Our Cardiac Testing Departments are Nationally Accredited by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL). In addition the Heart and Vascular Center in Clinton is accredited in both the Intersocietal Commission for the Accreditation of Nuclear Laboratories (ICANL) and the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL).
Vascular imaging is rapidly becoming the fastest and most accurate way to diagnose cardiac and vascular abnormalities. The Vascular Laboratory at Hunterdon Medical Center is accredited by the American College of Radiology (ACR).
Our services include:
- Echocardiography, or ECHO
- Stress Echocardiography
- Electrocardiography, or EKG
- Exercise stress testing
- Nuclear stress testing
- Holter monitoring
- Transesophogeal Echocardiogram (TEE)
Non-invasive Vascular Lab – Vascular imaging is performed through the following procedures:
- Carotid doppler
- Duplex arterial and venous ultrasound
- Magnetic resonance angiogram (MRA)
- Computed tomography scan (CT scan)
- Diagnostic angiogram
- PVR (pulse volume recording)
- ABI (ankle brachial index)
Echocardiography or ECHO
An echocardiogram, also known as an ECHO, is a noninvasive, diagnostic, cardiac study, which uses ultrasound to show the structure and blood flow of the heart. The test enables the cardiologist to assess the overall function of the heart and identify cardiac abnormalities.
A cardiac sonographer performs the study while the patient is required to lie still on their left side for approximately 45 minutes. Gel is applied to a transducer, which is placed on the patient’s chest to obtain images. Our state-of-the art technology allows images to be digitally captured for the cardiologist to review and interpret.
Unlike other ultrasound studies, there are no requirements prior to testing.
An exercise echocardiogram is a procedure that combines an ultrasound study of the heart with an exercise stress test. An echocardiogram is done at rest and then directly after exercising on a treadmill. A cardiac technician will apply electrodes to your chest to monitor your EKG throughout the test. A registered cardiac sonographer will capture the images of your heart. Throughout the study a cardiologist will monitor you.
The stress echocardiogram will be helpful in diagnosing coronary heart disease.
As with an echocardiogram, an electrocardiogram is a non-invasive, diagnostic study that measures the electrical activity of the heartbeat. Also known as an ECG or EKG, the electrocardiogram measures the “wave” that travels through your heart with each beat. This measurement tells your doctor whether there are any irregularities in your heart, or if parts of your heart are too large or overworked.
The electrocardiogram takes about 10 minutes and is performed with the patient lying on his back. ECG electrodes are placed on the chest to measure the waves. There is no pain or risk associated with the procedure.
Exercise stress tests
Exercise stress tests evaluate cardiovascular response to physical stress. The test is performed using a treadmill and patients are monitored by our cardiac services team. Vital signs, such as blood pressure and EKG are evaluated throughout the procedure. An exercise stress test provides information on the heart’s response to the exercise and can help to determine whether or not your heart is receiving enough oxygen and blood supply.
Patients should dress in comfortable, rubber soled shoes or sneakers. Eating and smoking should be avoided 2-3 hours before the test. Medication should be taken as usual, unless instructed otherwise by the physician ordering the test.
Nuclear stress tests
A nuclear stress test is a cardiac diagnostic study used to determine if the heart muscle is getting the blood supply it needs.
The test consists of two parts:
- An isotope will be injected while you are at rest, and a specialized camera will take pictures of your heart.
- An isotope will be injected one other time during the test, while you are walking on a treadmill or receiving medication that stimulates stress. Additional pictures will be taken of the heart.
These pictures allow the cardiologist to compare the amount of blood flowing through the heart muscle during stress and at rest.
When you schedule your appointment, a nuclear technician will go over instructions for the procedure. You should avoid any chocolate or caffeinated products for 24 hours prior to the test. You may only have juice or water the morning of the test, and can bring a small, healthy snack which does NOT contain chocolate. Please bring a list of your current medications. Sneakers or comfortable walking shoes and loose, comfortable clothing are advisable.
A Holter monitor is a small portable device that continuously measures the heart’s rhythm. It is usually worn for 24-48 hours, while you carry on with your activities of daily living.
Holter monitors are often ordered by a physician when the following occur:
- Fainting or syncope
- TIA (Transient ischemic attack) or “mini-stroke”
- Heart attack
- Palpitations/ heart rhythm problems
- Starting a new heart medication
- Change in a heart medication
When you wear a Holter monitor, electrodes that measure the heart’s activity, are attached to the chest and a small recording monitor. The monitor is battery operated and carried in a pocket, or in a small pouch that can be kept around your waist. The Cardiac testing team will be sure that you understand how to wear the monitor for best diagnostic results.
While you wear the Holter monitor, you should keep a diary of your activities. After the 24-48 hours, you will return to the Cardiac Testing Department where a cardiology technician will scan the monitor’s EKG reports. A board- certified cardiologists will then review the scanned EKGs and interpret the results.
A TEE allows the cardiologist to view the internal structures of the heart and major vessels. A narrow, bendable tube with a special tip is inserted through the mouth and down the esophagus (food tube). The tip sends out painless sound waves (ultrasound) that transmits into the heart/vessels and produce an image. The image is viewed on a screen, captured digitally and stored for the cardiologist to review.
