Echocardiogram

What is an Echocardiogram?

An Echocardiogram or Echo is a non-invasive ultrasound of the heart. This is done by obtaining 2 dimensional (2D) and Doppler (blood flow) images with an ultrasound device.

Ultrasound waves are sent into the chest using an ultrasound device that is moved over the chest with ultrasound gel (the gel aids in the transmission of the sound waves). The sound waves are transformed into pictures. These pictures allow the physician to see the structure, size, movement of the heart muscle, valves and the flow of blood through the heart chambers.

Echocardiography is safe. There are no known risks from the clinical use of ultrasound during this type of testing.

How safe is an echocardiogram?

Echocardiography is extremely safe. There are no known risks from the clinical use of ultrasound during this type of testing.

Why do I need an Echocardiogram?

An Echocardiogram may help identify the cause of symptoms such as shortness of breath, swelling in the legs or pain in the chest. The test produces images of your heart which are used to evaluate your heart, heart valves and heart muscle.

Other Uses:

Echocardiography is useful in the diagnosis of fluid in the pericardium (the sac that surrounds the heart). It also determines when the problem is severe and potentially life-threatening. Other diagnoses made by Doppler or echocardiogram include congenital heart diseases, blood clots or tumours within the heart, active infection of the heart valves, abnormal elevation of pressure within the lungs, etc.

How long is the test?

The test will take approximately 30 minutes.

How to prepare?

All clothing from the waist up will need to be removed and an examination gown will be provided for your privacy.

Electrodes will be placed on your chest to check the electrical activity of your heart (ECG).

To obtain a good trace your chest may need to be shaved and an abrasive pad used.

Fees

Please contact the surgery on 0242284955 to discuss the fees for the tests.

Stress Echocardiogram

What is a Stress Echocardiogram?

A stress echocardiogram is a non-invasive echocardiogram performed before and after exercise (walking on a treadmill) that allows your doctor to assess how your heart responds to exercise.

An Echocardiogram or Echo is a non-invasive ultrasound of the heart. This is done by obtaining 2 dimensional (2D), Doppler (blood flow) and 3 dimensional (3D) images with an ultrasound device.

Ultrasound waves are sent into the chest using an ultrasound device that is moved over the chest with ultrasound gel (the gel aids in the transmission of the sound waves). The sound waves are transformed into pictures. These pictures allow the physician to see the structure, size, movement of the heart muscle, valves and the flow of blood through the heart chambers.

What are the risks of a Stress Echocardiogram?

Walking vigorously on the treadmill may temporarily cause an irregular heartbeat. Serious complications such as a heart attack are rare. There are no known risks associated with the echocardiogram. You may feel some discomfort similar to pulling of a band aid when the technician removes the electrodes placed on your chest during the procedure.

What can I expect?

After undressing from the waist up you will be asked to lie on the examination bed. The technician will attach electrodes to your body to monitor your heart rate. The technician will then perform an echocardiogram prior to your exercise. (Resting images). The treadmill is programmed to get faster and steeper every 3 minutes. You will be asked to walk for as long as possible to increase your heart rate. If you feel unwell during the test you must inform the doctor who will stop the test when it is safe to do so. Your heart rate and blood pressure are monitored throughout the test.

When you exercised for long enough, the treadmill will stop and you will be moved to the examination bed so another echocardiogram can be performed. You might be asked to hold your breath while they are taking your images. It may be difficult to do so, but do your best so that we can get the best possible images. The cardiologist will then compare the resting images with the post exercise images.

Once the echocardiogram is done and your heart rate has returned to normal, the gel is wiped off and the electrodes are removed.

How to prepare?

The test is over 2 separate days; first you will need a Echocardiogram and then the Stress Test part of the Stress Echocardiogram is performed on another day.

You do not need to fast but it is advisable not to have a heavy meal prior to your test. We advise that you avoid caffeine for 4 hours before the test (chocolate, coffee, tea, fizzy drinks). Please refrain from smoking or drinking alcohol 4 hours before your test.

Please ensure you wear comfortable shoes and clothing as you will be on the treadmill.

A consent form will need to be signed on the day of the test for the treadmill.

Electrodes will be placed on your chest to check the electrical activity of your heart (ECG).

To obtain a good trace your chest may need to be shaved and an abrasive pad used.

If you use an inhaler for breathing, please bring it with you for the test.

How long is the test?

The test will take approximately 30-45 minutes including recovery time.

Why do I need a Stress  Echocardiogram?

Your doctor uses the stress echocardiogram to:

• Determine how well your heart tolerates activity
• Evaluate the function of your heart valves
• Determine your likelihood of having coronary artery disease (blocked arteries)
• Evaluate the effectiveness of your cardiac treatment plan

How to prepare?

We advise that you avoid caffeine for 4 hours before the test (chocolate, coffee, tea, fizzy drinks and energy drinks).You do not need to fast but it is advisable not to have a heavy meal prior to your test. Please refrain from smoking or drinking alcohol for 4 hours before your test.

Please ensure you wear comfortable shoes and clothing as you will be on the treadmill.

A consent form will need to be signed on the day of the test for the treadmill.

Fees

Please contact the surgery on 0242284955 to discuss the fees for the tests.

