St. Paul Cardiology St. Paul Cardiology

  Kim M. Loria, M.D. ~ Les B. Forgosh, M.D. ~ Vishwanatha S. Nadig, M.D.
W. Ted Zukowski, M.D. ~ John B. Davis, M.D.
Call us - 651-232-4340
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Patient Education


Frequently Asked Questions

Patient Testing Instructions



Frequently asked questions for St Paul Cardiology, P.A.

Setting up a New Patient appointment:

1. Are you being referred by your primary doctor?
  A: You have to be referred by your primary doctor to see the cardiologists not for insurance reasons but to rule out other parts of your body that might be causing you the problems.
 
2. Please call our main line at 651-232-4340 to schedule your appointment.
 
3. How long for my new patient appointment?
  A: Typically the appointment is scheduled for 40 minutes. During this time the cardiologist will be asking you about your current problems and other statistics. At the end of the appointment, the cardiologist may order a stress test, lab work and that will be scheduled for a different day (depends on your symptoms).
 
4. What locations do you have?
  A: We have 3 locations to better serve you:

  • Our main office is located at the Gallery Building:
    17 West Exchange Street, Suite 750
    St Paul, MN 55102

  • Our Maplewood office is located at:
    1675 Beam Avenue, Suite 210
    Maplewood, MN 55109

  • Our Woodbury office is located at:
    1875 Woodwinds Drive, Suite 240
    Woodbury, MN 55125


All of our stress testing, echocardiograms will be done at our St Paul location only.
 
5. After your appointment has been made, we will send you out an information packet that includes your appointment card, paperwork and driving directions. Please show to your appointment 15 minutes early.


If you are a returning patient:

Please call our main line 651-232-4340 to schedule your follow up appointment. Please let us know which location you want your appointment at and we will do our best to accommodate.

Please let the scheduler know if you have been hospitalized, had recent testing done or you changed primary doctors so we can obtain those records before your appointment.


GXT instructions:      (Top of Page)

EKG electrodes will be attached to your chest. To monitor your blood pressure throughout the test, a blood pressure cuff will be placed on your arm. You will be asked to walk on a treadmill that will gradually increase in speed and tilt until you achieve your targeted heart rate, which can last approximately ten minutes. After the treadmill portion of the test, you will sit or lie down while the nurse monitors your heart and blood pressure. The total time for the test is approximately 30 minutes.

Instructions:
  • No eating, drinking or smoking 4 hours prior to the test.
  • Wear walking shoes and comfortable clothing that can be easily removed from the waist up.
  • No caffeine for 24 hours prior to the test. Do not drink coffee, pop, tea even if it is decaffeinated or caffeine free. You can drink water, milk, juice, 7-UP or Sprite the day before your test. No chocolate.
  • If you are Diabetic and take insulin, ½ dose your insulin the day of the test. If you feel your blood sugar is dropping, you may have some juice.
  • Hold your Beta-blocker medications 2 full days before your test. (Atenolol, Metropolol, Propanolol, Lopressor, Toprol XL, Inderal, Tenormin, Coreg, Corgaard, Sotalol, Acebutol, Labetalol and Kerlone).
  • Hold your blood pressure medications the day of your test. (Tiazac, Diltiazem, Cardizem, Verapamil, Calan, Cartia and Avalide).


Apt. date:___________________ Time:____________ Location:____________________

Please check in 15 minutes prior to your appointment.

Stress Echo instructions      (Top of Page)

A Stress Echo is an exam that helps your doctor see how well your heart pumps during exercise. Sound waves are bounced off your heart to create images of your heart before and after exercise. A comparison of the before and after images tells the doctor if your heart is getting enough blood to meet the increased demand for oxygen during exercise. This is a one hour test. Instructions:

  • No eating, drinking or smoking 4 hours prior to your test.
  • Wear walking shoes and comfortable clothing that can be easily removed from the waist up.
  • No Caffeine for 24 hours prior to your test. Do not drink coffee, pop, tea even if it is decaffeinated or caffeine free. You can drink water, milk, juice, 7-UP or Sprite the day before your test. No chocolate.
  • If you are Diabetic and take insulin, ½ dose your insulin the day of the test. If you feel your blood sugar is dropping, you may have some juice.
  • Hold your Beta-blocker medications 2 full days before your test. (Atenolol, Metropolol, Propanolol, Lopressor, Toprol XL, Inderal, Tenormin, Coreg, Corgaard, Sotalol, Acebutol, Labetalol and Kerlone).
  • Hold your blood pressure medications the day of your test. (Tiazac, Diltiazem, Cardizem, Verapamil, Calan, Cartia and Avalide).


