Our Diagnostic Services Department

Cardiovascular Services:

The Cardiac and Vascular Imaging department at Landmark uses state-of-the-art Color Duplex Ultrasound and noninvasive physiologic equipment. Superior imaging, color, spectral and tissue Doppler capabilities, coupled with digital storage and retrieval employing advanced analytical software, further enhances the diagnostic accuracy provided by our expert Cardiology and Vascular Medical Staff. Testing is performed by highly trained, registered and/or registry-eligible Technologists in Echocardiography and Vascular imaging.

The following services are available:

Electrocardiography (ECG,EKG) Cardiac Stress Testing (Treadmill) Holter Monitoring (LCG)	Electrical evaluation of the heart at rest or during physical stress. Indications: chest pain, SOB, palpitations, arrhythmia, MI, CHF, LVH, etc.
Echocardiography w/wo Contrast Treadmill Stress Echocardiography Dobutamine Stress Echocardiography Transesophageal Echocardiograph Cardioversions ICD Testing	Anatomic and functional evaluation of the heart at rest and during physical or pharmaceutical stress. Indications: chest pain, SOB, palpitations, arrhythmia, MI, CHF, LVH, cardiac murmurs, heart failure, infection, neoplasm, congenital anomalies, etc.
Carotid Artery Duplex Ultrasound Transcranial Duplex Ultrasound	Anatomical and functional evaluation of extracranial and intracranial cerebral Arteries. Indications: Stroke, TIA, syncope, dizziness, vertigo, visual deficits, cervical bruit.
Lower Extremity Arterial Duplex Upper Extremity Arterial Duplex	Anatomical and functional evaluation of arterial circulation: Indications: limb pain, claudication, discoloration, ulceration, aneurysm, pseudo aneurysm, A/V fistula, atherosclerosis.
Lower Extremity Venous Duplex Upper Extremity Venous Duplex	Vein Mapping Anatomical and functional evaluation of arterial circulation: Indications: varicose veins, limb edema, limb pain, discoloration, ulceration, deep vein thrombosis (DVT), pulmonary embolism (PE), superficial thrombophlebitis, venous insufficiency.
Renal Artery Duplex	Evaluation of renal artery and kidney blood flow. Indications: uncontrolled hypertension, renal failure.
Physiologic Vascular Evaluations
Lower extremity Arterial PVR/Doppler Upper Extremity Arterial PVR/Doppler	Physiologic evaluation of segmental limb arterial perfusion. Indications: limb pain, claudication, discoloration, ulceration, digital cyanosis.
Lower Extremity Venous Plethysmography/Doppler	Adjunct to Lower Extremity Venous Duplex. Indications: Lower limb edema, ulceration, leg pain, DVT, PE.

Pulmonary Services:

Pulmonary Function Testing

Pulmonary function tests are used to evaluate a broad range of lung disorders including airflow obstruction, restrictive disorders, exercise limitations, and bronchial hyper reactivity. The information obtained from these tests enables the physician to recognize impairment, determine patients’ responses to therapy and follow the progress of a disease.

The Respiratory Care department at Landmark uses state-of-the-art pulmonary function equipment that sets a new standard for pulmonary function instruments. Capabilities include volume and flow based spirometry, helium dilution lung volumes and real time rapid response diffusing capacity testing. This state-of-the-art technology enhances the diagnostic interpretive accuracy provided by our expert Pulmonologist. Testing is performed by highly trained Registered Respiratory Care Practitioners. The following services are available:

Complete PFT (Spirometry w/lung volumes with or without a bronchodilator)	Used to diagnose obstructive and restrictive lung defects such as pulmonary fibrosis, massive pneumonia; diseases such as asthma, emphysema, bronchitis, or non-pulmonary causes such as elevated diaphragms due to massive obesity, ascites or pregnancy, massive cardiomegaly, pleural effusion, kyphoscoliosis and/or neuromuscular disorders. Patient indications: SOB, exercise intolerance, wheezing, chronic coughing and/or chest tightness.
Complete PFT w/DLCO (includes spirometry and bronchodilator)	Used to aid in the diagnosis of pulmonary emboli, asbestosis, emphysema, left heart failure, shunts, atrial septal defects, polycythemia, anemia, sarcoidosis, tuberculosis, interstitial fibrosis and/or scleroderma of the lung. Patient indications: SOB, exercise intolerance, wheezing, chronic coughing, chronic fatigue and/or chest tightness.
Arterial Blood Gases (ABGs)	Used in the diagnosis and management of clinical oxygenation and acid-base disturbances. Patient indications: SOB, exercise intolerance, wheezing, chronic coughing, chronic fatigue and/or chest tightness.

* Inpatient respiratory care services are provided by highly trained, licensed respiratory care practitioners, 24 hours per day, 7 days per week.

