Investigations

Exercise Stress Test

An exercise test, helps us to know how the heart copes with exertion. The test can show if the blood supply is reduced to the heart. You will walk slowly in place on a treadmill. The speed is then increased for a faster pace and the treadmill is tilted to produce the effect of walking up a hill. You can stop the test at any time if needed after which you will sit or lie down to have your heart and blood pressure checked.

The heart rate and blood pressure and electrocardiogram are monitored during the test. We may recommend you have a stress test to investigate how well your heart functions under strenuous work loads, and to predict the risk of a dangerous heart attack occurring in the future.

Echocardiogram (Echo)

This is a method of studying the heart’s structure and function by analysing sound waves bounced off the heart and recorded by an electronic sensor placed on the chest. It uses ultrasound to process the information to produce a 1, 2 or 3 dimensional moving picture that shows how the heart and heart valves function. The procedure is completely painless and does not require any preparation. The doctor or technician carrying out the investigation will ask you to lie on a couch partly on your left hand side and will use a probe which is placed on the left side of your chest to make the recordings. The procedure normally takes about 20 to 30 minutes.

24 Hour Tape

A 24 hr holter monitor provides a constant recording of your heart's electrocardiogram (rate and rhythm) over a 24 hr period. It is a safe and painless recording. It involves wearing a small monitor (the size of a match box) attached to your chest with 5 small wires connected to electrodes. It is worn either clipped to your belt or with a cord that hangs around you neck. While wearing the monitor you are instructed to carry out normal daily activities. Your doctor may request this monitor to see your heart's activity for various symptoms such as chest pain irregular or fast heart rates, dizziness and fainting spells. It also provides information on the effectiveness of medication. After the monitor is returned the results will be analysed and sent to your doctor within 1-2 working days.

Trans-telephonic Event Recorders

Trans- telephonic event recorders are portable hand-held patient activated arrhythmia recorders which enable a patient experiencing transient cardiac symptoms to press a single button that records into solid state memory a 32 second electrocardiogram. The event recorders are designed with built in electrodes for ease of use. Once in the cardiology unit the procedure is explained and demonstrated to the patient. It is advised that the patient place the device directly on the chest when symptoms occur. ECG recordings are taken at the touch of a single button, the patient calls then a receiving centre for the analysis of the event. Event recorders are quite small and weigh about four ounces and fit into a patients pocket, purse and briefcase.

CT Coronary Calcium Scoring and CT Coronary Angiography

Calcium Scoring is a technique where the extent of calcification in the coronary arteries is measured and scored from x-ray images produced by a multi-slice CT scanner. There is a direct correlation between the extent of calcium in the coronary arteries and the risk of a future cardiac event.

The CT scan accurately measures the level of calcified plaque in the walls of the coronary arteries. This will enable us to assess your relative risk.

CT Coronary Angiography is an alternative out-patient procedure to conventional angiography for evaluation of the coronary arteries. It is a non-interventional procedure which will not require a stay in hospital. It is particularly suitable for patients who have cardiac type symptoms but who are otherwise at low risk of coronary artery disease.

CT Coronary Angiography can be used to evaluate:

• the coronary arteries
• cardiac function
• the pulmonary veins
• the thoracic aorta
• the pericardium

Patients requiring this procedure undergo a strict screening process by a cardiologist to ensure their suitability for this test.