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Detection & Diagnosis

Union Hospital's Cardiovascular Testing department is equipped with advanced technology and trained staff to assist your Cardiologist to assess your condition and treat you appropriately.

Our labs are accredited through the Intersocietal Accreditation Commission (IAC) which requires high standards and ongoing quality assurance. We maintain accreditations in Adult Transthoracic Echocardiography, Peripheral Venous Testing, Peripheral Arterial Testing, and Extracranial Cerebrovascular Testing.

We offer a wide range of exams including electrocardiogram, Holter and event monitoring, echocardiogram, and vascular exams. We perform diagnostic exams for patients ranging from neonatal to geriatric level.

All of our examinations are interpreted by our highly qualified physicians who specialize in cardiology, cardiothoracic surgery, or vascular surgery.

We offer all of our exams on an outpatient basis as well as cover our inpatient and emergency needs for Union Hospital.

Outpatient Testing is available Monday thru Friday from 7 a.m. to 5 p.m. We provide inpatient services daily including on-call coverage 24/7.

Our staff consists of trained EKG technologists and Registered Sonographers who aid the physicians in providing the best care possible to our customers.

The Heart and Vascular Institute is located in the Union Hospital West Building. You may use our valet services for easy and convenient parking.

We offer services at Union Hospital Clinton to serve Parke and Vermillion counties. Testing conveniently offered at Union Hospital Clinton includes echo and vascular ultrasounds, Holter and event monitoring, as well as stress testing.

Patient Information: What to Expect

Our ultrasound exams are performed in a darkened, quiet room. We use advanced machines and monitors to perform your exam.

Venous Imaging
Veins are examined with ultrasound which allows us to look inside the veins and listen to the blood flow. The main indication for these examinations is to rule out blood clots and identify the cause of varicose veins and ulcers on the legs.

Exams such as these may help a surgeon plan for upcoming procedures such as heart bypass grafts or dialysis grafts.

The patient will be lying down and comfortable. The venous exams are painless and last approx. 30-70 minutes. 

Arterial Imaging
Arteries are examined with ultrasound which allows us to look inside the arteries as well as listen to the blood flow. Blood pressure may be taken in the arms and legs to assess adequate blood flow in the extremities. The main indication for these exams is to rule out a blockage in the arteries and look for abnormalities like aneurysms.

The patient will be lying down and comfortable. The arterial exams are painless and last approx. 30-45 minutes.

Carotid Duplex Imaging

The carotid arteries in your neck are examined with ultrasound which allows us to look inside the arteries as well as listen to the blood flow. Indications for this test are symptoms that are consistent with a stroke or mini-stroke (TIA). Some of those symptoms are sudden visual changes, dizziness, and weakness or numbness on one side of the body.

This exam will identify any abnormal build-up in the carotid artery which would cause decreased blood flow to the brain.

The patient will be lying down and comfortable. The carotid artery exam is painless and lasts approx. 20-45 minutes.

Echocardiogram

The heart is examined with 2D or 3D ultrasound to evaluate how well the heart is pumping. We can also look at the valves of the heart to check for leaking or blockage of the arteries.

The patient will be lying down on their left side while the sonographer uses a probe and ultrasound gel to visualize the heart. The echo exams are painless and last approx. 25-40 minutes.

Neonatal and Pediatric Echocardiogram
The heart of a newborn or child is examined with ultrasound to evaluate how well the heart is pumping, leaking of the valves, blockage of the arteries, or malformations.

All sonographers performing this exam have been given advanced training at Riley Hospital for Children.

These exams are read by the cardiologists at either Riley Hospital or the Children's Heart Center at St. Vincent's in Indianapolis.

This exam is painless and no sedation is needed for the infant. The exam lasts approx. 45 minutes to 1 hour.

Transesophageal Echocardiogram (TEE)
The TEE is an exam generally used to visualize areas of the heart that are difficult to see with a regular echo. It is performed by the cardiologist with assistance from our sonographer and staff RN.

Patients are given an IV and oxygen. Their throats are numbed with some gel to subdue the natural gag reflex. The cardiologist with instruct on which IV sedatives to administer. He will then gently slide the probe down the patient's throat and behind the heart. Ultrasound is used to visualize the structures and valves of the heart. 3D imaging can be used to evaluate heart structures such as a valve. Once everything is visualized, the probe is removed.

Vital signs are monitored for at least thirty minutes. This exam generally takes 1 to 1.5 hours and that includes preparation and recovery time.

Patients are prohibited from anything by mouth after midnight before the test and at least 2-4 hrs after the exam. The patient will need someone to drive them home.

