INFORMATION FOR PATIENTS

12 lead electrocardiograph (ECG)

 

An Electrocardiogram (ECG) records the rhythm and electrical activity of the heart.

There is no special preparation required.

 

The test will last 10 minutes in total. Electrodes will be placed on specific sites on the chest and limbs and attached to leads that will measure your hearts electrical activity. It is possible that some men will need to have some parts of their chest shaved.  You will not feel anything and there are no risks in performing the test. A few beats worth of information will be recorded onto a sheet of graph paper and the test is over. The physiologist will remove the electrodes.

 

24 hour Holter monitor

 

A holter monitor is a 24 hour version of the ECG, although only 3 electrodes are used.  These electrodes are attached to a very small, compact device that will record the hearts electrical rhythm.There are no risks in performing the test, and the patient is able to continue normal daily activities whilst wearing the holter monitor (with the exception of showering or getting the monitor wet). The patient is asked by the physiologist or technician to complete a diary of any events during the day the test is performed. The patient returns the monitor the following day after the 24 hours has been completed.

 

24 hour Blood Pressure Monitor

 

Ambulatory blood pressure monitoring involves a blood pressure cuff being placed on the upper arm and the blood pressure being measured periodically throughout a 24 hour period. The patient is able to continue normal daily activities. The blood pressure cuff is attached to a small device that stores the recorded measurements. The device is attached to a belt and worn around the waist. There are no risks in performing this test.

 

Exercise Stress Test

 

An exercise stress test in performed in order for a doctor to measure the electrical response of your heart to increased physical exertion. It may provide valuable information in assessing whether the patient is at risk of a heart attack, has high blood pressure, or has any electrical abnormalities of the heart. 

It is advisable to bring comfortable clothing that you are able to exercise in to the test. Sports shoes are also advisable. 

If you take medications, you should continue to take them as normal unless your doctor specifies otherwise. 

The test will last 30 minutes in total, with the exercise component of the test lasting anywhere between just a few minutes and 15 minutes depending on your level of fitness and your heart's response to the exercise. 

The cardiac physiologist will gently clean 10 small areas on your chest and place electrodes(small, flat, sticky patches) on these areas. It may be necessary to shave some chest hair from men to obtain better adhesion. The electrodes are attached to a monitor that charts your heart's electrical activity during the test. You will also wear a blood pressure cuff around your arm, which will be used to check your blood pressure during the test. 

A baseline reading will be taken of your heart rhythm and blood pressure at rest. You will be asked to walk on a treadmill. Every 3 minutes, the Cardiac Physiologist will increase the speed and slope of the treadmill, which will make you feel like you are walking uphill. Any changes that occur in your blood pressure or heart rhythm during the test will be recorded. The test will be stopped if any concerning signs are noticed on the blood pressure or heart rhythm (ECG) monitors, or if you develop symptoms such as chest pain, breathlessness or leg pain. 

For the test to be effective at detecting coronary artery disease, your heart rate must increase with the exercise to 85-90% of your predicted maximum possible heart rate (220 minus age in years). 

There is very little risk - no more than if you walked fast or jogged up a big hill. There's a slight risk that this test could bring on a heart attack or abnormal heartbeats, but this is very rare. Medical professionals are on hand in case anything unusual happens during the test.

 

Transthoracic Echocardiogram

 

An echocardiogram (echo) is an ultrasound scan of the heart. It uses standard ultrasound

techniques to image two-dimensional slices of the heart. Essentially, an ECG looks at your

hearts electrical rhythm, while an echo looks at the actual structures of the heart and

evaluates the heart valves, the heart chambers, and blood flow velocity.

A standard echo study will last 30 minutes. The cardiac physiologist will apply a clear water

based gel to specific sites on your chest and uses an ultrasound probe to gather images of

the heart. The patient will feel some gentle prodding around the chest area due to the

ultrasound probe being pressed against the ribcage.

 

There is no risk involved in performing this test.

 

Vascular ultrasound.

 

Vascular ultrasound provides pictures of the body's veins and arteries. It is done using an

ultrasound probe attached to an ultrasound machine.

 

Vascular ultrasound is performed to:

• help monitor the blood flow to organs and tissues throughout the body.
• locate and identify blockages (stenosis) and abnormalities like plaque or emboli and help plan for their effective treatment.
• detect blood clots (deep venous thrombosis (DVT) in the legs or arms.
• determine whether a patient is a good candidate for a procedure such as angioplasty.
• evaluate the success of procedures that graft or bypass blood vessels.
• determine if there is an enlarged artery (aneurysm).
• determine the source and severity of varicose veins.

A clear water-based gel is applied to the area of the body being studied to help the

transducer make secure contact with the body. The sonographer then presses the

transducer against the skin and sweeps it over the area of interest to obtain the required

images.

 

This ultrasound examination is usually completed within 30 minutes although more complex

examinations may take longer.

 

There is no risk in performing the test.