Frequently Asking Questions

When You Need to Have a Stress Test

A stress test is an objective way of determining your exertional capacity. It can be used for many reasons. By far the most common use is to assess the cause for a patient complaint such as chest pain or shortness of breath on exertion. Additional appropriate uses of stress tests occur after heart attack, angioplasty, or bypass surgery to assess safe exercise capacity, or prior to starting an exercise program for someone at high risk of problems. Such tests permit your doctor to design an appropriate regimen for you, to determine if your medications are at optimal level for your protection, or if you are at an unusually high risk for cardiovascular events.

If you have already been diagnosed with coronary heart disease (CAD), a stress test may enable the doctor to estimate the severity of the blockages. Likewise, if you have just undergone balloon angioplasty or bypass surgery, a stress test helps the doctors monitor the success of the procedure as well as determine an appropriate rehabilitation program for you.

Electrocardiogram

An electrocardiogram (ECG or EKG) is a test that checks how your heart is functioning by measuring the electrical activity of the heart. With each heart beat, an electrical impulse (or wave) travels through your heart. This wave causes the muscle to squeeze and pump blood from the heart. An ECG measures and records the electrical activity that passes through the heart. A doctor can determine if this electrical activity is normal or irregular. An ECG may be recommended if you are experiencing arrhythmia, chest pain, or palpitations and an abnormal ECG result can be a signal of a number of different heart conditions.

An ECG is used to:
  • Detect abnormal heart rhythms that may have caused blood clots to form.
  • Detect heart problems, including a recent or ongoing heart attack, abnormal heart rhythms (arrhythmias), coronary artery blockage, areas of damaged heart muscle (from a prior heart attack), enlargement of the heart, and inflammation of the sac surrounding the heart (pericarditis).
  • Detect non-heart conditions such as electrolyte imbalances and lung diseases.
  • Monitor recovery from a heart attack, progression of heart disease, or the effectiveness of certain heart medications or a pacemaker.
  • Rule out hidden heart disease in patients about to undergo surgery.
What to expect

An ECG is a non-invasive procedure, which means that nothing is injected into the body. It is painless. A number of electrodes – usually a total of 12 to 15 – are attached to various locations on your body including your arm, leg and chest. The electrodes are attached by small suction cups or adhesive patches. Sensors in the pads detect the electrical activity of your heart.The test is usually performed while you lie still. Results are most often recorded on graph paper and interpreted or read by your doctor or a technologist. The test usually takes 5 to 10 minutes.

If you require more detailed information, check with the facility where you are having your exam.

How to prepare

You do not have to restrict what you eat or drink before your ECG, although it is recommended that you not smoke just before the test. You will be asked to remove your jewelry and wear a hospital gown.

Echocardiogram

An echocardiogram (ECHO) uses sound waves (ultrasound) to create a picture of your heart. The recorded waves show the shape, texture and movement of your heart valves, as well as the size of your heart chambers and how well they are working. An ECHO may be done to assess a variety of heart conditions, such as heart murmurs, damage to heart muscle in those who have had a heart attack, and infections in the heart. It may also be recommended if you are experiencing abnormal heart sounds, shortness of breath, palpitations, angina (chest pain) or have a history of stroke. It is very useful in diagnosing heart valve problems.

What to expect

A gel is placed on your chest to help transmit the sound waves and a transducer (a unit that directs sound waves) is moved over your chest. This test involves no pain or discomfort. A typical test takes about 15 to 45 minutes.

How to prepare

For a regular echocardiogram, no special preparation is needed. If you have questions, it is best to check with the centre where you are having your test for specific information about how to prepare.

Holter monitoring

Holter monitoring is usually used to diagnose heart rhythm disturbances, specifically to find the cause of palpitations or dizziness. You wear a small recording device, called a Holter monitor, which is connected to small metal disks (called electrodes) that are placed on your chest to get a reading of your heart rate and rhythm over a 24-hour period or longer. Your heart’s rhythm is transmitted and recorded on a tape, then played back into a computer so it can be analyzed to find out what is causing your arrhythmia. Some monitors let you push a record button to capture a rhythm as soon as you feel any symptoms.

Event monitoring

Like a Holter monitor, an event monitor also uses a recording device to monitor your heart, although it uses a smaller monitoring device. One such device is the size of a beeper; another is worn like a wristwatch. Unlike the Holter, it does not continuously monitor your heart over a 24-hour period. It doesn’t record until you feel symptoms and trigger the monitor. When you feel the symptoms of an arrhythmia, you can telephone a monitoring station, where a record can be made. Or, if you cannot get to a phone, you can save the information in the event monitor, which can later be sent to a monitoring station.

