be monitored throughout the test.
  • A resting echocardiogram will be performed.
  • You will be asked to walk on a treadmill. The speed and incline will increase gradually every two to three minutes until an adequate heart rate is achieved or you are too tired to continue.
  • Within the first two minutes after exercise another echocardiogram will be performed.
  • You will continue to be monitored until your heart rate and blood pressure return to normal.
  • A cardiologist will review your electrocardiograms and blood pressures for any abnormal responses to exercise. They will compare the before and after echocardiograms for changes in how your heart muscle squeezes.
  • The cardiologist overseeing your test will send a report to your doctor with his findings.
  • The test will take approximately one hour, including preparation time and monitoring afterward. You may resume your normal activities after the test unless you are told otherwise.

Prep:

  • Have nothing to eat or drink for 3 hours before your test.
  • If you take Corgard, Inderal, Tenormin, Visken, Sectral, Lopressor, Trandate, Toprol or Tenoretic, you may be asked to hold one dose prior to your test. Take all other medications unless told otherwise by your physician. Diabetics should hold their sugar medications if unable to eat.
  • Wear loose fitting slacks or shorts and athletic shoes.
  • Do not apply lotions, oils or powder to your skin the day of your test.
  • Avoid coffee, tea, soft drinks, smoking and alcohol the day of your test

Dobutamine Stress Echocardiogram

A Dobutamine stress-echocardiogram is a procedure that uses chemically induced stress and an echocardiogram (ultrasound) to evaluate heart function. If you are unable to walk on a treadmill, you may be given a medication called Dobutamine to simulate the effect of exercise on the heart. It may also be used for patients unable to exercise adequately. A physician typically orders a stress-echo to determine if you have coronary artery disease.

An echocardiogram is performed before, during and after the administration of Dobutamine focusing on the heart's wall motion. These images will be compared side by side and will be evaluated for changes in the hearts squeezing capacity. The heart muscle will not squeeze properly if it does not get sufficient blood supply due to significant narrowing of the coronary arteries. An echocardiogram can detect this and other abnormalities with a high degree of accuracy, thereby giving the physician a better assessment of your heart condition.

  • Electrodes will be placed on your chest to enable continuous monitoring of your EKG during the procedure.
  • A nurse will start an IV in your arm.
  • Your blood pressure will also be taken at different intervals throughout the test.
  • An O2 Sat monitor will be placed on your finger to watch the oxygen levels in your blood.
  • A resting echocardiogram will be performed.
  • When the Dobutamine infusion is started the dosage will be increased every two to three minutes until an adequate heart rate is achieved.
  • Echo images will be obtained at intervals throughout the Dobutamine infusion.
  • Once the Dobutamine is discontinued your heart rate should return to normal within a few minutes. The cardiologist may prescribe another medication to help slow your heart rate back to normal.
  • You will continue to be monitored until your heart rate and blood pressure return to normal.
  • A cardiologist will review your electrocardiograms and blood pressures for any abnormal responses to exercise. They will compare the before and after echocardiograms for changes in how your heart muscle squeezes.
  • The cardiologist overseeing your test will send a report to your doctor with his findings.
  • The test will take approximately one hour, including preparation time and monitoring afterward. You may resume your normal activities unless you are told otherwise.

Prep:

  • Have nothing to eat or drink for 6 hours before your test.
  • If you take Corgard, Inderal, Tenormin, Visken, Sectral, Lopressor, Trandate, Toprol or Tenoretic, you may be asked to hold one dose prior to your test. Take all other medications unless told otherwise by your physician. Diabetics should hold their sugar medications if unable to eat.
  • Wear loose fitting slacks or shorts and athletic shoes.
  • Do not apply lotions, oils or powder to your skin the day of your test.
  • Avoid coffee, tea, soft drinks, smoking and alcohol the day of your test

Ambulatory Blood Pressure Monitoring

Ambulatory Blood Pressure Monitoring is a test that will allow your physician to observe your changingblood pressure over a 24 hour period.

A blood pressure cuff will be attached to your arm which will also be attached to a small monitor you will wear. You will be able to do all of your normal daily routines except bathe or shower. You will be asked to keep a diary of your activities. Your blood pressure will automatically be taken every thirty minutes while you are awake and every hour during the night. You will need to return the monitor the following day at the scheduled time.Your doctor will review your downloaded blood pressures and will notify you of the results.No prep is necessary.

