Heart Tests

Electrocardiogram (ECG)

This is a test that your doctor will do to record the electrical activity of your heart. You will be lying on your back for few minutes, while few sticky patches will be applied to your chest, your arms and legs. Several wires will be then attached to the patches and your ECG will be instantaneously recorded. There is no radiation involved in this scan, it is not a painful test and does not require sedation.

This is a useful test to check:

  • the heart rate
  • the heart rhythm
  • whether there is an arrhythmia
  • whether your chest pain is angina

Coronary angiogram

This is an invasive procedure during which contrast (dye) is injecting inside the arteries of the heart to check for partially or totally blocked arteries. This is a test that your doctor will request if there is a suspicion that your chest pain is angina. If there is a blocked artery the doctor doing the procedure will inform you and if possible proceed to open the artery with a stent.  This test involves radiation. It is usually not painful, as it is done under local anaesthetic applied near the wrist or in the groin, through which a small tube is inserted inside the artery. Sedation is not required in most cases. This procedure has some risks, which you should discuss with your doctor beforehand. This test involves the use of contrast (dye), so people with allergy to contrast should inform their doctor before having the test.

This is a useful test to check:

  • whether the chest pain is of cardiac nature (angina)
  • to improve the blood supply to the heart (if a stent is applied)
  • to check the arteries before a patient undergoes another heart operation (valve operation)

Echocardiogram (Echo)

This is an ultrasound scan of your heart. You will be lying on your back and your left side for about 20-30min while the person who is performing the scan is screening your heart and does all the measurements. You will have to undress from the waist up. The test is done with the use of a plastic probe which will be in contact with your chest. Ultrasound gel is also used to cover the probe. It is a similar scan to the ultrasound scan done during pregnancy. There is no radiation involved in this scan, it is not a painful test and does not require sedation.

This is a useful test to check:

  • the heart dimensions
  • the heart function (is the heart weak or not? is the heart stiff? Is there fluid around the heart?)
  • the function of the valves
  • congenital abnormalities of the heart (problems which you were born with)
  • the anatomy of the aorta (the large artery that receives blood from the heart)

24h ECG monitor/tape

This is a recording device that records the ECG for 24 hours. The ECG is stored on the tape, which is then analysed by a computer. You will have to visit the cardiology department to have the 24h tape fitted (usually in the morning). This involves some sticky patches applied on your chest and a tape secured on a belt, which you are expected to wear for 24 hours. After the monitor is fitted, you will be able to continue with your daily life as usual, while the device is recording your ECG. There is no radiation involved in this scan, it is not a painful test and does not require sedation. You will not be able to shower while have the monitor on. Lately, there are new monitors available, which can record your ECG for up to 14 days. Some of these monitors are in the form of a single patch, with which you can shower.

The ECG monitor is a useful test to check:

  • what is causing your palpitations
  • what is the heart rate over a 24h period
  • whether there are “silent” arrhythmias happening
  • whether your heart rate control drugs are effective

Cardiac MRI

This is a test that is performed with the help of an MRI scanner. You will be lying on the MRI table for 30-45min, while the scanner is collating images of your heart. The table moves inside the MRI tunnel for the test. There is no radiation involved in this scan, it is not a painful test and does not require sedation. However, the MRI is narrow, therefore this test is not recommended for people who are claustrophobic.

This is a useful test to check:

  • the heart dimensions accurately
  • the heart function accurately (is the heart weak or not? Is there fluid around the heart?)
  • the function of the valves
  • congenital abnormalities of the heart (problems you were born with)
  • the anatomy of the aorta (the large artery that receives blood from the heart)

CT coronary angiogram

This is an alternative test to the invasive coronary angiogram and is used for the same purposes. Instead of undergoing the procedure in the cath lab, this test is carried out at a radiology department with a CT scanner. For this test, you will be lying on a table for about 30min. A small cannula will be inserted in a vein of your hand, through which the contrast will be injected. The table will move inside the CT scanner “ring” and images of the arteries of your heart will be obtained. This test involves radiation, it is not a painful test and does not require sedation. However, it involves the use of contrast (dye), so people with allergy to contrast should inform the doctor before having the scan.

This is a useful test to check:

  • whether the chest pain is of cardiac nature (angina)
  • for blocked arteries before a patient undergoes another heart operation (valve operation)

24h Blood Pressure (BP) monitor

This is a recorder that records the blood pressure over a period of 24 hours. The measurements are usually taken every 30min and are stored in a tape. As with the 24h ECG monitor, you will have to visit the cardiology department to have the BP monitor fitted (usually in the morning). This involves a blood pressure cuff applied on your arm and a tape secured on a belt, which you are expected to wear for 24 hours. After the monitor is fitted, you will be able to continue with your daily life as usual, while this is intermittently recording your BP. There is no radiation involved in this scan, it is not a painful test and does not require sedation. You will not be able to shower while have the monitor on.

The BP monitor is a helpful test to check:

  • whether you have elevated BP (hypertension) and requires treatment
  • whether the treatment is effective
  • whether you suffer from “white coat” hypertension