Cardiology

ELECTROCARDIOGRAM ( ECG )

What is an Electrocardiogram (ECG)?
An Electrocardiogram (ECG) records the rhythm and electrical activity of the heart.

How do I prepare for the test?
There is no special preparation required. However, wearing clothing that gives easy access to the chest is helpful. You should come as you are and eat or drink as you normally do. If you take medications, you should continue to take them as normal unless your doctor specifies otherwise.

How much time the test will take?
The test takes about 10 minutes but expect to be at Medical Supervision for 30 minutes.

What happens during the test?

  • You will be escorted into an ECG room by a Cardiac Physiologist (technician).
  • You will be asked to remove all clothing covering your chest
  • You will lie down quietly on a bed. The cardiologist will place 6 small adhesive electrode pads across your chest from your lower breast bone (sternum) to an area below your left armpit. Other pads will be placed on each of your arms and legs. It may be necessary to shave some chest hair from men to obtain better adhesion. Insulated wires will connect each of these 10 pads to the ECG machine. Once these wires, called "leads," are attached, the ECG records a few heartbeats on a single sheet of graph paper. You will not feel anything while ECG is being recorded.

What are the risks from the test?
There are no risks from the test.

What happens after the test?
The cardiologist will interpret the recording and will then provide your physician with a written report.

 

EXERCISE STRESS TEST

Why do I need an Exercise Stress Test?
An exercise stress test helps your doctor find out how well your heart handles work. As you walk on the treadmill, an electrocardiogram (ECG) will check your heart’s electrical activity. The ECG may show if your heart lacks blood flow or has abnormal heartbeats during exercise. The test helps your doctor decide if you need further tests to evaluate your heart.

How do I prepare for the test?
• 
If you take medications, you should continue to take them as normal unless your doctor specifies otherwise.
• Wear loose comfortable clothing with a separate top and bottom. Wear comfortable, flat shoes that will not slip off while you are walking.  
• Do not eat 2 hours before the test and do not drink liquids 1 hour before the test.

How much time the test will take?
The test will last 30 minutes but expect to be at Medical Supervision for 45 minutes.

What happens during the test?
You will be escorted into an Exercise Stress room by a Cardiac Physiologist (technician).
You may be asked a few questions by the Cardiac Physiologist who will want to know why you are having the test, if you have had previous tests and if you have ever had open heart surgery. A brief explanation of the procedure will be given as well.
You will be asked to remove all clothing covering your chest. Females will be given a gown to wear during the test. 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).

After the test is concluded, your blood pressure and heart rhythm will continue to be monitored as they return to normal.

What are the risks from the test?
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.

What happens after the test?
You can eat and drink as usual.

The exercise ECG recordings will be submitted to our Cardiologist who is a specially-trained physician in reading these recordings. He or she will interpret the recordings and will then provide your physician with a written report. The Cardiac physiologist will not provide you with any results at the time of the test. 

 

HOLTER MONITOR

What is a Holter Monitor?
A Holter monitor is a device that records the heart rhythm continuously as you go about your normal routine. The monitor can be worn for 1 to 7 days (depending on your referring doctor's instruction). 

How do I prepare for the test?
There is no special preparation required. However, wearing clothing that gives easy access to the chest is helpful. You should come as you are and eat or drink as you normally do. If you take medications, you should continue to take them as normal unless your doctor specifies otherwise. Make sure you shower before you start the test as you will not be able to do so while you are wearing a Holter monitor.

How much time the test will take?
Please expect to be at Medical supervision for 30 minutes to be fitted with a Holter monitor. 

What happens during the test?
You will be fitted with a Holter monitor by our Cardiac Physiologist. Three self-adhesive patches will be attached to the skin on the chest. These are then connected by wires to the monitor. You carry the Holter monitor in a pocket or small pouch worn around your neck or waist. The monitor is battery operated. Our Cardiac Physiologist will start the monitor and tell you how to replace the electrodes should they fall off or become loose. It is very important for you to keep a diary of symptoms. The diary should include the date, time of day, type, and duration of symptoms. This will allow the Cardiologist to correlate symptoms with the ECG recording at that precise time. Our Cardiac Physiologist will also explain to you how to take off the monitor and how to return it to us. 

What are the risks from the test?
There are no known risks from the test. Some patients are sensitive to the electrode adhesive, but no serious allergic reactions are known. If you have redness/itching or are uncertain please remove the electrode adhesive and contact us.

What happens after the test?
The Holter recordings will be submitted to our Cardiologist who is a specially-trained physician in reading these recordings. He or she will interpret the recordings and will then provide your physician with a written report.

VASCULAR SCAN

What is a Vascular Ultrasound Scan?
The examination is an ultrasound scan in which special attention is paid to the blood vessels. The scan is sometimes called a ‘duplex ultrasound’ or ‘Doppler ultrasound scan’. The vessels most commonly examined are the arteries or veins in the neck, arm leg or abdomen.

How do I prepare for the test?
There is no special preparation required. You should come as you are and eat or drink as you normally do. If you take medications, you should continue to take them as normal unless your doctor specifies otherwise.

How much time the test will take?
The test will last 30 minutes but expect to be at Medical Supervision for 45 minutes. 

What happens during the test?
During the ultrasound scan you will either lie or sit on a couch, or stand on the floor. The room will be partially darkened to enable the person performing the scan to see the monitor. You will be asked to partially undress to allow the area of interest to be scanned. A clear, water-soluble gel is put on the skin and an ultrasound probe is slid over the skin of the area to be examined. The instrument causes no pain. You may be asked to change position during the scan.

What are the risks from the test?
There are no risks from the test.

What happens after the test?
The ultrasound recordings will be submitted to our Vascular Surgeon who is a specially-trained surgeon in reading these recordings. He or she will interpret the recordings and will then provide your physician with a written report. The Vascular technician will not provide you with any results at the time of the test. 

ECHOCARDIOGRAM

What is a Transthoracic Echocardiogram (Heart Ultrasound; Echocardiogram; Echo)?
Echocardiogram uses ultrasound waves to produce moving pictures of your heart that allows health of your heart to be evaluated.

How do I prepare for an echo?
There is no special preparation required. However, wearing clothing that gives easy access to the chest is helpful. You should come as you are and eat or drink as you normally do. If you take medications, you should continue to take them as normal unless your doctor specifies otherwise.

How much time the test will take?
The test will last 30 minutes but expect to be at Medical Supervision for 45 minutes.

What happens during the test?
You will be asked to remove all clothing over your chest. Females will be given a gown to wear during the test.  
Three electrodes will be attached to your chest to record an electrocardiogram at the same time. This is an aid for reading the echocardiogram.
During the test, you will lie comfortably on a bed. From time to time, you may be asked to move into different positions.  
A small probe, called the transducer, will be gently placed on various positions of the chest, to obtain the images of heart in real-time. Because the sound waves do not readily pass through air, a clear jelly-like substance will be applied between the chest and the transducer to improve the contact of the transducer with the skin. As transducer will move over heart you may hear a “whooshing” sound. This sound relates to the movement of blood within your heart.

When all the necessary information is obtained, the electrodes and jelly will be removed.

What are the risks from the test?
The echocardiogram has no known risk.

What happens after the test?
The ultrasound images and Doppler recordings will be submitted to a Cardiologist who is a specially-trained physician in reading heart ultrasounds. He or she will interpret the images and will then provide your physician with a written report. The Cardiac physiologist will not provide you with any results at the time of the test.