Holter Monitoring

A Holter monitoris a small device used to record heartbeats.It is used to detect abnormalities in the hearts rhythm. The holter will digitally record every heartbeat during the 24 hours it is worn. You will be able to do all of your normal daily routines except bathe or shower. You will also be asked to keep a diary of your activities.Do not use any lotions or oils on your skin the day of your test. Be prepared to return your monitor the following day at the scheduled time. A cardiologist will review your heart rates and rhythm and a report will be generated and sent to your physician.

Nuclear Stress Tests

A nuclear stress test is a procedure used to determine if your heart muscle is receiving adequate blood supply. The nuclear stress test involves an injection, of a radiopharmaceutical agent, which circulates in the bloodstream. Pictures are taken by a gamma camera which shows the blood flow to your heart. These pictures are taken both at rest and after you have completed the stress test. The "stress" test can either be a physical stress test (walking on a treadmill) or a pharmacologic stress test (a medicine is given to increase the heart rate or dilate the blood vessels).

Treadmill Nuclear Stress Test

  • Upon arrival you will be taken to the nuclear lab where the nuclear procedure will be explained and a consent form will be signed. Female patients under the age of 62 will be asked to sign a risk of pregnancy/ breast-feeding consent form. IV access will be obtained. The nuclear tech will inject the nuclear imaging agent.
  • You will then be laid underneath the nuclear camera and resting images will be obtained.
  • You will then be directed to the cardiology lab for stress. Electrodes will be placed on your chest to enable continuous monitoring of your EKG during the procedure. Your blood pressure will be monitored throughout the test.
  • You will be asked to walk on a treadmill. The speed and incline will increase gradually every two to three minutes until an adequate heart rate is achieved. Then, the nuclear tech will inject another dose of the radioisotope and you then will walk another one to two minutes.
  • You will continue to be monitored until your heart rate and blood pressure return to normal.
  • Then, you will be brought back to the nuclear lab and will lay underneath the camera again for your stress images.
  • The cardiologist will review your electrocardiograms, blood pressures, and the before and after nuclear images for any abnormal responses to exercise.
  • The cardiologist overseeing your test will send a report to your doctor with his findings.
  • The test will take approximately three to four hours, including preparation time and monitoring afterward. You may resume your normal activities unless you are told otherwise.

Prep:

24 Hours Before Your Test:

  • Do not drink coffee, tea of any kind, colas or soft drinks (including those labeled caffeine free).
  • Do not eat chocolate/candy cakes pies, cocoa, white chocolate, etc.
  • Do not take aspirin products containing caffeine, Persantine (Dipyridamole), or Theophylline type medications.
  • If you are taking Aggrenox, you must stop this medication 3 days before this procedure.
  • Do not use any tobacco products.

The Day of Your Test:

  • Have nothing to eat or drink 6 hours before your test.
  • Do not take water pills (diuretics) until after your test.
  • If you take Corgard, Inderal, Tenormin, Visken, Toprol, Tenoretic, Sectral, Lopressor, or Trandate, you may be asked to hold one dose prior to your test. Take all other medications unless told otherwise by your physician.
  • Diabetics should hold their sugar medications if unable to eat.
  • Wear loose fitting slacks or shorts and athletic shoes. Avoid wearing dresses, under-wire bras, jumpsuits, or clothing with metallic buttons.
  • Do not apply lotions, powder or oils to your skin.
  • Only patients will be allowed in the exam area.
  • The Radioisotopes for this procedure are a special order. Please give at least 24 hours notice if you are unable to keep your appointment.

THERE IS A POSSIBILITY IF YOU ARE SIGNIFICANTLY OVERWEIGHT THAT YOUR TEST WILL REQUIRE A VISIT THE FOLLOWING DAY.

Dobutamine Nuclear StressTest

  • Upon arrival you will be taken to the nuclear lab where the nuclear procedure will be explained and a consent form will be signed. Female patients under the age of 62 will be asked to sign a risk of pregnancy/ breast-feeding consent form. IV access will be obtained. The nuclear tech will inject a radioisotope, the nuclear imaging agent.
  • You will then be laid underneath the nuclear camera and resting images will be obtained.
  • You will then be directed to the cardiology lab for stress. Electrodes will be placed on your chest to enable continuous monitoring of your EKG during the procedure. Your blood pressure will be monitored throughout the test.
  • When the Dobutamine infusion is started, the dosage will be increased every two to three minutes until an adequate heart rate is achieved. The nuclear tech will inject another dose of the radioisotope.
  • Once the Dobutamine is discontinued your heart rate should return to normal within a few minutes. The cardiologist may prescribe another medication to help slow your heart rate back to normal.
  • You will be given a snack and will wait about 45 minutes. Then, you will be brought back to the nuclear lab and will lay underneath the camera again for your stress images.
  • The cardiologist will review your electrocardiograms, blood pressures, and the before and after nuclear images for any abnormal responses to exercise.
  • The cardiologist overseeing your test will send a report to your doctor with his findings.
  • The test will take approximately three to four hours, including preparation time and monitoring afterward. You may resume your normal activities unless you are told otherwise.

