89 Ho'okele St., Suite 103, Kahului, HI, 96732 - Fax: (808) 871-8867

our services

Electrocardiogram (ECG)

The electrocardiogram (ECG or EKG) is a noninvasive test that is used to detect underlying heart conditions by measuring the electrical activity of the heart.  Leads are placed on the body in standardized locations to record the electrical signals from the heart which can then provide information about many heart conditions by looking for characteristic patterns.  The ECG can help to measure or detect:

  • The underlying rate and rhythm mechanism of the heart.
  • Evidence of increased thickness (hypertrophy) of the heart muscle.
  • Evidence of damage to the various parts of the heart muscle.
  • Evidence of acutely impaired blood flow to the heart muscle.
  • Patterns of abnormal electric activity that may predispose the patient to abnormal cardiac rhythm disturbances.

Cardiac Monitoring

We have several different types of heart monitors that may be ordered by one of our providers depending on the situation.  These monitors include:

  • Holter Monitor
  • Event Monitor
  • Zio Monitor
  • ePatch Monitor


A holter monitor is essentially a 24 hour ECG.  This monitor would be hooked up in office and then returned the following day after recording has completed.  The event monitor functions quite similarly to the holter, however this monitor is worn for two to four weeks with the patient being able to take it off and on to shower.  The Zio monitor is a heart monitor that comes in the form of a patch.  This monitor is applied in office, then sent in by mail.  It can be worn for up to two weeks without needing to ever remove it during that time.  ePatch monitors are similar to the Zio in that it comes in the form of a patch and can only be worn for up to seven days.


After visiting with one of our providers they can help decide which monitor would be best given your symptoms and insurance.

Echocardiogram

An echocardiogram is an ultrasound of the heart that allows the doctor to take a closer look at how the patient's heart in functioning.  It allows the doctor to evaluate the valves and chambers of the heart in a noninvasive way so that they are able to diagnose, evaluate, and monitor:

  • Abnormal heart valves
  • Atrial fibrillation
  • Congenital heart disease
  • Damage to the heart muscle in patients who have had heart attacks
  • Heart murmurs
  • Infection in the sac around the heart (pericarditis)
  • Infection on or around the heart valves (endocarditis)
  • Pulmonary hypertension
  • The pumping function of the heart for people with heart failure
  • The source of a blood clot after a stroke or TIA

Stress Echocardiogram

A stress echocardiogram helps evaluate a patient for heart disease by having them exercise on a treadmill following a predetermined protocol.  The echocardiogram is performed before exercise as a baseline and then immediately afterwards to observe any changes in the heart's wall motion.  For a stress echocardiogram to be effectively interpreted, the exercise done needs to achieve certain minimum intensity.


When coronary arteries narrow due to atherosclerotic heart disease, the heart muscle may not get enough blood supply to meet its needs during exercise.  This can cause chest pain (angina) or shortness of breath or no symptoms at all.  On a stress echocardiogram, those areas of the heart muscle not receiving enough blood flow, may not squeeze as well as other parts of the heart and will appear to have motion abnormality.  This can indicate narrowing of the coronary arteries.For a stress echocardiogram to be effectively interpreted.

Aortoiliac Ultrasound

An aortoiliac ultrasound helps examine the abdominal aorta and iliac arteries.  This test is used to help assess the patient for a possible aneurysm and peripheral vascular disease.  To ensure clear images during the ultrasound it is advised the patient not eat a large meal within 6 hours of their appointment.

Carotid Ultrasound

A carotid ultrasound shows whether there is plaque or cholesterol built up in the carotid arteries. There are two common carotid arteries, one on each side of the neck.  They each divide into internal and external carotid arteries.  The internal carotid arteries supply oxygen-rich blood to the brain.  The external carotid arteries supply oxygen-rich blood to the face, scalp, and neck.  

Over time, plaque can harden or rupture.  Hardened plaque narrows the carotid arteries and reduces the flow of oxygen-rich blood to the brain.  If the plaque ruptures, a blood clot can form on its surface. A clot can restrict blood flow through a carotid artery, which can cause a stroke.

Lower Extremity Arterial Ultrasound

The purpose of a lower extremity arterial evaluation is to detect the presence, severity and location of narrowing of the arteries caused by plaque in your legs.  Some of the indications for a lower extremity arterial evaluation include:

  • Leg pain while walking (claudication)
  • Leg pain at rest
  • Leg numbness and tingling
  • Non-healing ulcers or sores of the legs or feet

Lower Extremity Venous Ultrasound

The purpose of a venous duplex scan is to detect the presence of thrombus (blood clot) in your veins.  Some indications for a lower extremity venous scan include warmth, pain and swelling of one or both legs, or ulcers of legs.

Segmental Ankle Brachial Index

This test is used to evaluate blood circulation in the major arteries.  Blood pressure measurements at various locations in the arms and legs. By detecting differences in blood pressure at specific locations in different limbs, this test helps to diagnose arterial blockages and other circulation problems. It is most commonly performed in people suspected of having peripheral arterial disease (PAD), a narrowing of arteries in the legs due to the accumulation of plaques.  It is the most useful initial test to identify PAD.  Sometimes the patient is asked to walk on a treadmill to help aid in diagnosis.


Purpose of the segmental limb pressures:

  • To evaluate arterial blood flow in the arms or legs and detect blockages, trauma, or other circulation problems
  • To aid in the diagnosis of PAD, determine the location and extent of any arterial blockages, and (with the treadmill test) determine the severity of functional impairment due to PAD
  • To monitor the progression of known PAD and evaluate the effectiveness of treatments such as arterial bypass grafts in the legs
  • To detect and evaluate possible arterial trauma

Upper Extremity Arterial Ultrasound

The purpose of an upper extremity arterial evaluation is to detect the presence, severity and location of narrowing of the arteries caused by plaque or cholesterol buildup .  Some of the indications for an upper extremity arterial evaluation include:

  • Asymmetrical brachial systolic blood pressure readings
  • Suspected upper extremity arterial embolism
  • Reduced pulses
  • Evaluation of arterial trauma
  • Numbness or tingling in the arms or hands

Upper Extremity Venous Ultrasound

The purpose of a venous duplex scan is to detect the presence of thrombus (blood clot) in your veins.  Some indications for a upper extremity venous scan include warmth, pain and swelling of one or both arms.

Renal Artery Ultrasound

A renal artery ultrasound is a noninvasive examination that consists of imaging both arteries that supply blood to the kidneys and observing the flow.  The purpose of this examination is to see if there are any blockages or constrictions within the artery.  This exam may have been ordered due to  high blood pressure, previous kidney problems, or diabetes.  It is best not to eat within 6 hours of the appointment for clearer images.