An electrocardiogram, or ECG, records the rhythm and electrical activity of your heart. If your GP (family doctor) thinks that you may have heart disease or a heart problem, he or she may refer you to the Balfour Hospital for an electrocardiogram. The test is carried out in the X-ray department. Some people have an ECG before having an operation. Others have one as part of a routine health check-up, even if there is no suspicion of heart disease.
What happens?
Several small patches, set in sticky plaster, are put on your arms, legs and chest and connected to a recording machine. The patches, called ‘electrodes’, are connected to wires which lead to the ECG recorder. This recorder picks up the electrical signals produced by each heartbeat. The machine records a few beats from each set of electrodes onto paper.
The ECG machine only records signals from your body. It does not give electric shocks and does not affect your heart in any way. The whole test takes about five minutes and will not be uncomfortable at all.
What can the test show?
An ECG can detect problems with your heart rhythm. It can show if you have had a heart attack, either recently or some time ago. It can also tell if your heart has become enlarged or is working under strain.
The ECG is a simple and useful test but it has some limitations. An abnormal reading does not always mean that there is something wrong. On the other hand, some patients who have serious heart disease may have a normal ECG.
Exercise Tolerance Test
Also known as an E.T.T., exercise ECG, exercise electrocardiogram, exercise electrocardiography or exercise stress testing.
What is an E.T.T.?
An E.T.T. test is a common way to measure how your heart and blood vessels respond to exercise.
How does it work?
In NHS Orkney a treadmill test is used. Before the test takes place a staff member will place a dozen small electrodes onto your upper chest. This is called an ECG which records your heart’s electrical activity.
A blood pressure cuff, wrapped around your upper arm, will record your blood pressure levels.
During the test, you will be required to walk on a treadmill with the speed and gradient of the treadmill increasing every 3 minutes. The length of test depends on your physical condition and can be stopped at your request at any point during the procedure. The test may stop early if the doctor believes it is unsafe for you to continue.
While you are exercising the doctor looks for changes in the ECG patterns and blood pressure levels. It also provides important information on how the heart is functioning and if it is receiving an adequate blood supply.
Who needs a tolerance test?
The doctor may have you take an E.T.T if:
You have symptoms of heart disease
You have heart disease
You have had a heart attack
You have had coronary bypass surgery or a balloon angioplasty
Instructions prior to your tolerance test:
Wear comfortable, loose fitting clothing, flat shoes or trainers.
Maintain an adequate fluid intake over a 24 hour period before the test.
Avoid food, tobacco, alcohol and caffeine for 3 hours before taking the test, but if you have a morning appointment please do have a light breakfast.
Avoid exercise or strenuous physical activity the day of the test.
Get an adequate amount of sleep (6 to 8 hours) the night before the test.
Take your normal prescribed medication, unless you are given specific instructions from your doctor to do otherwise.
You may feel quite tired after the test and may wish to have someone to accompany you and to drive you home afterwards.
If you normally use GTN tablets or a spray for relief of angina, then bring these with you.
If you have forgotten to take any of your regular medications or have run out of your prescription, don’t exercise. Report to the medical staff.
If you have a sore throat, a cold, flu, a chest infection or are feeling unwell then do not come in.
Preparation and the test will take at least half an hour.
Where do I go?
The Exercise Tolerance tests are conducted in the Day Hospital at the Balfour Hospital. The entrance to the St Magnus Day Hospital is at the Ninian car park.
24-hour ECG recordings
Also know as Holter monitoring
This technique involves continuously recording an electrocardiogram (ECG) over 24 hours. It is usually done as an outpatient. This test can help to diagnose symptoms such as palpitation, which don’t happen very often and which rarely happen in the doctor’s surgery.
What happens?
You’ll need to make two visits to the hospital – once to have the recorder fitted and once to return it.
Small patches, set in sticky plaster, are put on your chest. Wires are attached to these and are taped down. The wires lead to a small portable tape recorder, similar to a personal stereo, which you wear on a belt round your waist. The whole system is very comfortable and quiet so you should hardly be aware of it. You can do everything you normally do, except have a bath or shower. It is best to wear loose clothing.
The doctor will ask you to spend a normal day and do any activity which might bring on your symptoms. You will also nee to keep a simple ‘diary’, writing down what activities you do and when, and making a note of any times when you have symptoms such as palpitations or dizzy spells. When you write down the times, remember to say whether you mean morning or afternoon day or night. When the ECG is analysed later, the doctors will pay special attention to the recordings at these times. That is why it is important to fill in your diary accurately.
What can the test show?
A 24-hour ECG recording can give a lot of useful information. For example, it can show if you may need treatment. It can also reassure you if you think you have palpitations but are in fact just ‘over-aware’ of your normal heartbeat.
Echocardiogram
This information is for patients having an ultrasound scan of the heart – known as an echocardiogram or “ECHO”. It explains what the scan involves and any significant risks there may be.
What is an echocardiogram?
It is a scan of the heart using ultrasound (that is, sound waves – not x-rays). It produces pictures of the heart as it is beating and shows the blood flowing through the heart valves.
Why are you having it?
The pictures of the beating heart are produced on a screen monitor, so the Doctor can tell whether or not the heart muscle is contracting properly and the heart valves are working normally. Other heart problems may also be identified.
Do you need any preparation?
No preparation is needed for this test. You can continue to take your usual medications unless instructed otherwise by the doctor.
What does it involve?
An echocardiographer (a technician) or doctor will usually do the scan. Please do not hesitate to ask any questions you may have about the test.
The scan takes place in a private room.
You will need to remove your clothes to the waist, and lie on a bed or couch.
Wires with sticky pads are attached to your chest to monitor your heart rate.
The technician/doctor will move a small, handheld ultrasound probe, with some gel on the end, over your chest. This will transmit pictures onto a screen and record them on a videotape or computer discs.
You may hear some whooshing sounds – these come from blood pulsing through your heart.
The scan can take 20 – 40 minutes.
After the test
You can get dressed again and resume your normal activities.
Results
The results of your echocardiogram will be sent to the doctor who requested the scan.
Are there any risks?
This is a very safe test: there are no known risks.
