Diagnostic tests for heart conditions

At Royal Brompton & Harefield Hospitals Specialist Care, our specialists diagnose, treat and care for adults and children with heart and lung conditions. There are various tests for heart conditions available to you.

Our high-quality diagnostic facilities have the latest technology. We offer a range of diagnostic tests and scans for heart conditions, including:

24-hour blood pressure monitoring

In order to get an accurate picture, our specialists may need to monitor your blood pressure over a 24-hour period.

In this case, you’ll be asked to wear a cuff around your arm that’s attached to a small monitor worn on a belt. The cuff will inflate and take readings every half an hour during the day and every hour at nightime. You will then return the monitor to the hospital so that the data can be transferred to your medical records.

Echocardiogram (including stress echo and transoesophageal echo)

An echocardiogram (also known as an ‘echo’) allows our heart specialists to see and monitor your heart structure. It is a still or moving image of the internal parts of the heart using ultrasound. From this, they can identify the exact size of your heart and see how well the valves are functioning at diagnosis, treatment and aftercare stages.

There are different types of echo:

  • A transthoracic echocardiogram (TTE) is the most common type of echocardiogram. In this case, the probe (or ultrasonic transducer) is placed on the chest or abdomen to get various views of the heart. The test is in a private room as you will be asked to remove your clothes from the waist up and then lie on an echo bed. Sometimes for an echo, the specialist will secure small electrode patches to your chest, which are attached to a machine that records the echoes of sound waves reflected by your heart. The test can take between 15 minutes and one hour.
  • A transoesophageal echo (TOE) takes detailed pictures of your heart from your oesophagus (the tube than connects your mouth to your stomach) which lies behind your heart. A very thin tube, attached to a transducer, is passed down the throat into the oesophagus. This test is used to get a closer and more defined image of the heart valves as it can detect things that are too small to be seen on a regular echo.
  • During an exercise stress test you will first undergo a standard echo so our specialists can obtain a clear picture of how your heart works when resting. Next, you’ll be asked to exercise using a treadmill or bike to raise your heart rate, before the echo test is performed again. The results will be compared by our heart specialists to understand how your heart copes with stress.

Electrocardiogram (ECG)

An electrocardiogram (ECG) measures the heart’s electrical activity and rhythm. It shows how fast your heart beats, whether your heartbeat is regular or not, and the strength and frequency of the electrical signals. It can be used to investigate symptoms of a possible heart problem, such as palpitations, chest pains, dizziness and shortness of breath.

For the test, small sensors are attached to your chest, arms and legs. These electrodes send signals to a machine which records the heart’s electrical activity on a graph. The test takes around 10 minutes to complete.

Holter monitoring (ECG tape)

A holter monitor (or ECG tape) is a small, battery-operated device that records the heart’s activity continuously for 24, 48 or 72 hours. It is worn around the waist or over the shoulder.

The device allows consultants to assess how well the heart is functioning at rest and when going about normal daily activities. The test can help to check for an irregular heartbeat, identify palpitations or heart flutters, evaluate a pacemaker or effectiveness of medication, and other similar reasons.

Following the test, the results can help the consultant and the patient decide if medication should be changed, if more tests are required, or if a procedure is needed to restore regular heart rhythm.

Transtelephonic event recorders

At Royal Brompton & Harefield Hospitals Specialist Care, we use transtelephonic event recorders to electronically capture the heart’s activity and understand various heart conditions. It is often used to diagnose and understand atrial fibrillation and tachycardia.

In one transtelephonic event recorders, the monitor is placed over the heart and a button is pressed. The data is transmitted to our receiving centre via the telephone. The other is worn continuously to identify symptoms that are difficult to diagnose.

Pacing check

A follow-up check for a single or dual chamber pacemaker or defibrillator is also known as a ‘pacing check’.

Ongoing care for all our heart patients is key to our values. After a cardiologist fits a single or dual chamber pacemaker, a chest x-ray will assess the position of the pacemaker. Routine follow-up pacing checks then take place every two, three or six months, or on a more regular basis if required. This allows your consultant to understand the condition of your heart and whether it’s being correctly assisted by your pacemaker.

Cardiopulmonary exercise testing (VO2 max)

The ‘VO2 max’ test is used to understand the maximum volume of oxygen your heart is able to deliver to your muscles during continued activity. Understanding your VO2 max score will allow our specialists to get a true measure of your heart’s stamina.

The test is straightforward. Just as with an ECG, small electrodes are stuck to your chest and a small clip-on monitor is placed on the end of your finger. Next, your nose will be closed using a padded clip and you will be asked to walk on a treadmill or pedal on an exercise bike while breathing into a tube.

Imaging tests

Consultants at Royal Brompton & Harefield Hospitals Specialist Care can use a range of imaging tests to build a more detailed picture of your heart and lungs:

  • Chest x-ray: A chest x-ray allows us to get a picture of your lungs, heart, large arteries, ribs and diaphragm. You will be asked to hold your breath during the x-ray and most often two will be taken.
  • Computed tomography (CT) scan: A CT scan is a special imaging test that allows us to build detailed pictures  of your heart and lungs. You will lie on a bed as it moves through a scanner and will be asked to hold your breath whilst the scan is taken.
  • Cardio Magnetic Resonance (CMR) scan: A CMR scan provides detailed images of the heart function and structure, by using strong magnetic and radio waves. You will lie on a bed as it moves through the scanner. You will be asked to keep still and to hold your breath during the scan.
  • Nuclear medicine: Nuclear medicine can be used in the diagnosis of heart or lung conditions by injecting a special substance with radioactive properties into the blood. Known as a ‘tracer’ this substance helps to  highlight the part of the body being scanned.

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