Apt. date:___________________ Time:____________ Location:____________________

Please check in 15 minutes prior to your appointment.

Cardiolite Nuclear Stress Testing      (Top of Page)

The Cardiolite stress test takes approximately 3 ½ hours to complete and this test is done at our St Paul location. We do the test in the morning so the cardiologist has the chance to read the results that afternoon and you will be notified of your results the following day by one of our nurses.

When you come to the office, you will have an I.V. port put into your hand so we can administer the nuclear dosage. This dose takes 45 minutes to get to your heart. The dose will saturate your heart so we can look at your heart functions when you are under the camera. After your first scan, you will go on the treadmill between 5-9 minutes so we can increase your heart rate. After the treadmill you will be administered another nuclear dose which takes another 45 minutes to get to you heart then you will be scanned for the last time.

We will compare your pre-treadmill and post-treadmill pictures to see if there are blood flow restrictions which would indicate possible blockage in your arteries. The nuclear dose doesn’t do any damage to your body and will leave your body in a couple of hours. You will not feel groggy or tired so you can drive yourself home after the test.

Here are some instructions so you can prepare for the test but the scheduler will go through the preparations.

  • No eating, drinking or smoking 4 hours prior to the test.
  • Please wear comfortable clothing that, from the waist up, can be easily removed and walking shoes.
  • No caffeine for 24 hours prior to the test. This includes chocolate, caffeine free soda and decaf products. You can drink water, milk, juice, 7UP or Sprite.
  • The scheduler will go over the medications that you might need to hold prior to having your test done.


Adenosine/Drug Induced Nuclear Stress Testing      (Top of Page)

The Adenosine stress test takes approximately 3 ½ hours to complete and this test is done at our St Paul location. We do the test in the morning so the cardiologist has the chance to read the results that afternoon and you will be notified of your results the following day by one of our nurses.

When you come to the office, you will have an I.V. port put into your hand so we can administer the nuclear dosage. This dose takes 45 minutes to get to your heart. The dose will saturate your heart so we can look at your heart functions when you are under the camera. After your first camera scan, you will be given the Adenosine dose. This test is ideal for patients who can not walk on a treadmill so Adenosine will be given to you to do the work for you. After the Adenosine, you will be administered another nuclear dose which takes 45 minutes to get to your heart then you will be scanned for the last time.

We will compare both your pictures to see if there are blood flow restrictions which would indicate possible blockage in your arteries. The nuclear dose doesn’t do any damage to your body and will leave your body in a couple of hours. You will not feel groggy or tired so you can drive yourself home after the test.

Here are some instructions so you can prepare for the test but the scheduler will go through the preparations.

  • No eating, drinking or smoking 4 hours prior to the test.
  • Please wear comfortable clothing that, from the waist up, can be easily removed.
  • No caffeine for 24 hours prior to the test. This includes chocolate, caffeine free soda and decaf products. You can drink water, milk, juice, 7UP or Sprite.
  • The scheduler will go over the medications that you might need to hold prior to having your test done.


Echocardiograms      (Top of Page)

Echocardiograms are one of the easiest tests you can do. This test takes about 40 minutes and is done by one of our echo techs at our St Paul office. The echo tech will bring you back to the ultrasound room and you would be put on a bed. The echo tech will put gel on your chest and will go back forth with an ultrasound wand to bring out your heart image on the monitor. An echocardiogram uses sound waves to produce an image of the heart and we can see if your heart valves are closing properly and the basic heart wall motion. This is what the cardiologists are looking for when you have completed the echocardiogram:

Congestive Heart Failure (CHF): Is a condition in which the heart can’t pump enough blood to the body’s other organs. The failing heart keeps working but not as efficiently as it should. People with CHF can’t exert themselves because they become short of breath and tired.

