Investigations Services


This is a recording of the electrical activity of the heart. An electrocardiogram is a non-invasive test that is used to reflect underlying heart conditions by measuring the electrical activity of the heart. By positioning leads (electrical sensing devices) on the body in standardized locations, information about many heart conditions can be understood by looking for characteristic patterns on the ECG. Electrodes are placed on the skin of the chest and connected in a specific order to an ECG machine thatmeasures electrical activity over the heart.


An Ambulatory Blood Pressure Monitor (ABPM) measures your blood pressure at set intervals as you move around, living your normal daily life. It is normally worn over 24 hours. It uses a small digital blood pressure machine that is attached to a belt around your body and which is connected to a cuff around your upper arm. It is small enough so you can go about your normal daily life and even sleep with it on. The device records your blood pressure every 30 minutes during the day and every 45 minutes overnight. Some patients state that their blood pressure is elevated when they see their doctor so this test is effective in determining whether an elevated blood pressure seen in the doctor’s surgery is an ongoing problem. A normal Ambulatory Blood Pressure Monitor reading will show blood pressure readings less than 125/75 mmHg during the day with a blood pressure drop to less than 110/70 mmHg overnight. Persistently elevated blood pressure overnight is a problem with requires addition blood pressure medications.


Holter monitors are small, portable electrocardiogram devices that record your heart’s electrical activity for long periods of time while you do your normal activities. These monitors can record how fast your heart is beating, whether the rhythm of your heartbeats is regular or irregular, and the timing of the electrical impulses passing through each part of your heart. Information from these recordings helps to diagnose various types of arrhythmia, or irregular heartbeat(s), and is also useful to check whether treatments for these arrhythmias are effective. We now have waterproof monitors which allow patients to shower and even swin with the monitor on. Your cardiologist will determine whether you are suitable for a waterproof monitor if Holter monitoring is required.


An echocardiogram is a diagnostic test that uses ultrasound waves to create an image of the heart muscle. Ultrasound waves that rebound off the heart can show the size,shape and movement of the heart’s valves and chambers as well as theflow of blood through the heart. It is one of the most widely used diagnostic tests in the assessment of heart disease.

It can provide a wealth of helpful information, including the heart’s pumping strength and the location and extent of any damage to its tissues. It is especially useful for assessing diseases of the heart valves. With this investigation, we are, for example, able to evaluate and detect abnormalities in the pattern of blood flow, such as the backward flow of blood through leaky heart valves, known as valvular regurgitation.

Echocardiography may show such abnormalities as poorly functioning heart valves or damage to the heart tissue from a past heart attack.


An Exercise Stress Echocardiogram measures the function of the heart muscle under physical stress. It is done to help diagnose blocked arteries in the heart (coronary artery disease) and may also provide specific information about valvular heart disease as well as provide an assessment of the pressure in the heart and lungs.

There are two parts to this test. First, a cardiac scientist performs an echocardiogram using an ultrasound machine. An echocardiogram checks how your heart functions at rest. You lie on your left side. To ensure good contact between your skin and the probe, surgical jelly is placed at several different sites on your chest. During this part of the test you may hear loud swishing noises. This is the blood flowing through the valves of your heart.

In the second part of the test, your heart is exercised or ‘stressed’. This is performed with your walking as gradually increasing speeds and inclines on a treadmill. The speed and slope of the treadmill will increase every 3 minutes. This makes your heart gradually do more work and by the end of this test you will have exercised quite hard. The test will be stopped if you have chest pain, become very tired or have significant shortness of breath (puffed). When you cannot exercise any longer you will be asked to stop exercising and quickly lie back down onto the bed. More echocardiogram pictures are taken. Comparing the pictures before and after exercise helps us determine whether there is a significant narrowing in the vessels to your heart and if any problems are found further investigations may need to be organised.