E.C.G. (Electrocardiogram) An E.C.G. records the electrical activity of the heart and can give an indication of ischaemia (lack of blood supply to the heart muscle). A 12 lead E.C.G. gives more information as it records the electricity from 12 angles through the heart. The heart is very resilient and changes do not always show immediately, a series of E.C.G.’s will give information that can be compared to a previous E.C.G. reading which will give a fuller picture to help the doctor with the diagnosis.

This is the equipment used to record an ECG (electrocardiogram)

Stress Test A stress test is sometimes referred to as a treadmill test or exercise tolerance test (ETT). The patient has a 12 lead E.C.G. recorded whilst walking on the treadmill. The test is carried out over five three-minute cycles with blood pressure recorded at each stage (called the BRUCE protocol). At each stage the treadmill elevates and increases speed, this allows a physician to have a recording of how the heart performs and the level of ischaemia (lack of blood supply) caused by exercise. The test is classed as negative, positive or inconclusive. It is usually classed as inconclusive if the patient is unable to walk very far, often due to arthritis or other complaints that restrict their mobility. If the patient is unable to achieve their target heart rate the doctor won’t have enough information to assess the results. Alternatives are available when medication can be used to increase the heart rate whilst the patients heart is monitored by a twelve lead ECG. This information is used by the cardiologist or consultant physician to decide if any further investigations are required.

This is the treadmill where you have an exercise tolerance test

Echocardiogram An echocardiogram is an ultrasound scan of the heart. Jelly is applied to the chest wall and an ultrasound probe is placed on the chest wall to build up a picture of the function and structure of the heart. It can measure the effectiveness of the pumping action of the heart and how efficiently the heart valves are working. This investigation is done as an out patient appointment.

This is the equipment used to record an echocardiogram

Angiogram This is carried out by injecting a dye which can be seen on X-ray into the coronary arteries via a catheter (tube) which is fed into the femoral artery (groin) or brachial artery (arm). The area is first treated with local anaesthetic. A series of x-rays are taken to determine the percentage of narrowing of the three branches of the coronary artery. This investigation is usually done as a day case, but occasionally an overnight stay in hospital is necessary; usually if the test has been done in the afternoon.

This is a catheter Lab, where you undergo an angiogram