Non invasive tests: (performed in consulting rooms)
This is a simple test that analyses the electrical signals emitted by your heart. It is performed by attaching electrodes to your chest and limbs. It takes only a few minutes to be performed. Stickers (called electrodes) are placed on your chest, arms and legs, which connect to the ECG machine. The machine then measures and records your heart’s electrical activity. Having an ECG doesn’t hurt and takes approximately 5 minutes.
An echocardiogram, also called an “echo,” is an imaging test that creates pictures of your heart as it beats. During an echo, a doctor or a highly trained technician uses a thick wand, called a “transducer”/”probe,” to send sound waves into the heart. The sound waves create images that show the size of the heart chambers, how well the heart pumps, and how well the heart valves work. It is a simple test performed to evaluate the size of your heart, the function of the heart as well as the heart valves. It is performed with you lying down. Stickers are placed on your chest to monitor the heart rhythm. The probe is pressed against the chest to obtain pictures of your heart. The test in not painful, however pressure from the probe on the chest may be sometimes be experienced. It is very safe test and the same technology is used to scanned unborn babies during pregnancy. This test typically takes 20-40 minutes.
Exercise stress test (EST):
A stress test measures how well your heart works when it is beating fast and working hard. When the heart pumps fast, it has the need for a higher blood supply. A stress test helps your doctor determine if the heart is getting enough blood during these times. A stress test is sometimes called an “exercise test” or a “treadmill test.” The stress test is used to screen for potential problems with the arteries supplying your heart as well as to assess your exercise capacity. Electrodes are attached to your chest (like for an ECG) and your heart rhythm is monitored, before, during and after the stress test. Your blood pressure is checked at regular intervals. The exercise part is performed on a treadmill. You will need good walking or running shoes. The test starts off quite slowly (adjusted to your ability), and the speed is progressively increased every few minutes. The test is usually very safe, and you are monitored throughout by a doctor and a nurse. Sometimes patients can experience chest pain, dizziness or abnormal heart rhythms. The test typically takes 10-30 minutes.
Exercise stress echocardiogram (Stress echo):
A stress echocardiogram (Stress echo) is an exercise stress test, combined with a focused echocardiogram examination. An ultrasound scan (echo) of your heart is performed prior to the stress test. A the stress test is then performed as described above, following which the ultrasound scan of the heart is repeated. The echo that is performed after the stress test need to be performed very quickly after the stress test is stopped. It is a more accurate and sophisticated type of stress test. The risks associated with a stress echo, are the same as for a stress test. The test typically takes 20-40 minutes.
24 hour heart monitor (Holter Monitor):
This is a test that is designed to assess the electrical system of your heart. It is used predominantly to determine whether your heart has a rhythm problem (palpitations, racing heart, missed beats, slow heart rhythm). A holter monitor is a small wearable ECG recording device. Like an ECG, it has electrodes that are attached to your chest. The monitor is usually worn for 24 hours though sometimes it can be used for up to 48 hours, and it records every heart beat during that period of time. You are encouraged to carry on as normal with all yours usual activities that you would normally do, while your heart is being monitored. You will be asked to keep a note/diart of any symptoms you may have while the monitor is on. The device also has a button you should press if you experience any symptoms, and this will allow the doctor to correlate your symptoms with the heart rhythm at the time. The test is painless, but men may require some chest hair to be shaved.
24 hours Blood pressure monitor (BP monitor):
This test is used to determine your blood pressure during the course of a day. It is can be used to determine whether there are significant variations in your blood pressure and if these are different to those obtained at the time of consultation. It can also be useful in assessing the effectiveness of blood pressure treatment. The test involves wearing a blood pressure cuff around your arm, attached to a small monitor. The cuff is inflated at periodic intervals during the day and night for 24 hours. You are encouraged to perform your normal daily activities while the monitor is on. Some discomfort may be experienced with the cuff inflations.
Patients with an implanted pacemaker, defibrillator or biventricular pacemaker will require periodic monitoring of these devices to ensure that they are performing appropriately. The test is not painful and is performed by placing a “wand” over your device. Newer devices can also be interrogated wirelessly. The test typically takes 10-15 minutes.
Home monitoring of pacemaker/defibrillator:
Some patients with implanted devices may benefit from home monitoring to keep a more detailed check on the device on a daily basis. This feature is not available with all devices.
Biventricular pacemaker optimization:
Most patients with biventricular pacemaker will have a significant improvement in their symptoms following a device insertion for a weak heart. Some patients however require more specific and tailored pacemaker adjustment to derive the maximum benefit. To perform this, a prolonged appointment will be required. This consists of performing a device check at the same time as an echocardiogram. Adjustments to the device are made based on detailed evaluation of the heart with the aid of an echocardiogram. The procedure in not painful and it takes 30-60 minutes to perform.