Work at the Department

The Department of Non-Invasive Cardiac Diagnostics performs its activities within the Polyclinic of the Institute “Dedinje”. Non-invasive cardiac diagnostics includes a range of tests which allow for the timely detection or continuous monitoring and assessment of existing heart disease(s). Having the latest technology for detecting heart disease, allows our cardiologists, in cooperation with certified technicians, to detect potential problems with the heart and large blood vessels in the earliest stages of the disease. Non-invasive heart examinations do not cause discomfort or complications and help direct patients to further procedures (interventional or surgical) treatment.

Неинвазивна дијагностика обухвата:

  • Echocardiographic assessment of the patient, as well as monitoring patient condition during and after interventional procedures (without opening the chest) or heart surgery
  • Functional tests (performed on a treadmill or semi-recumbent bicycle) or pharmacological stress tests, which involve the use of drugs to induce the stress. If necessary, a combination of these tests is used. We use functional tests when we want to examine the existence of significant narrowing of the blood vessels of the heart or assess the disease(s) of the heart valves, or determine further treatment for patients suffering from cardiac insufficiency.
  • Evaluation of patients suitable for non-surgical closure of openings between heart cavities, closure of left atrial sac that may be responsible for thromboembolic complications as well as evaluation of patient suitability for non-surgical heart valve replacement or repair (FOA, ASD, VSD, DAP, DAP, left auricle closure, TAVI, Mitral clip).
  • Prospective monitoring of patients with diseases of special interest
  • Training for the staff members in the field of echocardiography (basic and advanced courses)

The Department of Non-Invasive Cardiac Diagnostics works in two shifts, from 08 a.m. to 08 p.m., on the premises of the Outpatient units for echocardiography and functional diagnostics of the heart.

List of procedures

Types of test performed by the Department of Non-invasive Diagnostics:

  • Transthoracic ECHO examinations (Ultrasound examinations of the heart are performed with a probe that rests on the chest. This examination assesses the size and strength of the heart muscle, normal motility of the heart valves, size and patency of large blood vessels)
  • Transesophageal ECHO examinations with a multiplane probe (A special type of examination using a flexible probe that is swallowed under local anesthesia of the palate and throat, which provides a better view of individual cardiac structures. It is performed only on certain group of patients. For example: suspected aortic wall dissection, altered valve function, suspected inflammatory valve process, suspected atrial septal defect, abnormal pulmonary vein infusion, fistula, suspected pulmonary thromboembolism or left atrial clot before heart rate conversion…)
  • Physical stress test on a treadmill or semi-recumbent bicycle (Physical stress test should be performed in situations where ischemia is assessed (insufficient blood supply to the heart muscle under stress).
  • Pharmacological tests: Dipyridamole, Dobutamine, Adenosine (assessment of coronary flow reserve (CFR) – tests are used to assess ischemia (insufficient blood supply to the heart muscle under stress), i.e. reduced blood flow to the heart muscle in patients when physical stress test is not possible (in patients who have an ECG record which cannot be interpreted under stress, in those who suffer for diseases of the lower limbs or lack of knowledge required to walk on a treadmill or ride a bicycle). These tests are performed on patients who have been stress tested, but the result is not clear enough.
  • The reason for performing a pharmacological stress test can also be an assessment of vitality, i.e. an assessment of whether there is living tissue at the site of a myocardial infarction (heart attack).
  • Ergospirometry is performed in a manner similar to ergometry. However, in this case a special mask, placed on the patient’s face, is used to continuously monitor gas exchange and assess oxygen consumption and carbon dioxide elimination, as well as changes in ventilatory parameters (exhalation gases) and respiratory reservoirs.
  • Spirometry is a method that measures basic lung function, i.e. the amount of air that is inhaled and exhaled from the lungs during the test. The main purpose of spirometry is to determine the presence or absence of pulmonary disease, assess the extent of lung damage, as well as to assess the effects of therapy.
  • 24-hour blood pressure monitoring in the outpatient unit is performed by a mobile device that automatically registers blood pressure. This test is performed in a 24-hour interval, whereby the measurements are performed at regular daytime intervals of 15 minutes, and nighttime intervals of 30 minutes.
  • The six-minute walking test is a simple test that determines the maximum distance that a patient can free-style walk in 6 minutes with the assessment of difficulties and with continuous monitoring of peripheral oxygen saturation of blood.

Instructions for patients

General information:

Transthoracic echocardiographic examination of the heart requires the following:
Documentation and analyses:

  • Referral letter for a specialist examination (for patients coming from other parts of the country the referral letter needs to be certified by the competent health insurance fund)
  • Report by a competent doctor about the reason for referring the patient
  • ECG
  • X-ray imaging the lungs and heart (if any)
  • Previous documentation (if any)

Transesophageal ultrasound examination of the heart requires the following:
Documentation and analyses:

  • Referral letter for a specialist examination (for patients coming from other parts of the country the referral letter needs to be certified by the competent health insurance fund)
  • Report by a competent doctor about the reason for referring the patient
  • ECG
  • X-ray imaging the lungs and heart (if any)
  • Previous documentation

It is necessary to avoid eating or drinking at least 4 hours before the scheduled.

Preparation for physical stress test / pharmacological stress test
Documentation and analyses:

  • Provide referral letter for specialist examination and other medical documentation.
  • Do not take beta-blockers (e.g. Presolol, Inderal, Prinorm, Dilatrend, Sotalol and Concor…) and calcium antagonists (e.g. Nifelat, Norvask, Amlopin, Vasotal, etc.) for three days preceding the test and on the day of the test, unless otherwise advised. If you have any doubts about the medicine you need to omit, consult a competent cardiologist or contact our outpatient unit for functional cardiac diagnostics.
  • Administer other therapy as usual on the day of the test;
  • Provide result of serum potassium not older than 48 hours, otherwise the test will not be performed (serum potassium results must not be under 4.0 mmol/l);
  • Appear for testing in comfortable clothes and shoes (sneakers, flats);
  • Take a lighter meal 2-3 hours before the test. Do not take stimulants, alcohol, tea, coffee, Coca-Cola, energy drinks. Do not smoke for at least 3 hours preceding the scheduled test (if you are diabetic, follow your diet and therapy)

NOTE: The treadmill has a limitation in terms of load (maximum load 120 kg of the patient’s body weight)

Spirometry – does not require and special preparations

24-hour blood pressure monitoring in the outpatient unit – does not require and special preparations

Six-minute walking test – does not require and special preparations

Working hours:

Required documentation:

Outpatient unit

The Department of Non-Invasive Cardiac Diagnostics includes the Outpatient unit for Echocardiography and Functional Cardiac Diagnostics

Working hours: 08 a.m. – 08 p.m.
Procedure for scheduling outpatient unit examination:
xaminations within the Department of Non-Invasive Diagnostics can be performed if they are scheduled by means of electronic number via the IHIS system for that particular date, if they are scheduled internally, since a follow-up examination will be required within six months with a valid referral letter or without an appointment, in case of emergency outpatient unit patients, referred from the admission cardiac, cardiac surgery or vascular outpatient units.

Contact details

Telephone:

  • 011 3601 671
  • 011 3601 670

Fax:

E-mail: