Cardiac & Respiratory

An ECG (electrocardiogram) is a test that records the electrical activity of your heart, including the rate and rhythm. It can take up to 10 minutes to complete.

This is an non invasive test.

An ECG (electrocardiogram) is referred by a doctor or healthcare professional if they think you're having symptoms of:

• a heart attack
• coronary heart disease
• problems with how quickly or regularly your heart beats (arrhythmia)
• if you've been diagnosed with a heart condition or another condition that affects how well your heart works
• before and while taking certain medicines

Preparing for an ECG (electrocardiogram)

• Wear a top that's easy to take on and off
• Avoid putting body lotions, oils or talcum powder on your skin before the test
• Some people may need to have their chest shaved before the test.

An exercise stress test is a diagnostic tool to assess a person’s cardiac function as well as exercise capacity.

What will happen on the day of the test

You will be hooked up to ECG equipment to monitor the heart.

You will walk start off walking slowly in place on a treadmill, and will then increase with speed and incline every 3 minutes .

You can stop the test at any time if needed (but you are then in a recovery stage ).

After the test, you’ll be given water and asked to rest.

Preparation

Wear comfortable exercise clothes and exercise shoes (NO flip flops / sandals).

Allow up to 1 hour for the test.

Avoid putting body lotions, oils or talcum powder on your skin before the test

Some people may need to have their chest shaved before the test.

An echocardiogram, also known as an echo, is a non-invasive imaging test used to examine the heart and is performed by a cardiac physiologist.

How it works

• A small probe is placed on the chest wall with ultrasound gel. Echoes are captured by the probe and transformed into a moving image displayed on a monitor during the scan.

An echocardiogram helps diagnose and monitor various heart conditions by assessing

1. Heart Structure: It examines the heart’s anatomy, including its chambers, valves, and blood vessels.
2. Blood Flow: It analyses how blood flows through the heart.
3. Pumping Chambers: It evaluates the function of the heart’s pumping chambers.

Common uses of echocardiograms include detecting

• Damage from a Heart Attack: Identifying areas affected by reduced blood supply.
• Heart Failure: Assessing the heart’s ability to pump blood effectively.
• Congenital Heart Disease: Detecting birth defects affecting heart function.
• Heart Valve Problems: Evaluating valve function and blood flow.
• Cardiomyopathy: Assessing thickening or enlargement of heart walls.
• Endocarditis: Detecting infections that damage heart valves.

Process

You’ll be asked to remove any clothing covering your upper half before lying down on a bed. You may be offered a hospital gown to cover yourself during the test.

When you’re lying down, several small sticky sensors called electrodes will be attached to your chest. These will be connected to a machine that monitors your heart rhythm during the test.

An ultrasound gel will be applied to your chest or directly to the ultrasound probe. You’ll be asked to lie on your left side and the probe will be moved across your chest.

The probe is attached by a cable to a nearby machine that will display and record the images produced.

You won’t hear the sound waves produced by the probe, but you may hear a swishing noise during the scan. This is normal and is just the sound of the bloodflow through your heart being picked up by the probe.

The whole procedure will usually take between 30 and 60 minutes, and you’ll normally be able to go home shortly afterwards.

No Preparation needed.

Ambulatory Blood Pressure Monitoring (ABPM) is a valuable diagnostic tool that provides a comprehensive view of your blood pressure over a 24-hour period. 

What Is ABPM?

• ABPM involves measuring your blood pressure as you go about your usual daily activities. Unlike a single blood pressure reading taken in a clinical setting, ABPM captures your blood pressure fluctuations throughout the day and night.
• A small digital blood pressure monitor is attached to a belt around your waist, and a cuff is placed around your upper arm. You will also sleep with it on.
• By monitoring your blood pressure over an extended period, doctors gain insights into how it changes during different activities and times of day.
  

Benefits of ABPM

Holistic View: ABPM provides a more accurate representation of your blood pressure patterns than a single clinic visit.

Avoids White Coat Effect: It helps avoid the “white coat” syndrome, where blood pressure rises due to anxiety during doctor visits.

Diagnosis and Medication Management: ABPM assists in diagnosing high blood pressure, identifying patients with elevated readings in clinics, and determining the need for blood pressure medication.

Control Assessment: It evaluates how well your blood pressure medications are working throughout the day and even during sleep.

How Is ABPM Performed?

Similar to regular blood pressure measurements, an electronic monitor inflates a cuff around your upper arm and gradually releases the pressure.

The monitor is fitted at the cardiac department – this appointment takes 15-20 minutes.

Readings are taken at regular intervals (every 30 minutes during the day and 60 minutes at night).

You’ll wear the monitor throughout the night, and it will store all your readings for analysis.

Tips During Monitoring:

Ensure the tube connecting the monitor isn’t twisted or bent.

When the monitor alerts you for a reading keep your arm still and straight to allow an accurate reading.some text

You will not be able to shower for 24 hours (while wearing this monitor).

A heart monitor is a valuable tool used to assess your heart rate and rhythm over a specific period, typically 24 hours or longer. 

Reasons why you might need one

1. Symptoms Evaluation: If you experience symptoms such as palpitations, dizziness, fainting, or irregular heartbeats, a heart monitor helps track your heart’s activity during these episodes. It provides crucial information to diagnose the cause of your symptoms.
2. Detecting Abnormal Rhythms: Heart monitors can identify abnormal heart rates or rhythms, including too slow (bradycardia) or too fast (tachycardia) heart rates. Detecting these irregularities helps guide treatment decisions.
3. Medication Monitoring: If you’re taking medications that affect your heart, monitoring ensures their effectiveness and safety. It helps healthcare professionals assess whether the medication is controlling your heart rate appropriately.
4. Post-Procedure Monitoring: After cardiac procedures (such as pacemaker implantation or ablation), monitoring ensures that your heart is functioning correctly and that the procedure was successful.
5. Risk Assessment: For individuals at risk of heart conditions (such as atrial fibrillation), continuous monitoring provides valuable data to assess their overall cardiovascular health.

How does it work?

• A heart monitor is typically a small device, similar in size to a mobile phone.
• Electrodes (sticky pads) are attached to your chest, and the monitor continuously records your heart’s electrical activity.
• You wear the monitor for the specified duration (e.g., 24 hours, 72 hours, or seven days).
• The data collected helps healthcare professionals analyse your heart rhythm and make informed decisions about your care.

Preparation:

There is no preparation needed as the monitor can be removed at home for brief periods to shower or bathe.

The monitor can be worn during exercise such as golf, running, gym etc.

Spirometry is a simple test used to help diagnose and monitor certain lung conditions by measuring how much air you can breathe out in one forced breath.

Why spirometry is carried out

Spirometry may assist in diagnosing a lung condition if you exhibit symptoms or if your physician suspects an elevated risk of developing a specific lung ailment. For instance, it might be advised if you experience persistent coughing or breathlessness, or if you're over 35 and a smoker.

Spirometry can detect and track various conditions, such as:

• Asthma: a chronic condition characterised by recurring inflammation and narrowing of the airways
• Chronic obstructive pulmonary disease (COPD): a group of lung diseases resulting in airway constriction
• Cystic fibrosis: a genetic disorder leading to the buildup of thick mucus in the lungs and digestive tract
• Pulmonary fibrosis: involves the development of scar tissue within the lungs

If you've previously received a diagnosis of one of these conditions, spirometry may be conducted to assess the condition's severity or monitor your response to treatment.

Preparing for the test

You should avoid smoking for 24 hours prior to the test and refrain from consuming alcohol, engaging in vigorous exercise, or eating heavy meals for several hours beforehand.

What happens during a spirometry test

During the test, you'll be seated, and a soft clip will be placed on your nose to prevent air leakage. The examiner will provide instructions, and you might be encouraged to practise a few times beforehand.

For the spirometry procedure, you'll be instructed to:

• Inhale deeply until your lungs are completely filled with air.
• Seal your lips tightly around the mouthpiece.
• Exhale forcefully and rapidly, ensuring complete emptying of your lungs.

The process typically needs to be repeated at least three times to ensure accuracy.

A lung volume test assesses both the total air capacity within your lungs and the volume of air remaining after maximal exhalation.

When is a lung volume test used?

A lung volume test helps determine whether a lung condition is restrictive or obstructive. In obstructive lung conditions, airways become narrow, causing air to remain in the lungs after exhalation. Such conditions include COPD and asthma.

Preparation

• Do not do any intense exercise 30 minutes before the test.
• Do not smoke 1 hour before the test 
• Do not eat a large meal 2 hours before the test
• Do not drink alcohol 4 hours before the test 

 How is a lung volume test done?

You will be seated and instructed to inhale through a tube. A nose clip will be applied to ensure no air escapes through your nose. The test typically lasts around 20 minutes.