Mild sedation is required during the TEE to help you in swallowing the probe and for your comfort. An anesthesiologist will be present during the procedure to assist the cardiologist.
A TEE is used to evaluate the following:
- Source of blood clots
- Severity of leaky heart valves
- Congenital defects
- Function of artificial heart valve
Non-invasive Vascular Lab
A Carotid Doppler is a diagnostic study used to determine if there is any plaque or blockage of the carotid arteries. A Carotid Doppler is a noninvasive ultrasound procedure performed by a sonographer with special training in vascular studies. The sonographer scans each side of the neck using an ultrasound probe and gel. Each study averages about 30 minutes. Unlike other ultrasound studies, there are no requirements prior to testing.
An Ultrasound is a diagnostic test that creates pictures of the structure of the blood vessels, including the walls of the arteries or veins.
Duplex arterial and venous ultrasound
Duplex arterial and venous ultrasound combines standard ultrasound images with Doppler ultrasound, which uses sound waves to track the blood as it moves through the vessels. This allows doctors to trace the speed and direction of blood flow, and to detect any changes caused by PAD (peripheral artery disease) or diseases of the veins.
Duplex ultrasound can be used to diagnose and investigate:
- Carotid (neck) artery disease
- Kidney artery disease
- PAD (peripheral artery disease)
- Deep vein thrombosis (DVT)
- Chronic vein disease and varicose veins
MRA (magnetic resonance angiogram)
MRA uses specialized imaging to look at blood vessels and how well the blood is able to flow through the arteries. This diagnostic test uses a powerful magnet and radio waves to create detailed images of your arteries and surrounding tissues. The test does not require entering the body (it is non-invasive) and does not involve exposure to radiation. It can find problems of the arteries and veins, such as an aneurysm, a blocked blood vessel, or the torn lining of a blood vessel (dissection). Sometimes contrast (dye) is used to see the blood vessels more clearly.
MRA can determine the location and severity of artery narrowing or blockages caused by:
- PAD (peripheral artery disease) of the legs
- Kidney artery disease
- Carotid (neck) artery disease
- Aortic (aorta) disease
CT Scan is a diagnostic test that uses X-rays and an injected dye to produce 3-dimensional images of the carotid (neck) arteries.
Diagnostic Angiogram is a nonsurgical procedure in which a thin, flexible tube (catheter) containing a special dye, visible only by X-ray, is inserted into an artery, usually in your groin or arm. The catheter is then guided to visualize your carotid, cerebral, renal, or peripheral arteries, depending on your symptoms. Images will provide information on any blockages you may have and the status of blood flow to these areas.
Pulse volume recording, or PVR (also called plethysmography) is a test that measures blood flow in the leg arteries. PVR can be used to diagnose PAD in the legs, determine how severe the disease is, and find the general location of the blockage. The PVR test is fast and painless, and does not require entering the body.
ABI (ankle brachial index)
ABI testing is a simple screening procedure that can determine whether more extensive testing is needed to diagnose PAD. It is done by taking blood pressures of both arms and ankles and comparing the results by calculating an index. Sometimes this simple, yet effective screen, uses a small hand-held Doppler (ultrasound) along with a blood pressure cuff.
Heart and Vascular Services conducts noninvasive studies to diagnose and manage both heart and vascular disease at two convenient locations.
Hunterdon Heart and Vascular Centers:
Hunterdon Medical Center
2100 Wescott Drive
Flemington, NJ 08822
Hours of operation:
Monday thru Thursday: 7 am – 6 pm
Friday: 7 am – 5 pm
Saturday: 8 am – noon
Hunterdon Heart and Vascular Center
Hunterdon Health and Wellness
1738 Route 31 North
Clinton, NJ 08809
To contact the staff at Clinton, please call: 908-735-6275
To schedule an appointment, please call: 908-788-6388
Hours of operation:
Monday thru Friday: 8 am – 5 pm
Somerset Medical Office Building
1121 Route 22 West
Bridgewater, NJ 08807
Hours of operation:
Monday thru Friday: 8 am – 4:30 pm
When using Google Maps enter 1125 Route 22 Bridgewater, NJ 08807
Ted Bialy, MD, FACP, FACCNon-Invasive Cardiologist
Jonathan Horiuchi, MDNon-Invasive Cardiologist
Austin Kutscher, MDNon-Invasive Cardiologist
Robert S. Lind, MDNon-Invasive Cardiologist
Andrew Rudnick, MDCardiac Electrophysiologist
Dubravka Starcevic, MDNon-Invasive Cardiologist
Glen Tonnessen, MDInterventional Cardiologist
Andrey Espinoza, MDInterventional Cardiologist
William Schafranek, MDInterventional Cardiologist
Yaser Elnahar, MDCardiologist
Herman Maeuser, MDGeneral Surgeon
Andrew Loesberg, MDInterventional Radiologist
Thomas Woo, MDInterventional Radiologist
Additional Staff & Specialists
Maria Feo, BSN, RN-BC, CTTS, Cardiovascular Care Coordinator
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