E.C.G.
What is it?
An E.C.G. (electrocardiogram) is a recording of heartbeats. It is the most common test performed to help a doctor decide on or in many cases eliminate a possible heart problem. It is a simple test that causes no pain and has no side effects. Following this test the results the doctor will discuss, with the patient, all of the tests performed (blood tests, chest X-ray, echocardiogram and E.C.G.)
Why is it done?
E.C.G.'s are performed for many reasons. Listed below are four of the most common reasons for recording an E.C.G.
To aid diagnosis of pain.
To know more about heart rhythm.
To examine the heart with a murmur. To examine the heart in patients who have high blood pressure to help form a diagnosis.
How is it done? |
Leads are placed on the chest and legs
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The technician - a person specifically trained to record the heart's activity, will ask the patient to remove their clothes from the waist upwards. Electrodes are attached to the arms, legs and chest with E.C.G. cream between the skin and electrodes. The patient then lies down and is told to completely relax as any movement will interfere with the recording. The recording will be printed out (example image on right). The whole process takes just 5 minutes. The technician, carrying out the procedure, will answer questions the patient may want to ask.
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Echocardiogram
What is it?
An Echocardiogram - usually called Echo is a scan of the heart using ultrasound (similar to a pregnancy scan). This is a routine painless test which has no side effects.
Why is is done?
The Echo obtains pictures of the heart as it is beating to give the doctor information about the structure, function and the blood flow.
- To verify that the patient has a normal heart
- To help identify the cause of the murmurs
- To help follow the progress of some heart diseases
- To help check the effectiveness of medication
- To check on the progress of patients after surgery.
How is it done?
The Echo is performed by a technician or a doctor and takes approximately 15 minutes. The patient is asked to strip to the waist and lie on a couch on their left side (making it easier to demonstrate the heart). A small transducer is covered with cold jelly and used to obtain images from different positions on the chest. When looking at the blood flow in the heart then machine makes noises which help with the interpretation of the scan. These noises are not indications of any abnormality. The patient can usually see the pictures as they appear on the screen. The technician or doctor records the pictures on a video tape and takes a series of measurements. Using the information from the pictures and the measurements a report of the Echo is ent back to the doctor who requested it so that he decides the best way to treat the patient.
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Echo machine
Output from echo machine
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Implantable Loop Recorders
What are they?
A revolutionary medical device that monitors the heart representing a breakthrough in the diagnosis of fainting. The Reveal Implantable Loop Recorder (ILR) can determine if fainting is related to heart rhythm problems n 94% of cases. Smaller than a pack of gum, the Reveal ILR is inserted just beneath the skin in the upper chest in a brief out-patient procedure that typically takes 15 to 20 minutes.
Why is it done?
The Reveal ILR captures an E.C.G. during the actual fainting (dizziness) episode, which allows the doctor to confirm or rule out an abnormal heart rhythm more definitively than other tests. There is the benefit as well in knowing if the cause of fainting is not heart-related because it enables the doctor to focus on other possible causes. Most importantly, diagnosing the cause of fainting (or dizziness) can lead to effective treatment more quickly.
How is it done?
Once a patients' events (usually up to three) have been successfully captured (using an activator over the Reveal ILR, a green light on the hand held device will confirm that an E.C.G. is being stored) a visit to the E.C.G. department is necessary to retrieve the stored E.C.G. from the Reveal ILR memory and analysed. Patients must telephone the department to confirm their visit, which may take up to 20 minutes. During this time , the technician will interrogate the loop recorder by placing a programming head over the site to download your events. These are printed out (and saved to disc) for further analysis by the doctor. These events will be cleared before leaving the department so further events can be stored. |
Implantable Loop Recorder
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24 Hour Tape Recordings
What is it?
A 24 hour tape recording sometimes called a Holter Monitor or Ambulatory Monitor is a means of recording your E.C.G. over a 24 hour period. This is a straightforward procedure with no side effects.
Why is it done?
The 24 hour heart recording is doe to see what your heart rhythm does when you are undertaking normal daily activities. Basic E.C.G.'s are very short and any heart problems may not manifest themselves during this time. Therefore 24 hour recordings are of more use. The method of diagnosis includes:-
- Assessment of your heart rhythm (fast or slow)
- To check if you medication is working
- To record any dizzy spells experienced.
How is it done?
The technicians will ask the patient to undress from the waist upwards and will then apply 4 electrodes to your chest and wires will be connected to these. These electrodes pick up your heart signal onto a cassette which is held in a small tape recorder (similar size to a personal stereo). You will be asked to record any events you may have on a diary and note the time down. This enables accurate analysis of the tape. The process takes about 5-10 minutes.Patients must not bath or shower whilst wearing this monitor.
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24 Hour Tape device. Several electrodes are attached to the chest and are connected to a recorder worn on the belt
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Exercise Testing
What is it?
Sometimes called an electrocardiogram (E.C.G.) or stress test and is basically and E.C.G. recorded whilst the pateint is on a treadmill.
Why is it done?
It may provide the doctor with important information about heart function during physical activity which cannot be detected on the resting E.C.G. They are predominantly performed on people with known or suspected heart disease or angina to assess the severity or possibility of further treatment.
How is it done?
Just as with a basic E.C.G. recording, the patient is asked to undress to the waist while electrodes are applied to the chest. Prior to the application of electrodes the skin will be cleaned (and/or shaved) with alcohol. The technician will make some recordings before the exercise is started. The doctor will also take blood pressure readings throughout the test.
The exercise
Use of a commercial treadmill determines your heart response to varying speeds and inclines (slope) which alters at 3 minute intervals in line with an internationally recognised programme of stages.The test may take up to 30 minutes. Patients should not have eaten a large meal prior to the test or smoked or drunk large amounts of fluid for about one hour prior to the test. Patients should also have with them any medication that they are taking, some of which (Beta-blockers) patients may have been advised to stop taking 48 hours prior.
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Excercise treadmill
ECG machine
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