Mitral Valve Prolapse (MVP): Sometimes small amounts of blood may leak backwards into the upper chamber of the heart because the valve does not close normally. This causes a “heart murmur,” although the heart itself is working normally. The heart has an adequate blood supply, even with MVP.

Atrial Fibrillation (A-Fib): The heart’s two upper chambers beat chaotically and irregularly out of coordination with the two lower chambers of the heart. The result is an irregular and often rapid heart rate that causes poor blood flow to the body and symptoms of heart palpitations, shortness of breath and weakness. Episodes of Atrial Fibrillation can come and go. Although Atrial Fibrillation usually isn’t life threatening, you need to see your doctor to get it addressed.

The cardiologist will read your ultrasound and a final report will be dictated. Your primary doctor will get a copy of the ultrasound so they are aware of your ultrasound results.

Carotid Ultrasound      (Top of Page)

Carotid ultrasound is a painless test that uses high frequency sound waves to create images of the insides of the two large arteries in your neck. These arteries supply your brain with blood. You have one carotid artery on each side of your neck. Carotid ultrasound show whether plaque has narrowed your carotid arteries.

This test takes about 40 minutes and is done by one of our echo techs at our St Paul office. The echo tech will bring you back to the ultrasound room and you would be put on a bed. The echo tech will put gel on your neck and will go back and forth with the ultrasound wand to get pictures of the blood flow.

The cardiologist will read your ultrasound and a final report will be dictated. Your primary doctor will get a copy of the ultrasound so they are aware of your ultrasound results.

Abdominal Aortic Aneurysm Ultrasound (AAA screening)      (Top of Page)

Ultrasound is sound waves used to produce images to determine the presence of an abdominal aneurysm or stenosis of the abdominal aorta. You will lie down on your back and the echo tech will put gel on your abdomen and will use the ultrasound wand to produce the pictures. This test is done at our St Paul location and the test takes 40 minutes. Please wear clothing that can be easily removed from the waist up and there is no prep for this test.

The cardiologist will read your ultrasound and a final report will be dictated. Your primary doctor will get a copy of the ultrasound so they are aware of your ultrasound results.

Cardioversion      (Top of Page)

Cardioversion is a brief procedure where an electrical shock is delivered to the heart to convert an abnormal heart rhythm back to a normal rhythm. These Cardioversions are performed to treat atrial fibrillation or atrial flutter, benign heart rhythm disturbances originating in the upper chambers of the heart. Abnormal rhythms are associated with faintness, low blood pressure, chest pain, shortness of breath.

The goal of the cardioversion is to disrupt the abnormal electrical circuit in the heart and to restore a normal heart beat. The shock causes all the heart cells to contract simultaneously, thereby interrupting and terminating the abnormal electrical rhythm without damaging the heart. This split second interruption of the abnormal beat allows the heart’s electrical system to regain control and restore a normal heartbeat.

An electrical cardioversion is performed in a hospital setting such as an emergency room, intensive care unit, recovery room or special procedure room. A cardiologist, a nurse and an anesthesiologist are present to monitor your breathing, blood pressure and heart rhythm. Special cardioversion pads are placed on your chest and back (or alternatively, both pads can be placed on the front of the chest). The pads are connected to an external defibrillator by a cable. The defibrillator allows the medical team to continuously monitor your heart rhythm and to deliver the electrical shock to restore your heart's rhythm back to normal.

Preparations:

  • Nothing to eat or drink after midnight prior to the procedure.
  • You can brush your teeth before you go to the hospital.
  • You need someone to drive you home after your discharge.
  • The nurse will go over your medications in case we need to hold any of your medications.


This procedure is usually done at St. Joseph or St John’s hospital and preferably done in the morning since you won’t be able to eat after midnight.


   
St. Paul Cadiology
St. Paul Office (Main)
17 W Exchange St # 750
St. Paul, MN 55102
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Maplewood Office
1675 Beam Avenue #210
Maplewood, MN 55109
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Woodwinds Office
1875 Woodwinds Drive #240
Woodbury, MN 55125
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