 

Exercise Stress Test

What is an Exercise Stress Test?

An exercise stress test (EST) is designed to assess how your heart, lungs and blood vessels respond to exercise. It can help provide information about the level to which you can exercise, if there are any problems affecting your ability to exercise and how your condition changes with exercise. The test is performed on a treadmill using Bruce protocol.

Why do I need an Exercise Stress Test?

Your doctor has decided that your management will be helped by an EST. There are different reasons why patients may require an EST and these may include:

• Symptoms or signs suggestive of coronary artery disease
• Symptoms of chest pains
• Risk factors such as smoking, high blood pressure and high cholesterol
• Evaluation of exercise capacity in patients with unexplained shortness of breath or fatigue
• Evaluation of blood pressure response to exercise
• Examination for exercise induced heart rhythm disturbances (arrhythmias)
• Assessment of your condition after a cardiac procedure such as bypass surgery or angioplasty

What can I expect?

The test will be supervised by Dr J Gohil and a cardiac technician.

Prior to the test you will have to remove the top half of your clothing. For females a gown is provided. Electrodes (heart monitoring stickers) will be placed on your chest. These electrodes are attached to cables which are linked to the computer. These will be looped to your waist with a belt during your test.

A blood pressure cuff will be placed around your arm.

You will perform a graded EST. The exercise level will be in stages in order to increase your heart rate. The treadmill will begin at a slow pace. Every 3 minutes it increases in speed and incline (slope).

The test will be stopped if you experience severe chest pain, become very tired or short of breath. Your pulse, blood pressure and ECG are monitored during and after the test.

You will be asked at times during the test if you are ok or if you have any symptoms such as chest or leg discomfort or shortness of breath. If you feel unwell you should inform Dr Gohil at once.

How long is the test?

The test will take approximately 30 minutes; this includes your recovery time.

What are the risks?

In recommending this procedure your doctor has balanced the benefits and the risks of the test against the benefits and risks of not proceeding. Your doctor believes there is a net benefit of you having an EST.

The procedure is generally safe however a few risks include:

• Chest pain
• Shortness of breath
• Sore muscles or joints
• Fainting (rare)
• An abnormal heart rhythm that continues for a long time (rare)
• Build-up of fluid in the lungs which may need treatment (rare)
• Heart attack (rare)
• Death as a result of this procedure is extremely rare, less than 1:10,000 patients

The risks are higher if you already have blocked arteries or heart disease.

 

Holter Monitoring

What is Holter Monitoring?

A Holter monitor is a small, wearable device that records the heart’s rhythm. It’s used to detect or determine the risk of irregular heartbeats (arrhythmias).

A Holter monitor test may be done if a traditional electrocardiogram (ECG) doesn’t provide enough details about the heart’s condition. If the irregular heartbeats are infrequent, a longer term monitor called an event recorder may be needed.

Why do I need Holter monitoring?

Your doctor may recommend a Holter monitor if you have:

• Signs and symptoms of an irregular heart rhythm (arrhythmia)
• Unexplained fainting
• A heart condition that increases the risk of arrhythmias

A Holter monitor may be able to spot irregular heart rhythms that an ECG missed.

What are the risks of Holter monitoring?

There are no significant risks involved in wearing a Holter monitor. Some people have minor discomfort or skin irritation where the electrodes are placed.

Holter monitors aren’t usually affected by other electrical appliances. But some devices may interrupt the signal from the electrodes to the Holter monitor. If you have a Holter monitor, you should avoid the following:

• Electric blankets
• Electric razors and toothbrushes
• Magnets
• Metal detectors
• Microwave ovens

Also, keep mobile at least 15 cm from the Holter monitor for the same reason.

How to prepare?

Have a shower before this appointment. The monitor can’t be removed and must be kept dry once monitoring begins.

Electrodes are placed on your chest. These electrodes detect the heartbeat. They’re about the size of a silver dollar. If you have hair on your chest, some of it may be shaved to make sure the electrodes stick.

Wires attached to the electrodes connect to the Holter monitor recording device. The device is about the size of a deck of cards.

Once your Holter monitor is fitted, you can leave your doctor’s office and return to everyday activities.

Returning after 24 hours

Once your monitoring period is over, you’ll return the device to your doctor’s office. If you were asked to keep a record of symptoms that you had while wearing the device, your provider can compare the Holter monitor’s data with your notes. This can help your provider make an accurate diagnosis.

What can I expect?

A Holter monitor is typically worn for 24 hours. During that time, the device records all the heartbeats.

Holter monitoring is painless and non-invasive. The electrodes and wires are hidden under clothing. The device is worn on a strap around your neck.

Don’t take the Holter monitor off — it must be worn during the entire recording period, even while sleeping.

Water can damage the Holter monitor. Don’t swim or shower whilst wearing the Holter monitor

While you wear a Holter monitor, you can do most other daily activities. You may be given a form to record your any symptoms. It’s important to note if/when you have any of the following symptoms:

• Pounding, fluttering or skipped heartbeats
• Shortness of breath
• Chest pain
• Lightheadedness

Write down what activities you do and exactly what time you do them.

Fees

Please contact the surgery on 0242284955 to discuss the fees for the tests.