Doppler Studies

Doppler Studies allow a doctor to asses the circulation of blood to your arms and legs. Blood pressures are taken at each of the sites, and are then amplified on a speaker. There will be a print out of the waveforms which looks similar to a cardiogram printout. At times the procedure may be uncomfortable if you have severe occlusion of blood flow, but it is not painful. Circulation problems can be diagnosed or can be ruled out with this procedure.

The patient will need to wear shorts or something that can go up enough to place cuffs at the thigh level. On the day of the exam, DO NOT have alcohol, coffee, or cigarettes prior to the exam. These could affect the results.

The length of time for the procedure does vary with each individual, but will be between 30 and 60 minutes.

NDX Testing

NDX testing is an electrical test which takes only a few minutes and determines if a person with diabetes is at risk for a silent heart attack. Over one third of people with heart attacks die before they reach the hospital. Individuals with diabetes may not feel heart pain. This test identifies those individuals and allows advanced warning of their risk and to use alternative strategies to recognize a heart attack.

NDX TESTING (SST) is used to determine if the nerves to the heart which sense pain have been affected by diabetes. People with diabetes are at risk for developing heart disease and heart attacks. In some diabetic individuals, pain sensation from the heart is affected and these individuals are at risk for a "silent" heart attack. Consequently, they do not seek medical care because there are no heart symptoms. It has long been known that the sensory pain nerves from the heart travel with the same nerves that keep the heart beating automatically and regularly. The heart rate normally speeds up with breathing out (expiration) and slows down slightly with taking air in (inspiration). By measuring the duration of expiration and inspiration and comparing it with the electrocardiogram using a computer program, it is possible to determine if the sensory nerves have been damaged and you are at risk for a silent heart attack. In this instance, the heart rate no longer changes with respiration. The test is pain free and only takes a few minutes. It usually can be scheduled on the same day as a regular appointment. (Some insurances will only pay if done ANOTHER day. We will advise you if that is your insurance.) This test needs to be rechecked yearly.

If your NDX test is abnormal it would suggest that the sensory nerves that allow you to feel heart pain may have been damaged by diabetes. You may still feel heart pain, but chances are that you will not. Instead, you will feel fatigue but not usual fatigue. It will be severe as if you had been working out physically in the sun for several hours and are severely exhausted. It comes on suddenly and overwhelmingly with no obvious explanation - for example, a virus with fever; or a kidney infection. If you develop this severe unexplained FATIGUE which feels like you have been run over by a steamroller and it lasts 15 minutes, go to the nearest emergency room and tell them you think that you are having heart attack. Again, you will probably have fatigue and not chest pain or pressure.