Outpatient Procedures:
Abdominal Ultrasound: Monday – Friday, 8:30 AM – 11:00 AM /Physicians: MUDr. Henrieta Dávidová, PhD., MUDr. Alexander Ruttkay, MUDr. Anna Šimegová/ Patient must be fasting!
Lower Extremity Vascular Duplex: Monday – Friday, 8:30 AM – 11:00 AM /Physicians: MUDr. Henrieta Dávidová, PhD., MUDr. Alexander Ruttkay, MUDr. Anna Šimegová/
Echocardiography: Monday – Friday, 9:00 AM – 12:00 PM /Physicians: MUDr. Pavol Poliačik, PhD., MUDr. Peter Snopek, PhD., MUDr. Martin Uhliar, MUDr. Milan Klačanský/
Holter Monitoring: Monday – Friday, 8:00 AM – 9:00 AM
Bicycle Ergometry: Monday – Friday, 8:00 AM – 9:00 AM
Transesophageal ECHO: Tuesday – Friday, 7:30 AM – 9:00 AM /Physicians: MUDr. Peter Snopek, MUDr. Milan Klačanský/ Patient must be fasting!
Tilt Table Test /HUT/: Wednesday at 8:00 AM Patient must be fasting, in comfortable sports clothing and footwear.
In the Department of Functional Diagnostics, we perform non-invasive (non-bloody) examinations to assess the structure and function of the heart. The basic and most frequently used method is echocardiography (ultrasound examination of the heart, ECHO). It is performed through the chest or through the esophagus (in certain indications). Transesophageal echocardiography is a partially invasive method, as it requires venous access (cannula) for medication administration and insertion of a probe into the esophagus for a more precise assessment of cardiac structures.
Some diseases require evaluation of the ECG and cardiac performance during stress, and assessment of its functional reserve. Stress can be achieved physiologically by cycling (bicycle ergometer) or by administering special medications (dobutamine) that affect the heart similarly to cycling. This way, cardiac stress can be achieved even in patients who, for any reason, are unable to undergo examination on a bicycle ergometer.
Commonly available non-invasive methods performed at our workplace also include Holter monitoring (24-hour, 72-hour, 14-day) of ECG and 24-hour blood pressure measurement.
Transthoracic Echocardiography (ECHO)
This is an ultrasound examination of the heart. Ultrasound is a very high-frequency sound that is inaudible. It is emitted and received by an ultrasound probe, which is placed on the chest. Ultrasound reflections from the heart are analyzed by the device and transformed into a moving image of the cardiac structures. During the examination, we visualize individual heart chambers and valves, their structure, size, and function. During the examination, the patient lies on the examination bed, on their left side or on their back. Ultrasound gel is applied to the examination probe, and then the probe is placed on the chest. Apart from mild pressure at the given spot, the examination is painless. The examination itself takes 15-30 minutes, depending on the complexity of the echocardiographic findings. Ultrasound has no significant adverse effects on the body, and therefore this examination can be repeated as needed. No special preparation is required before the examination.
Transesophageal Echocardiography (TEE)
In certain situations, echocardiographic examination through the chest is insufficient (poorer examinability or visualization, or the examined areas of the heart are inaccessible). In such cases, we perform transesophageal echocardiography. The ultrasound probe is not placed on the chest but is located at the end of an endoscope (a thin flexible tube), which is inserted into the esophagus. This is a similar device to that used for stomach examination (gastroscopy).
How is the examination performed? Initially, the back of the oral cavity and pharynx are numbed with a special spray (Lidocaine). In some cases, anti-emetic drugs (Degan, Ondansetron) and sedatives (Midazolam) are administered intravenously via a thin cannula. The patient is placed in a stabilized position on their left side. Subsequently, a flexible examination probe coated with numbing gel (Mesocain) is introduced to the base of the tongue, and the patient is asked to swallow. At this moment, the probe is inserted into the esophagus or the upper part of the stomach, and then the examination itself proceeds, lasting approximately 15-30 minutes, depending on the complexity of the findings. Throughout the examination, the patient is connected to an ECG and is under the supervision of the examining physician and trained nurse.
Preparation before the examination. Before the examination, the patient must not eat or drink for 6 hours; long-term oral medication is also not advisable. After the examination, due to the risk of aspiration after pharyngeal numbing, eating or drinking is prohibited for another 2 hours. Sedatives are often administered during the examination, so in these cases, driving immediately after the examination is not permitted. If a sedative (Dormicum) is administered, it is essential for the patient to be accompanied by an escort. Older patients should also be accompanied by another person.
ECG Holter
An ECG Holter is a portable, non-invasive device for 24 to 72-hour (sometimes up to 14-day) continuous monitoring of cardiac activity in daily life. Electrodes on the chest record the ECG, which helps detect rhythm disturbances and correlations between symptoms (palpitations, dizziness) and heart activity.
Key information about the ECG Holter:
Examination procedure: A small device is worn on the waist or neck, with electrodes attached to the chest.Patient diary: During the measurement, it is necessary to keep a diary of activities and sensations (pain, arrhythmia), which facilitates analysis by the physician.Monitoring duration:
Usually 24 hours, but modern devices also allow longer monitoring (48h – 14 days) for better detection of occasional disturbances.
Significance: Helps diagnose rhythm disturbances (atrial fibrillation, flutter) and monitor treatment effectiveness.
The examination is painless and safe, providing detailed information that a standard brief ECG in the outpatient clinic would not capture.
Ergometry
Ergometry (stress ECG) is a non-invasive cardiology examination that monitors heart response, heart rate, and blood pressure during progressively increasing physical exertion on a bicycle or treadmill. It is used to diagnose ischemic heart disease, rhythm disturbances, and assess fitness. The examination continues until the target heart rate is reached or symptoms appear.
Main Use and Significance:
Diagnosis: Detection of myocardial ischemia and arrhythmias that manifest only during exertion.Fitness: Assessment of physical fitness and exercise tolerance.Control: Evaluation of the effectiveness of treatment for heart diseases or rehabilitation after a heart attack.
