Diagnostic services - Finding out if your heart is healthy - Community Hospital of the Monterey Peninsula

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Diagnostic services

At Community Hospital, we are proud to offer the latest imaging and diagnostic technologies to provide your doctors with the best possible picture of your heart. Your doctor may order the following diagnostic tests individually, or in combination, to diagnose your condition:

Electrocardiogram (ECG or EKG)

The heart's electrical signals set the rhythm of the heartbeat. An electrocardiogram, also called an EKG or ECG, is a simple, painless test that records the heart's electrical activity.

An EKG shows how fast your heart is beating, whether the rhythm of your heartbeat is steady or irregular, and the strength and timing of electrical signals as they pass through each part of your heart.

What to expect

A technician will attach 10 soft, sticky patches called electrodes to the skin of your chest, arms, and legs. The patches are about the size of a quarter. This helps detect your heart's electrical activity from many areas at the simultaneously. The nurse may have to shave areas of your skin to improve electrical contact.

After the patches are placed on your skin, you'll lie still on a table while the patches detect your heart's electrical signals. A machine will record these signals on graph paper or display them on a screen.

The entire test will take about 10 minutes.


You usually can go back to your normal daily routine after an EKG.


Watch this video showing our 3D echocardiogram

An echocardiogram is a noninvasive test that uses sound waves to record a two-dimensional image of a beating heart. This 3D image reveals important information about the heart's wall motion, valve function, and direction and velocity of blood flow through the valves of the heart.

What to expect

No special preparation is needed for a transthoracic echocardiogram. You will be asked to remove clothing from the upper half of the body, and you will be given a drape for privacy.

When the test begins, you will be asked to lie down on your back on an exam table. A colorless gel will be applied to your chest, and the technologist will begin to glide a thick, handheld wand over your chest. The wand transmits sound waves that translate into an image of your heart. The technologist may ask you to move from your back to your side during the exam to capture images of the heart from several angles. You may also be asked to breathe slowly or hold your breath for short periods to help capture a higher-quality image.

Your technologist will be able to view the images as they are being captured, and they will be recorded for review by your doctor.


Generally, no recovery time is needed after a transthoracic echocardiogram.

Transesophegeal echocardiogram (TEE)

There’s also a different type of echocardiogram, called a transesophegeal echocardiogram (TEE), during which sound waves are transmitted from a small device on the end of a thin, flexible tube that goes down your throat to be positioned directly behind the heart into the esophagus. A TEE is sometimes necessary if adequate images cannot be obtained by a transthoracic echocardiogram, generally because the patient has a particularly thick layer of muscle or fat over the chest and ribcage, or because the patient has emphysema or another upper respiratory condition.

What to expect

A transesophegeal echocardiogram (TEE) exam takes 10 to 30 minutes, but your appointment will last about 2 hours, including the preparation and observation time.

At the start of the TEE procedure, a mild sedative may be administered using an IV, along with local anesthesia.

Your heart rate, blood pressure, and breathing will be monitored during the procedure. Your throat will also be numbed with an anesthetic spray to minimize any pain or discomfort.

You will be asked to swallow a small device that will transmit the sound waves during the exam. The device is similar in size to a large grape; it is attached to the end of a long flexible tube, and you will swallow it in the same way you swallow food. Once you have swallowed the tube, the device will be positioned in your esophagus, directly behind your heart. Your echosonographer may rotate and move the tube and the sound device during the exam to capture different angles of the heart.


For a transesophegeal echocardiogram:

  • Allow 2 hours for the numbness in your throat to wear off before eating or drinking.
  • Do not drive for at least 12 hours after the procedure.
  • Avoid hot food and drink for 24 hours after the procedure.
  • Mild soreness in the throat is common, and throat lozenges may help soothe the irritation.

Stress test

A stress test, also called a treadmill test, can be an important diagnostic tool because some heart problems only become apparent when the heart is working a little harder. The stress test is used to evaluate the heart and vascular system during exercise.