Prep:

24 Hours Before Your Test:

  • Do not drink coffee, tea of any kind, colas or soft drinks (including those labeled caffeine free).
  • Do not eat chocolate/candy cakes pies, cocoa, white chocolate, etc.
  • Do not take aspirin products containing caffeine, Persantine (Dipyridamole), or Theophylline type medications.
  • If you are taking Aggrenox, you must stop this medication 3 days before this procedure.
  • Do not use any tobacco products.

The Day of Your Test:

  • Have nothing to eat or drink 6 hours before your test.
  • Do not take water pills (diuretics) until after your test.
  • If you take Corgard, Inderal, Tenormin, Visken, Toprol, Tenoretic, Sectral, Lopressor, or Trandate, you may be asked to hold one dose prior to your test. Take all other medications unless told otherwise by your physician.
  • Diabetics should hold their sugar medications if unable to eat.
  • Wear loose fitting slacks or shorts and athletic shoes. Avoid wearing dresses, under-wire bras, jumpsuits, or clothing with metallic buttons.
  • Do not apply lotions, powder or oils to your skin.
  • Only patients will be allowed in the exam area.
  • The Radioisotopes for this procedure are a special order. Please give at least 24 hours notice if you are unable to keep your appointment.

THERE IS A POSSIBILITY IF YOU ARE SIGNIFICANTLY OVERWEIGHT THAT YOUR TEST WILL REQUIRE A VISIT THE FOLLOWING DAY.

Adenosine Nuclear Stress Test

  • Upon arrival you will be taken to the nuclear lab where the nuclear procedure will be explained and a consent form will be signed. Female patients under the age of 62 will be asked to sign a risk of pregnancy/ breast-feeding consent form. IV access will be obtained. The nuclear tech will inject a radioisotope, the nuclear imaging agent.
  • You will then be laid underneath the nuclear camera and resting images will be obtained.
  • You will then be directed to the cardiology lab for stress. Electrodes will be placed on your chest to enable continuous monitoring of your EKG during the procedure. Your blood pressure will be monitored throughout the test.
  • Lexiscan will be injected over 30 seconds.  the nuclear tech will inject another dose of radioisotope immediately after the Lexiscan. 
  • You will continue to be monitored until your heart rate and blood pressure returns to normal.
  • You will be given a snack and will wait about 45 minutes. You will be brought back to the nuclear lab and will lay underneath the camera again for your stress images.
  • The cardiologist will review your electrocardiograms, blood pressures, and the before and after nuclear images for any abnormal responses to exercise.
  • The cardiologist overseeing your test will send a report to your doctor with his findings.
  • The test will take approximately three to four hours, including preparation time and monitoring afterward. You may resume your normal activities unless you are told otherwise.

Prep:

24 Hours Before Your Test:

  • Do not drink coffee, tea of any kind, colas or soft drinks (including those labeled caffeine free).
  • Do not eat chocolate/candy cakes pies, cocoa, white chocolate, etc.
  • Do not take aspirin products containing caffeine, Persantine (Dipyridamole), or Theophylline type medications.
  • If you are taking Aggrenox, you must stop this medication 3 days before this procedure.
  • Do not use any tobacco products.

The Day of Your Test:

  • Have nothing to eat or drink 6 hours before your test.
  • Do not take water pills (diuretics) until after your test.
  • If you take Corgard, Inderal, Tenormin, Visken, Toprol, Tenoretic, Sectral, Lopressor, or Trandate, you may be asked to hold one dose prior to your test. Take all other medications unless told otherwise by your physician.
  • Diabetics should hold their sugar medications if unable to eat.
  • Wear loose fitting slacks or shorts and athletic shoes. Avoid wearing dresses, under-wire bras, jumpsuits, or clothing with metallic buttons.
  • Do not apply lotions, powder or oils to your skin.
  • Only patients will be allowed in the exam area.
  • The Radioisotopes for this procedure are a special order. Please give at least 24 hours notice if you are unable to keep your appointment.

THERE IS A POSSIBILITY IF YOU ARE SIGNIFICANTLY OVERWEIGHT THAT YOUR TEST WILL REQUIRE A VISIT THE FOLLOWING DAY.

If you would like to learn more about our role in providing the highest level of cardiology services in Gainesville and North Georgia or for scheduling and questions, please call 770-297-4985.