What to expect

Setting up the monitor only involves a few minutes and then you can go about your regular daily activities. You may be asked to write down any symptoms you have while wearing the monitor so your heartbeat at that particular time can later be analyzed.

How to prepare

It is best to check with the centre where you are having your test for specific information about how to prepare.

Exercise electrocardiogram (Stress test)

An exercise electrocardiogram (ECG) records your heart’s response to the stress of exercise. An exercise ECG measures your heart’s electrical activity, blood pressure and heart rate while you exercise, usually by walking on a treadmill.

It is usually done to pinpoint the cause of unexplained chest pain, especially if coronary artery disease (heart disease) is suspected. If you have been diagnosed with coronary artery disease, you may be given an exercise ECG to determine how far the disease has progressed and how much exercise you can do safely. If you have had a heart attack or heart surgery, it can help determine how much work or exercise you can do safely. It may also be recommended if you are experiencing irregular heartbeats (arrhythmia), very fast or slow heartbeats (tachycardia or bradycardia), palpitations (unusual throbbing or fluttering sensations in the heart), dizziness or excessive fatigue.

What to expect

An exercise ECG is usually done in a clinic or hospital. You will be asked to walk on a treadmill (or sometimes pedal a stationary bicycle). Small metal electrodes are attached to your chest, then you will either begin by walking slowly or pedalling. As you walk, a technician will monitor your heart’s activity and rate, your breathing and blood pressure. Gradually the speed of the treadmill is increased so you have to walk more quickly. This will help your doctor see how your heart handles progressively greater challenges. The test continues until your heart is beating as fast as it safely can (you reach your peak exercise capacity, given your age and condition), or until you experience chest pain. It is generally a safe procedure, although it may trigger chest pain or irregular heart rhythms. Be sure to let someone know if you are feeling any discomfort or other symptoms. The length of time for the test is usually between 15 and 30 minutes.

How to prepare

Wear clothing and shoes that are comfortable for exercising. You’ll probably be told not to eat for at least two hours before the test. If you’re a smoker, you’ll also need not to smoke for at least two hours before the test. Talk to your doctor about any medications you are taking. If you have questions, it is best to check with the centre where you are having your test for specific information about how to prepare.

Important notice

To make a diagnosis, your doctor will most likely need to review your medical history. He or she may also want to run a few other tests before discussing your symptoms and recommending treatment.

When you  visit us by appointment:

  • Bring your valid health card.
  • Please provide us with 24 hours notice for cancellation.
  • Please bring a complete list of your medications to all tests.
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Cardiac Event Loop Recorder

The Cardiac Event Loop Recorder  is a revolutionary diagnostic and monitoring tool with 1 or 3-lead ECG recording. It’s small, lightweight, wearable and highly innovative. Heart patients remain mobile and have a normal daily life while they are constantly monitored without the need for an invasive procedure. Patients can be monitored during exercise, anywhere, anytime.

The recorder monitors the heart rhythm continuously using ECG electrodes. It only records an ECG if the patient pressed the record button or if it automatically detects a cardiac arrhythmia, which is previously set in the menu.

The last makes the recorder highly efficient in use because it is possible to note asymptomatic arrhythmias.

The ECGs from the Cardiac Event Loop Recorder are sent to the Tele-ECG receiver via Bluetooth and mobile phone. The transmission of ECGs is done automatically after each ECG, without the intervention of the patient.

The Event Loop Recorder allows up to 15 ECGs in memory. With the automatic transmission of ECGs the memory of the Event Loop Recorder is not exhaustive and the recorder actually has a virtually unlimited memory.

The Cardiac Loop Event Recorder is able to automatically detect the following arrhythmias:

  • tachycardia cardiac abnormalities
  • bradycardia cardiac abnormalities
  • atrial fibrillation (AF)
  • ventricular tachycardia (VT)
  • cardiac pauses (asystoles)

 

The automatic detection of one or more of these arrhythmias is managed and programmed in the setup menu of the recorder.

The duration of the recordings is also set in the menu, the so-called pre-event and post-event period. Total duration of the recordings vary between 40 seconds and 7 minutes.

The recorder also includes a timer interval option it can be set between 1 and 99 hours. And will automatically record an ECG according to the setting.

Furthermore the recorder alerts if it does not receive a good signal from the electrodes.

The device can, depending on the settings, be used continuously for 14 to 28 days, and this duration is only limited by battery life (standard batteries).

In summary, the Cardiac Event Loop Recorder offers unique monitoring capabilities of cardiac arrhythmias that no other device on the market have to offer.