Diagnostic Testing

Pulmonary Function Testing 
KVH Hospital is home to one of the most advanced pulmonary function test (PFT) labs in Washington State and our staff members have been trained at the top-rated PFT training facility in the United States located in Yorba Linda, CA.

PFT testing is ordered by physicians and used to diagnose pulmonary (lung) disease, track the progress of disease, identify if a patient’s symptoms are pulmonary related, and evaluate the effectiveness of prescribed medications. 

How to prepare
If your doctor orders a PFT and you are currently taking breathing treatments, please do not take these medications four hours before testing is scheduled.

What to expect

  • Allow approximately one hour for testing.
  • Albuterol, a bronchodilator, is used as part of this treatment to relax muscles in the airways and increase air flow to the lungs.
  • The PFT measures how air flow, using a variety of breathing maneuvers.
  • All PFTs completed at the hospital are over-read by a board-certified pulmonary physician.

Cardiac Stress Testing
KVH Hospital provides both standard cardiac stress testing and cardiac stress echocardiogram testing. 

Cardiac stress testing is a tool used by physicians to determine the presence of cardiac disease by evaluating arterial blood flow to the heart muscle during physical exercise, compared to blood flow while at rest. 

The cardiac stress echocardiogram is performed by a sonographer, a technician specializing in using ultrasound techniques. The sonographer applies warm gel to the chest area. This gel helps the transducer, a wand-like instrument, glide smoothly over the body and send high-frequency sound waves to the heart. The transducer picks up the echoes of the sound waves and transmits them as electrical impulses. The echocardiography machine converts the impulses to moving images of the heart. These images are studied before exercise, the echocardiogram process is repeated after exercise, and the results of each are compared.

This service requires a physician’s order and a stress test qualified provider must be present.

How to prepare

  • Wear comfortable, loose fitting clothes.
  • Wear a pair of walking shoes or sneakers.
  • Do not apply any creams, lotions, or powders to the chest area on the day of your test.

What to expect

  • Allow approximately one hour for testing.
  • You will be asked to remove the clothing from your upper body. Female patients will be given a hospital gown for a cover-up.
  • Ten electrodes will be placed on the upper body to monitor your heart’s electrical activity during testing. This recording, which is called an EKG (electrocardiogram), shows how fast your heart is beating and the heart’s rhythm. The machine also records the strength and timing of electrical signals as they pass through each part of your heart.
  • A blood pressure cuff will be placed on your arm to monitor blood pressure changes before, during, and after exercise.
  • The patient will walk on a slightly inclined treadmill at a very slow pace. Every three minutes, the treadmill will increase in speed and incline, and patients will be required to meet target heart rates based on national standards. For some patients, this target may be reached very quickly with only walking; however, athletically fit patients may require very fast walking or even running on the treadmill to reach their target.
  • When it is determined by you and your physician that it is time to end the stress test, you will lie down for the recovery period.
  • With a stress echocardiogram, you will lie in position for the post stress echocardiogram.
  • Your physician can inform you as to how the test looked based on the EKG data, but in the event of a stress echocardiogram, your physician may defer the final reading until the echocardiogram has been over-read by a cardiologist.

Holter Monitoring
KVH Hospital provides 24-hour holter monitoring services. This testing is used by your physician to diagnose irregular cardiac rhythms, cardiac symptoms, medication effectiveness, medication reactions, or any other type of cardiac-related issue that cannot be diagnosed by a simple in-office 12 lead EKG.

The hospital uses state-of-the-art digital monitors. These monitors are very small and portable; with the proper clothing can be worn very discreetly.

This service requires a physicians order.

How to prepare

  • Wear a buttoned blouse or shirt without an undershirt for easy access to your chest.
  • Do not apply any creams, lotions, or powder to the chest area on the day of your test.

What to expect

  • Allow 45 minutes for the hook up portion of the procedure.
  • You will have seven electrode patches placed on your chest. These patches will be connected to electrodes with wires that are connected to the digital recorder. The digital recorder is placed in a small pouch that can be worn over the shoulder or around the waist.
  • You may go about your daily activities, except you will not be able to shower, bathe, or get the equipment wet during the 24-hour recording period.
  • You will be required fill out a symptom diary during the 24-hour period.
  • At the end of the 24-hour period you will return to KVH Hospital to have the Holter removed. You should allow 15 minutes and your portion of the study is complete.
  • The RT staff will download data and create a report that will go to KVH Internal Medicine for over-read by a specially trained physician.
  • Once the over-read is complete, a dictated report/result will be sent to your ordering physician.

KVH Hospital provides both inpatient and outpatient electrocardiogram (EKG) services. The EKG is used by your physician to analyze the electrical activity of the heart, identify heart damage, identify irregular rhythms, and to identify potential problems before they occur. This service is available to everyone even if your physician is outside the area.

This service requires a physician’s order that must include the specific indication for the EKG. You must have an appointment to get an EKG.

What to expect

  • You should allow 15-30 minutes for this procedure.
  • Do not apply creams, lotions, or powders to your chest, arms, or legs on the day of the test.
  • Generalized indications such as pre-op EKG or annual physical may be declined from insurance providers. In the event of a generalized indication, you will be asked to sign an ABN statement indicating you are aware or have been informed that insurance payment may be declined for the service and that you agree to pay for the service in full should this occur.
  • You will be asked to remove your clothing and wear a hospital gown.
  • Several electrodes will be placed on the upper body, arms and legs to monitor your heart’s electrical activity during testing. This recording shows how fast your heart is beating and the heart’s rhythm. The machine also records the strength and timing of electrical signals as they pass through each part of your heart.

Cardiac Event Monitor
Unlike the Holter Monitor, which records every beat of your heart for a 24 hour period, the Cardiac Event Monitor is designed to record your cardiac events for up to 30 days. This recorder requires the patient to trigger the recorder when they are having a suspected cardiac related event. The recorder will also record certain cardiac arrhythmias on its own when detected. All recordings are transmitted to a receiving center via telephone.

What to expect

  • You will be required to sign a special enrollment form that will be faxed to the receiving center prior to being hooked up.
  • You will be scheduled for the initial hook-up and training. A baseline recording will be recorded and sent during this appointment.
  • All event recorders hooked up at KVH will be monitored by Dr. Birger of KVH Internal Medicine. Dr. Birger will report all findings to your provider. 
  • You will be required to wear the event monitor for a minimum of two weeks. At the two week point, you will contact Dr. Birger’s office to see if enough data has been collected. If not, you will be required to wear the monitor for an additional two weeks.
  • Upon completion of the monitoring period, you will place all the equipment in the provided pre-paid envelope and place it in the mail for return.