Diagnostic tests and procedures

Diagnostic tests and procedures

Diagnostic tests and procedures

Exercise stress tests

Exercise stress tests is used to assess the response of the heart and blood vessels to exercise. It will require you to walk on a treadmill.  A series of sticky dots (electrodes) will be positioned across the chest to allow monitoring during exercise. Your heart rate, blood pressure and symptoms will be assessed throughout the test. A cardiac technologist performs the test with supervision by a doctor. Some medications interfere with stress testing so it is important to discuss your medications with us when you make a booking. Please let our staff know if you have Diabetes or if you think you may have problems that will affect your ability to exercise or complete the test. Please wear a two piece outfit such as shirt and pants and comfortable shoes like runners. Please do not wear talc, body lotion or neck chains. The test will take approximately 30 minutes.  

Exercise stress echocardiogram

This test measures how the heart performs and its capacity to respond to exercise. It uses the combination of exercise by walking on a treadmill and performing an ultrasound of the heart after exercise has been completed. A series of sticky dots (electrodes) will be positioned across the chest to allow monitoring during exercise. Your heart rate, blood pressure and symptoms will be assessed throughout the test. Ultrasound pictures will be taken of your heart before you begin to exercise and immediately after the exercise test. Please let our staff know if you have Diabetes or if you think you may have problems that will affect your ability to exercise or complete the test. Please wear a two piece outfit such as shirt and pants and comfortable shoes like runners. Please do not wear talc, body lotion or neck chains. The test will take approximately 45 minutes.  

Dobutamine Stress Echocardiogram (DSE)

This is a variation of exercise stress echocardiography and is suitable for patients who cannot exercise on a treadmill or stationary cycle. 2 hours before having the test, you must have a light breakfast or lunch. It will involve lying on your side and on your back. A series of sticky dots (electrodes) will be positioned across the chest to allow monitoring the heart. Your heart rate, blood pressure and symptoms will be assessed throughout the test. A small intravenous cannula will be inserted into the vein in your arm. The drug called Dobutamine will be given through this cannula. Dobutamine mimics the effects of exercise on the heart. Symptoms such as headache, flushing or a thumping heart rate are often reported. Ultrasound pictures will be taken of your heart. Some medications interfere with this test so it is important to discuss your medications with us when you make a booking. Please wear a two piece outfit such as a button through shirt and pants. Please do not wear talc, body lotion or neck chains. The test will take approximately one and a half hours to complete and the cannula is removed from your arm when the test is completed. You should allow 10 minutes to rest before leaving our Department and someone will need to drive you home.

Transthoracic Echocardiogram

An echocardiogram (also called TTE or echo) is a procedure that uses high frequency sound waves or ultrasound to take pictures of the heart and is performed by a Cardiac Sonographer. It may take up to an hour to obtain images of the heart to assess the muscle, valves, chamber size and function. It can be used to assess known or suspected cardiac disease including symptoms of chest pain, shortness of breath, murmur and other symptoms. This is a painless procedure using an ultrasound probe or transducer with gel across the chest wall while the patient is lying down. No preparation is required however patients are asked to wear a button through shirt as undressing to the waist is required. Sometimes, patients are asked to move into different positions so better pictures can be obtained. The room lights can also be dimmed to reduce glare.

Electrocardiogram (ECG)

An electrocardiogram (ECG) is a graph showing the electrical signals or activity of the heart. It takes around 10 minutes to perform and requires a series of sticky dots (electrodes) to be positioned across the chest and one on each arm and on each leg while lying down. It is used to provide information about the heart’s rhythm and rate. This test can provide reasons for chest pain, palpitations and shortness of breath as it is able to detect abnormalities in the heart muscle. No preparation is required for this test but a button through shirt is always helpful. 

Holter monitoring

A Holter monitor is used to record the heart beat continuously for a 24 hour period and is attached to a series of sticky dots (electrodes) which are positioned across the chest attached to a small portable recorder. During the monitoring period, the equipment must stay connected to the body and cannot get wet, therefore, patients cannot shower, bath or swim during this time and are worn while sleeping. Monitors are fitted by a Cardiac Technologist and take around 20 minutes to connect and must be returned to the department the following day. Holter monitoring is used to investigate symptoms such as palpitations, fainting and dizziness. Usually an ECG is completed before the Holter Monitor is positioned onto the patient.

Event Monitoring

An event monitor records the heart’s activity and rhythm for a period for 48 hours and is attached to a series of sticky dots (electrodes) which are positioned across the chest attached to a small portable recorder. During the monitoring period, the equipment must stay connected to the body and cannot get wet, therefore, patients cannot shower, bath or swim during this time and are worn while sleeping. Monitors are fitted by a Cardiac Technologist and take around 20 minutes to connect and must be returned to the department after 48 hours. Event monitoring is used to investigate symptoms such as palpitations, fainting and dizziness and patient are asked to push a button to record or monitor the incident. Usually an ECG is completed before an Event Monitor is positioned onto the patient. 

Ambulatory Blood Pressure Monitoring

This measures blood pressure in patients who might have variable blood pressure. The portable blood pressure machine, worn in a pouch around your neck, has a cuff attached and is fitted by our Cardiac Technologist, to your upper arm. It takes approximately 10 to 20 minutes to fit. The machine is programed to inflate the cuff, take your blood pressure and release the air in cuff over a 24-hour period throughout the day and night. The machine’s computer stores the readings and a report is written and sent to your Doctor.  You should wear loose fitting clothes, especially around the upper arm. You are not required to undress fully. If possible, please wear a blouse or shirt which buttons at the front - this allows easier fitting of the equipment. The Technician will ask you to keep a diary recording symptoms you might experience while wearing the blood pressure machine. While the monitor is being worn, the device must be kept dry so no showering can occur. Both the diary and the machine will need to be returned the next business day to Diagnostic Cardiology, Level 1 at Bendigo Health. There is a cost associated with this test. Please speak to our friendly staff.

 

Pacemaker/ICD checks

Pacemakers are implantable devices that help the heart maintain an appropriate rhythm. After insertion by a Cardiologist, they require regular checking to ensure parameters are set correctly and that they are providing maximal benefit. A Pacemaker Technologist, Cardiologist or pacemaker specialist will perform the check at least once per year. Appointments are usually made well in advance and require an indefinite referral from your doctor.

Cardioversion (DCR)

Cardioversion restores normal heart rhythm (sinus rhythm) from an abnormal heart rhythm (atrial fibrillation). This can occur with medications or as a day procedure performed in Hospital and your Cardiologist will provide the referral. For day procedures; Blood tests will be required usually a week before your booking. A discussion about your medications will occur with our Cardiac Services Liaison Nurse. In particular, blood thinning medications must be taken without a dose missed in a 3 to 4 week period. Warfarin patients must have weekly blood tests to ensure that correct levels are present. Patients must ensure they are fasted before the procedure, organise transportation from Hospital and have an adult present overnight after the procedure. If this is not possible, please discuss with our Cardiac Services Liaison Nurse.