Stress Exercise Echocardiogram
Stress echocardiograms are used to evaluate how well the heart is pumping, any leaking of the valves, or any blockage of the arteries during rest as well as after being stressed (riding a supine bicycle or walking on a treadmill).

Ultrasound of the heart is performed first while the patient is at rest. Then one of the EKG technologists places electrodes on the patient and prepares them to begin bicycling.

The cardiologist is present during the exercise portion of the exam. The patient can expect to gradually increase their exercise until the target heart rate is achieved. During a bicycle stress echo, the patient can continue to exercise while a sonographer acquires echo images. This allows the doctor to evaluate the heart function during the actual exercise. This exam lasts approx. 1 to 1.5 hours.

Dobutamine Stress Echocardiogram
Dobutamine stress echocardiograms are used to evaluate how well the heart is pumping. This is done by administering medication to increase the patient's heart rate and blood pressure instead of walking on the treadmill.

Patients are brought back to an exam room where our staff RN applies oxygen and starts an IV. The sonographer uses ultrasound to obtain images of the heart.

The cardiologist will instruct the RN to administer the Dobutamine through the IV. Ultrasound images of the heart will be examined while the medication is being given. Additional Dobutamine is given until the patient's target heart rate is achieved. The length of time and how much dobutamine is given will be determined by how sensitive and reactive the patient is to the medication.

Patients are monitored by the sonographer and RN until the heart rate returns to normal.

Holter Monitoring
Holter monitors allow a provider to examine a patient’s heart rate and rhythm for a full 24-48 hrs to look for changes or causes for symptoms throughout a patient’s normal day. There are 4 sticky patches that are applied to the chest that are attached to a small monitor that can be worn discreetly. The monitor is worn under your clothes and will be worn for the full 24-48 hr evaluation period without being removed during that time. A patient won’t be able to shower or swim while wearing this monitor. The patient will be given instructions on how to remove the monitor or we can assist in taking the monitor off when the patient returns to the hospital. The monitor will need to be returned the same day the monitor is removed.

A provider looks for any changes in your EKG while you exercise, sleep, or at any time during the day that you might report a symptom such as dizziness, palpitations, chest discomfort, or even passing out.

EKG Rhythm Recording

A single recording device with an adhesive patch is placed on the upper left side of the chest for the purpose of recording the patient's heart rate and rhythm. The device is worn for a duration of three to 14 days. The patient is permitted to shower during the wear time.

Event Monitoring
An Event Monitor is a single monitoring device with an adhesive patch that is placed at the center of the chest for the purpose of monitoring the patient’s heart rate and rhythm. Any abnormal heart rhythms will be recorded by the device and automatically transmitted to healthcare professionals for review. The device can be worn for up to 28 days. The patient is permitted to shower during the wear time.

Tilt Table Exams
A tilt table is performed on patients with syncopal episodes (passing out). The patient will have their EKG and blood pressure monitored by an EKG tech, an RN, and the provider. A patient will begin by lying flat on a bed. The patient is secured to the bed as the table is tilted upright to simulate a patient standing up. The provider is able to check to see if the changes in position are causing the patient's syncope. This exam can take about an hour.

Nuclear Cardiology

Nuclear cardiology studies use noninvasive techniques to assess myocardial blood flow, evaluate the pumping function of the heart as well as visualize the size and location of a heart attack.  Among the techniques of nuclear cardiology, myocardial perfusion imaging is the most widely used.  Union Health has skilled clinicians who combine myocardial perfusion images with exercise or pharmacologic stress to assess the blood flow to the heart muscle.

During the test, a small amount of an imaging agent is injected into the blood stream during rest and during exercise or pharmacologic stress followed by images with a special camera to measure the uptake of the heart.  If there is significant blockage of a coronary artery, the heart muscle may not get enough of a blood supply in the setting of exercise or during chemical stress.  This decrease in blood flow will be detected by the images and will give the doctors the information needed to decide what steps should be taken next.

The Nuclear Cardiology department at Union Health is accredited by the Intersocietal Accreditation Commission (IAC) in:

  • Nuclear Cardiology
  • Positron Emission Tomography (PET)

The following tests are offered within the Nuclear Cardiology department:

  • Stress Myoview Scans
  • Lexiscan Myoview Scans
  • Muga Scans
  • Regular Treadmills
  • Cardiac PET/CT scans


Nuclear Cardiology Imaging


Nuclear Cardiology Treadmill Stress Test


Nuclear Cardiology Images

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