Diagnostic Services:

Sleep Disorder Testing

A sleep disorder is defined as anything that interferes with one’s ability to get a good night’s sleep or to function in a well-rested manner when awake.

A sleep study, also called a polysomnogram, is an overnight diagnostic study that includes a number of separate studies performed in one exam such as brain waves, breathing, heartbeat, muscle activity and blood oxygen level. The Respiratory Care department at Landmark operates a two-bed sleep disorder lab that uses state-of-the-art equipment. Testing is performed by a highly qualified Respiratory Care Practitioner. This technology enhances the diagnostic interpretive accuracy provided by our expert Pulmonologist who is Board Certified in Sleep Medicine. The following are just a few of the many conditions and problems that are considered sleep disorders.

Sleep Apnea – 3 Types Obstructive Sleep Apnea The airway becomes blocked by the tongue, excess tissue or relaxed throat muscles, breathing usually stops for 10 – 90 seconds, the body struggles for air briefly waking the sleeper before breathing begins again. Central Sleep Apnea The brain “forgets” to tell breathing muscles to move, the lack of oxygen causes the brain to wake the sleeper before breathing begins again. Mixed Sleep Apnea This involves brief periods of central sleep apnea followed by longer periods of obstructive sleep apnea.	Signs of Sleep Apnea include: loud snoring followed by a breathless pause ending with a snort or gasp, restless movements, high blood pressure, morning headache, impotence, problems with memory / concentration and extreme tiredness or sleepiness. Risks of Sleep Apnea include: irregular heartbeat, high blood pressure, heart disease, and stroke. Daytime sleepiness can cause lost productivity accidents.
Narcolepsy – a neurological disorder involving the REM phase of sleep characterized by an uncontrollable need to sleep, regardless of the time of day or the situation.	Symptoms include: extreme sleepiness, hallucinations just before or after sleep, muscle weakness when emotions are strong, and the inability to move for several minutes after waking up.
Chronic Insomnia – the inability to fall asleep or stay asleep from time to time.	Causes include: stress, worry or excitement about an upcoming event, general anxiety, depression, pain and/or medication(s).
Restless Leg Syndrome	People with this disorder have “crawling” sensations in their legs when they lie down to sleep. The sensation goes away as soon as they get up to “walk it off”.
Periodic Limb Movement Disorder	Some people’s legs and arms jerk repeatedly during sleep. In the morning, they wake feeling tired.
Sleepwalking	Many children sleepwalk and most outgrow the behavior. Sleepwalking in adults may be a sign of an emotional or physical problem that needs treatment.
Nightmares	Long, frightening dreams that occur frequently, disrupting sleep.
Night Terrors	Terrifying episodes that cause the sleeper to suddenly awaken during the night.

Diagnostic Services:

Electroencephalogram (EEG)

An electroencephalogram (EEG) is a test that records the electrical impulses in the brain. These impulses create patterns that can be recorded, stored then interpreted by a physician, usually a Neurologist, to help make a diagnosis or monitor treatment.

An EEG can help diagnose, monitor or rule out conditions such as epilepsy, brain tumor, brain injury, cerebral palsy, stroke, drug overdose, sleep disorders, herpes simplex, encephalitis, liver and kidney disease and/or brain death. An EEG does not treat or cure illness. It does not measure intelligence, tell the technologist what you’re thinking nor detect mental illness, unless there’s a physical cause.

The Diagnostic Services department at Landmark operates a part-time Neurology lab. Testing is performed by a qualified technologist, then read and interpreted by a Neurologist who specializes in the study of EEGs.

Electromyogram (EMG)

An electromyogram (EMG) is a test that records the electrical activity of muscle. These impulses create patterns that can be recorded, stored then interpreted by a physician, usually a Neurologist, to help make a diagnosis.

An EMG can help diagnose conditions such as inflamed muscles due to injury, disease or a ruptured disk, along with primary muscle disorders such as muscular dystrophy and neuromuscular disorders such as myasthenia gravis.

The Diagnostic Services department at Landmark operates a part-time Neurology lab. Testing is performed, then read and interpreted by a Neurologist who specializes in the study of EMGs.

Nerve Conduction Studies (NCS)

A nerve conduction study (NCS) is a test that records the speed and intensity of electrical signals that travel along nerves and the time it takes muscles to respond to these signals. These impulses create patterns that can be recorded, stored then interpreted by a physician, usually a Neurologist, to help make a diagnosis.

A NCS can help diagnose conditions such as a pinched nerve due to injury or disease, carpal tunnel syndrome, neuromuscular disorders and nerve disorders such as amyotrophic lateral sclerosis (Lou Gehrig’s disease).

The Diagnostic Services department at Landmark operates a part-time Neurology lab. Testing is performed, then read and interpreted by a Neurologist who specializes in the study of NCSs.