A gas transfer test evaluates your lungs' ability to absorb oxygen from the air you inhale. The outcome of this test is referred to as the transfer factor, alternatively known as the diffusing capacity.

What’s it used for?

A gas transfer test serves as a diagnostic and monitoring tool for lung conditions like COPD and pulmonary fibrosis. Additionally,  it may be employed to assess lung function before surgery or to observe how the lungs respond during chemotherapy.

What happens during a gas transfer test?

You breathe in a mixture of air containing minute quantities of helium and carbon monoxide (CO), both of which are completely safe at the low levels used in the test. With a nose clip in place, you'll be prompted to take a deep breath through a mouthpiece, followed by holding your breath and exhaling steadily into the machine. This sequence may be repeated multiple times, with short breaks in between attempts. Don't worry if it takes a few tries to achieve a reliable result.

Preparing for the test

Smoking can influence the results; therefore, if you are a smoker, refrain from smoking for 24 hours before undergoing the test.

What will the results look like?

The gas transfer test informs your consultant about the efficiency of oxygen exchange from the lungs into the bloodstream. Result interpretation takes into account factors such as age, height, gender, ethnicity, and the level of haemoglobin in your blood.

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The response of a patient's bronchial tubes to this challenge can provide doctors with critical information about their respiratory health. It's akin to a stress test for the lungs, providing a glimpse of their performance under certain conditions.

If you've been suffering from persistent coughing, wheezing, or shortness of breath - particularly if these symptoms get worse with exercise or exposure to certain triggers - your doctor might recommend a bronchial challenge to aid in diagnosing conditions like asthma or chronic obstructive pulmonary disease (COPD).

The process involved in a bronchial challenge test consists of 3 main steps:

• Preparation: Gathering your medical history and general health information is a crucial first step. This might involve discussions about your symptoms, lifestyle choices (like smoking), and exposure to environmental factors. Before undergoing the test, you'll be asked to avoid certain medications and activities that may affect the test's results.
• Procedure: During the test, you'll be asked to inhale a substance that mildly irritates the airways while your doctor significantly monitors your lung function using a device called a spirometer. This device measures how much air you can breathe in and out, and how quickly.
• Aftercare: Your doctor will keep a close eye on you for a short period after the test to ensure you're okay. It's also vital to understand that if your test results indicate a breathing issue, further treatments or tests may be required.

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The Sleep monitor device is indicated for use by Health Care Professionals (HCP), where it may aid in the diagnosis of sleep disordered breathing for adult patients. 

The sleep monitor records the following data: patient respiratory nasal airflow, snoring, blood oxygen saturation, pulse and respiratory effort during sleep. The device uses these recordings to produce a report for the HCP that may aid in the diagnosis of sleep disordered breathing or for further clinical investigation

On the night you’ve scheduled your home sleep test, you’ll follow your normal evening routine, prepare for sleep, attach everything as you’ve been shown at your clinic appointment and start the recording. In the morning, you’ll remove everything as previously demonstrated and return the recording device to the clinic the next day.

What is a FeNO Test?

A FeNO test, also known as an exhaled nitric oxide test, is utilised in individuals with allergic or eosinophilic asthma to gauge the level of lung inflammation and assess the effectiveness of inhaled steroids in managing it. Even if you perceive your breathing as normal with allergic or eosinophilic asthma, your exhaled nitric oxide levels could remain notably high. In such cases, adjusting your inhaled steroid dosage slightly upward may lead to better long-term control of inflammation.

What is Nitric Oxide?

Nitric oxide is a gas generated by cells participating in the inflammatory processes linked to allergic or eosinophilic asthma.

How is Nitric Oxide Measured?

The FeNO test employs a portable device to gauge the concentration of nitric oxide in parts per billion (PPB) within the air exhaled from your lungs at a slow pace. Unlike many lung function tests, the exhaled nitric oxide test necessitates a slow and steady exhalation rather than a forceful and rapid one to ensure precise measurements.

Why is Nitric Oxide Measured?

Your allergist might assess your exhaled nitric oxide levels to detect the characteristic inflammation linked to allergic or eosinophilic asthma during the diagnostic process. Subsequently, they may reevaluate these levels to ensure that the steroid inhalers you're prescribed are effectively suppressing nitric oxide levels.

Your consultant can utilise data obtained from FeNO testing, along with spirometry and other lung function assessments, to tailor and fine-tune your medication regimen, ensuring optimal control of your asthma.