You may require some or all of these tests and they will be explained to you on the day
- Electrocardiogram (ECG, or in the USA it is called EKG). This is a tracing of the electrical activity in the heart. It is done by placing 10 ‘electrodes’ (stickers) on the wrists, ankles and across the left chest, attaching wires to the stickers and recording the electrical activity which is printed onto paper. No electricity is passed to the patient. The test takes about five minutes from start to finish, and the only discomfort can be in removing the ‘stickers’ at the end.
- Echocardiogram (ECHO). This is an ultrasound scan of the heart. This is done to look for heart muscle problems, holes in the heart, leaky valves and to measure the pump function of the heart. If you have been told you have a murmur, this is often the best test to see if this is an important murmur or an ‘innocent’ murmur. You lie (often on your side) on an examination couch and we use a cold jelly on the tip of a ‘’probe’ which is pressed against the chest to take pictures of the heart. This is very similar to the scan that pregnant women get of their babies, and even can make similar noises from time to time. The test can take anything from 15-30 minutes to perform. It should not be uncomfortable, just sometimes it is hard to lie still for the duration of the test.
- Exercise stress test. For this test we attach the same stickers and wires for the ECG as above, and then we get you to either walk on the treadmill or cycle an exercise bike while we watch your heart tracing. The treadmill gets a bit faster and steeper every 2-3 minutes, which gets your heart pumping quite fast, but most people don’t need to run to give us the information we need. On the bike the same effect is achieved by making the pedals stiffer every 2- 3 minutes. This helps us to look for any signs of reduced blood supply to heart muscle due to coronary artery disease (blockages or hardening of the arteries), and also can help bring on some changes associated with some of the electrical conditions such as Long QT and CPVT. We also monitor your blood pressure carefully while you exercise. We ask you to does much exercise as you feel comfortable with so we can see how your heart acts when put under a little pressure. Most people exercise between four and 12 minutes. We continue to monitor your heart as you recover for five to 10 minutes. This complete test takes approximately 20 to 30 minutes.
- 24-hour ECG (or Holter) uses a small box the size of a mobile phone, from which three or five leads (wires) are attached by sticky pads to your chest. The ECG monitor continuously records the heartbeat over 24 – 48 hours. Sometimes, if you have reported symptoms of palpitations or change in your heart beat, we may give you a monitor that you wear for six days (we give you extra stickers so that you can take them off to wash). Depending on where you live, we either ask you to drop the monitor back into us, or else post it back to us by registered post.