Cardiac Stress Test

There are other types of stress tests as well. The stress echo test involves exercising on a treadmill or stationary cycle while you are closely monitored. Or, during a nuclear perfusion stress test, a special type of radioactive contrast material is injected to help create more detailed images of your heart.

What to expect

With a standard treadmill stress test, your test will take place in an exercise lab. Your heart rate and blood pressure will be recorded at rest, then a total of 10 electrodes will be attached to your chest, shoulders, and hips. The electrodes are painless and will feel like sticky patches with lightweight wires attached.

Once the electrodes are attached, you will step onto a treadmill and the exam will begin. The speed and incline will increase every three minutes; each increase is called a stage. Your blood pressure will be recorded using an arm compression device.

Generally, the exam will end once you have reached your target heart rate, as determined by the doctor supervising the exam. If you are performing exceptionally well at your target heart rate, the test may continue. Conversely, the test may be stopped early if you begin to experience significant chest discomfort, shortness of breath, dizziness, unsteady gait, serious irregular heartbeats, or if your blood pressure rises or falls outside of acceptable limits.

The performing cardiologist or staff may give you a general overview of the results before you leave, and your regular doctor will follow up with official results.

In the case of a nuclear perfusion stress test, before your test begins, a small amount of liquid contrast material (called an isotope) is injected into the bloodstream. Then you will be asked to lie down on an exam table under a scanning camera. The scanning process will take about 10 to 20 minutes.

After the resting scans are taken, you will proceed with the treadmill stress test.


There is no recovery time needed with a stress test.

Angiogram (cardiac catheterization)

The procedure is effective at diagnosing any serious coronary artery disease. It is an invasive procedure using a long flexible tube that is inserted into an artery and gently directed toward the heart. Once there, a special dye is injected, and images of the blood vessels are captured. This enables your doctor to look for potentially dangerous blockages.

What to expect

Angiograms are performed in the catheterization (cath) lab of the hospital. Your doctor will meet with you for a consultation prior to your treatment to discuss the specifics of your case and prepare you for what to expect during the procedure.


  • You will be given specific wound-care instructions before you leave.
  • You may experience some soreness at the catheter entry site as the numbness wears off.
  • Do not drive for at least 12 hours after the procedure.

After an invasive procedure, your heart-care team may recommend a follow-up program to assist in your recovery.

Coronary calcium scan

A coronary calcium scan is used to detect the development of atherosclerotic plaques on the wall of the artery which usually contain calcium detectable by the CT scan. The amount of calcium, also known as plaque, will be measured using the images from your cardiac CT scan. Your calcium score is a percentile score for your gender and age.

Find out more

CT coronary angiogram

A CT coronary angiogram is used to determine if fatty deposits or calcium deposits have narrowed a patient's coronary arteries, putting the patient at risk for coronary artery disease. CT is an abbreviation for Computed Tomography. CT scanning, which is non-invasive, uses special X-ray equipment in combination with sophisticated computers to produce multiple images of the heart.

What to expect

Depending on the type of exam, a special dye may be used to make certain internal organs or systems of the body show up more clearly in the pictures. The dye is injected through an intravenous line (IV). 

When the scan begins, you will be lying on a CT exam table. The technologist will help position you to ensure you maintain the correct position throughout the exam.


When the scanning is complete, the technologist will review the images to verify that they are of high enough quality. The images will then be reviewed by a radiologist and a cardiologist within 1-2 days.

Generally, no recovery time is needed after a coronary CT angiogram, and you will be able to drive yourself home, or even back to work immediately after your appointment.

How to make an appointment

To see a doctor at the Tyler Heart Institute, you will first need to be referred by a cardiac specialist.

Visit your family doctor, who can refer you to a cardiologist if needed.

Our cardiologists

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Know Your Numbers

Meet with one of the Tyler Heart Institute clinical staff to find out your numbers and risk for heart disease.

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