Medical Tests & Procedures Archive

Ask the doctor

Q. My doctor wants to measure my ejection fraction. What does that mean, and what should I expect?

A. With every heartbeat, your heart contracts and relaxes. During the contraction, the heart's main pumping chamber, the left ventricle, ejects blood out to the rest of the body. When your heart relaxes, the ventricle refills with blood. The ejection fraction is the percentage of blood leaving the chamber each time it contracts.

Research we're watching

Picture this: One day, you may be able to use your smartphone camera to detect atrial fibrillation. Also known as afib, the irregular heart rhythm raises the risk of stroke. New research suggests that the technique, which relies on a special app, is almost as accurate as an FDA-approved mobile electrocardiogram.

Here's how it works: You place your index finger on the smartphone camera, which uses the camera's light to detect changes in your pulse. The app algorithm then uses that information to determine whether your pulse is steady and regular (normal rhythm) or fast and irregular (afib).

Ask the doctor

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Q. Is it possible to have a heart attack even if you don't have any blockages in your heart's arteries?

A. Yes, you can. Doctors refer to heart attacks without blocked arteries as MINOCA, which stands for myocardial infarction (that is, heart attack) with non-obstructive coronary arteries. When it occurs, people may experience typical heart attack symptoms, such as chest pressure or pain in the center of the chest (or the arms, jaw, neck, or stomach) and trouble breathing. They also have elevated blood levels of a protein called troponin, a marker of heart damage that is used to diagnose a heart attack. But the next test — a special x-ray of the heart's arteries called an angiogram — shows no evidence of a significant buildup of fatty plaque blocking any of the heart's arteries.

Ask the doctors

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Q. I just saw that the FDA issued a warning on vaginal laser procedures. Are these procedures dangerous?

A. More study of these laser procedures is needed to conclusively determine if they're safe and effective for vaginal conditions. If you're considering one of these procedures, have a detailed conversation with your doctor about traditional medical therapies as well as the pros and cons of laser treatments. The FDA issued a warning on July 30 about energy devices (laser therapy).

Research we're watching

A test that screens for human papillomavirus (HPV) beat a commonly used cervical cancer screening method in detecting changes that may lead to cervical cancer, according to a study published July 3 in The Journal of the American Medical Association. Some 19,000 women were screened for cervical cancer using either the HPV test or a more traditional and commonly used liquid-based cytology test. After 48 months, all the women were tested again using both tests. Researchers found that among women who'd had a normal initial screening, those who'd been screened with the HPV test had significantly fewer grade 3 or worse precancerous cervical changes at the final testing compared with those screened with liquid-based cytology.

In response, the U.S Preventive Services Task Force now recommends either HPV testing only once every five years or liquid-based cytology once every three years for women ages 30 to 65.

According to a new guideline, testing should start at age 45, but not everyone needs to have a colonoscopy. Other tests are also available.

Colon cancer screenings for people at average risk for the disease should start at age 45 instead of 50, says a new guideline from the American Cancer Society (ACS).

The change to the screening recommendation, which was published in the May 30 issue of CA: A Cancer Journal for Clinicians, was made because the number of colon cancer cases among adults under age 55 rose 51% from 1994 to 2014, and colon cancer deaths in this age group rose 11% from 2005 to 2015.

Ask the doctor

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Q. I was recently diagnosed with aortic stenosis after my doctor heard a slight heart murmur and referred me for an echocardiogram. I don't have any symptoms, so the cardio­logist recommended that I get periodic echocardiograms to monitor the condition. Is there anything else I can — or should — do?

A. Aortic stenosis — also called aortic valve stenosis — occurs when the one-way valve inside the heart's largest vessel, the aorta, stiffens and becomes clogged with calcium deposits. As a result, the valve doesn't open as easily. During a heartbeat, as the heart's main pumping chamber (the left ventricle) contracts, pressure builds up behind the aortic valve. This creates the turbulent blood flow that a doctor can hear through a stethoscope.

Certain tests involve small amounts of radiation. Here's some perspective on the benefits and risks.

Cardiologists have many options for visualizing the heart, some of which involve exposure to radiation. Used appropriately, these tests can identify possibly life-threatening conditions, such as dangerous heart artery blockages. In recent years, the accuracy of many of these noninvasive tests has increased. They're also being used with increasing frequency.

Because ionizing radiation can damage cells, potentially raising the risk of cancer, experts acknowledge that imaging tests that involve radiation should be used judiciously. Earlier this year, the American College of Cardiology published a consensus statement on the best practices for safe and effective use of radiation in cardiac imaging tests.

This hormone, which helps the body manage water and sodium, is a focus of growing interest among researchers.

High blood pressure — which has no symptoms or warning signs — can harm your blood vessels, heart, brain, eyes, and kidneys. An estimated 46% of adults in the United States have this stealth condition. A combination of unhealthy habits, such as smoking, a poor diet, and lack of exercise, can contribute to a rise in blood pressure. While kidney disease may cause high blood pressure, for most people the underlying cause is unknown.

However, for about one of every 15 people with high blood pressure, an imbalance of the hormone aldosterone may be to blame. This problem may be even more common among people with poorly controlled high blood pressure (also called resistant hypertension). "Among those people, up to one in five may have too much aldosterone," says Dr. Gail Adler, chief of cardiovascular endocrinology at Harvard-affiliated Brigham and Women's Hospital.

On call

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Q. I'm 65 years old and have never had any bone health issues. Should I get a bone density test?

A. Bone density testing is a specialized x-ray technique used to diagnose osteoporosis (thin bones), a condition that increases the lifetime risk of fracture by six times in men.