In-Office Services

Dr. Alrich L. Gray // Central Montana Heart & Vascular Institute

Striving to meet every healthcare need

At Central Montana Heart and Vascular Institute, Dr. Gray knows that every patient is unique and each patients’ treatment plan should reflect that individuality. Our staff's focus on in-office services provide the best opportunity for personalized care and the attention that you deserve. If you're a new patient looking for a consultation, feel free to contact CHMVI today. If you're a returning patient, log into our patient portal.


Cardiology Consultation

During a cardiology consultation, you will sit down with your doctor and discuss your cardiovascular health. You will discuss your detailed medical history and family medical history, and then answer questions regarding your current health, symptoms you are experiencing, medicines you are taking, and more. The consultation may include performing a physical exam.

The goal of the consultation is to get to the root of your cardiovascular issue and begin treating it. Sometimes, you may have to undergo further diagnostic testing such as getting an echocardiogram or wearing a Holter/cardiac monitor.

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Cardiac Device Management

Patients that have received a surgically implanted cardiac device such as a pacemaker, implantable cardiac defibrillator (ICD), biventricular device, and long-term implantable loop recorder will require routine monitoring and management of these cardiac devices. Management includes in-office and remote home device interrogations and monitoring, as well as replacement of devices when batteries have expired and replacement of damaged or failed leads/wires. In some cases the entire device and leads are extracted.

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Cardiac Monitoring

A cardiac monitor is a small device used to track your heart’s electrical activity. There are many types of monitors and they can be worn for 24 hours to 14 days. These monitors are designed to monitor your heart rhythm throughout your daily activities. Your doctor may monitor your heart activity with one of these monitors to check for electrical abnormalities in your heart and, if found, to determine the best course of treatment.

Holter Monitor

A Holter monitor is a battery-operated portable device that measures and records your heart’s activity (ECG) continuously for 24 to 48 hours or longer depending on the type of monitoring used. The device is the size of a small camera. It has wires with silver dollar-sized electrodes that attach to your skin. The Holter monitor and other devices that record your ECG as you go about your daily activities are called ambulatory

Long-Term Holter

Cardiac event monitoring is a long term diagnostic tool used by medical professionals to connect patient symptoms to cardiac events. Cardiac event monitoring is generally ordered by physicians when the symptoms are not captured in a 24 hour Holter monitor or when the clinician suspects the symptoms too transient to be captured in a 24 hour monitoring period.

Implantable Loop Recorder

An implantable loop recorder is a small device inserted under the skin over your chest that records your heart rhythm. It can monitor the electrical signals of your heart continuously for several years.

Your doctor may recommend an implantable loop recorder to get more conclusive results if other tests have failed. For example, some patients may have abnormal heartbeats (arrhythmias) or fainting spells intermittently. If these problems occur infrequently, a short duration test such as an electrocardiogram (ECG or EKG) may not catch these events. An implantable loop recorder allows for long-term heart rhythm monitoring to increase the chance of diagnosing a relatively infrequent heart rhythm disorder.

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King of Hearts Express (KOH)

The King of Hearts Express (KOH) is a patient activated monitor that is worn for 30 days. It is used to evaluate symptoms such as dizziness, palpitations, and chest pain. It captures EKG information before and after you experience a cardiac symptom.

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DC Electrical Cardioversion

A DC electrical cardioversion (direct current cardioversion) is a procedure used to convert some abnormal heart rhythms to a normal heart rhythm. Your doctor will discuss with you whether this is the right option for you. During the procedure, you are sedated, and an electrical shock is sent through your heart via pads or paddles. This electrical shock will typically reset your heart rhythm to normal.

Cardioversions have quick recovery times, and you will most likely go home the same day as your procedure.

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Cardiac Diagnostic Studies


Carotid Doppler

A carotid Doppler is an imaging test that uses ultrasound to examine the carotid arteries located in the neck. This test can show narrowing or possible blockages due to plaque buildup due to coronary artery disease.

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Electrocardiogram (EKG/ECG)

An electrocardiogram is a test used to record the electrical activity in your heart. Your doctor will perform an electrocardiogram to monitor your heart’s health and detect any heart problems.

During the test, electrodes will be placed on your body and they will detect the electrical activity of your heart.

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Echocardiogram (Echo)

An echocardiogram (echo) is a test that uses high-frequency sound waves (ultrasound) to make pictures of your heart. The test is also called echocardiography or diagnostic cardiac ultrasound.

  • An echo uses sound waves to create pictures of your heart’s chambers, valves, walls and the blood vessels (aorta, arteries, veins) attached to your heart.
  • A probe called a transducer is passed over your chest. The probe produces sound waves that bounce off your heart and “echo” back to the probe. These waves are changed into pictures viewed on a video monitor.
  • An echo can’t harm you.
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Stress Echo

A stress echo shows how well your heart and blood vessels are working During a stress echo you’ll exercise on a treadmill or stationary bike while the doctor measures your blood pressure and heart rhythm. When your heart rate reaches peak levels, a tech will take ultrasound images of your heart to determine whether your heart muscles are getting enough blood and oxygen while you exercise.

The stress echo may be used to diagnose problems with your heart, guide treatment decisions, or measure the effectiveness of treatment.

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Treadmill Stress Testing

A stress test shows how your heart works during physical activity. As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. This test can show if the blood supply is reduced in the arteries that supply the heart

During the test, you may be walking on a treadmill. You will be hooked up to equipment that will monitor your heart rate, breathing, blood pressure, and an electrocardiogram, which is a test used to record the electrical activity in your heart. The stress test may be used to diagnose problems with your heart, guide treatment decisions, or measure the effectiveness of treatment.

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