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Cardiac Services
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Cardiology Outpatient Diagnostic Testing

Our Cardiology Department provides a high level of cardiac diagnosis and care for various conditions. It has the very latest equipment and investigates a range of symptoms including: chest pain, shortness of breath, palpitations and blackouts.

We perform a wide range of tests, including:

 

Electrocardiogram (ECG)

An ECG is an efficient way to assess the rate, rhythm and electrical activity of the heart to identify cardiac arrhythmias, palpitations and effectiveness of medication. It is also used during a routine medical to determine if the heart is working within normal limits. It is a quick and painless procedure where you lay down on a bed, and 10 electrodes are non-invasively placed on your chest, wrists and ankles.

24 hr BP

Ambulatory blood pressure monitoring is a non-invasive method to obtain BP recordings over a 24 hour period. This consistent monitoring at regular intervals can be used to test for high blood pressure, and to determine the most effective medication or to ascertain whether current medication is having the desired effect. It involves wearing a blood pressure cuff around your non-dominant arm that is attached to a monitor worn around your waist.

24 & 48 hr ECG

A 24 hour or 48 hour electrocardiogram monitor provides a constant recording of your heart rate and rhythm over that period. The test is prescribed for various symptoms such as irregular or fast heart rates, palpitations, dizziness and fainting spells. It also provides information on the effectiveness of medication and treatments. It is a safe and painless recording that involves electrodes placed on your chest and attached to wires. These wires are connected to a small monitor worn around your waist.Seven Day monitor

7 Day monitor

A seven day electrocardiogram monitor provides a constant recording of your heart rate and rhythm over seven days. The test is prescribed for various symptoms such as irregular or fast heart rates, palpitations, dizziness and fainting spells. It also provides information on the effectiveness of medication and treatments. It is a safe and painless recording that involves electrodes placed on your chest and attached to wires. These wires are connected to a small monitor and clipped to a belt or worn with a cord that hangs around your neck.

Exercise stress test

A stress test or exercise tolerance test is designed to provide information about coronary artery disease, cardiac arrhythmias, possible heart related chest pain, dizziness and shortness of breath. This test involves you  walking on a treadmill, so you will be asked to bring comfortable clothes appropriate for exercise.

Electrodes are attached to the chest, connected to an ECG and used to monitor the heart rhythm/waveform and ensure to patient safety. Blood pressure will also be monitored at three minute intervals throughout the test.

Baseline measurements of your heart rate and blood pressure will be taken before the exercise starts. You will start walking on the treadmill where the pace and incline of the treadmill will slowly be increased. The test will continue until you reach a target heart rate, are advised to stop, or need to stop due to fatigue or other symptoms. You will be monitored after exercising until your heart rate and blood pressure return to their baseline.

3D Echocardiogram (3D-ECHO)

This is an ultrasound scan of the heart. It involves placing a probe on various areas of the chest to evaluate the heart’s structures and functions. It will look at the different chambers of the heart, the valves and blood flow in a more detailed way. This scan is used for more specific cardiac conditions. No preparation is necessary for this test. You will be provided with a gown to wear, as clothing from the waist up must be removed. The scan will take approximately 15-30 minutes, reporting often takes a little longer.

Echocardiogram with Bubble Contrast Injection

A bubble echocardiogram is an extension of an echocardiogram that uses simple air bubbles as a contrast medium during the test.  It is used to detect a hole in the heart. A cannula is inserted in your arm and a small amount of blood is mixed with sterile salty water and a small amount of air. During the scan the mix is injected to look for bubbles moving from one heart chamber to another. The scan will take approximately 30 minutes, reporting often takes a little longer.

Stress Echocardiogram- Exercise

This test is used to compare the function of the heart at rest and also under stress (i.e. exercise). Electrodes are placed on your chest and connected to wires in order to monitor your heart rate (Electrocardiogram) throughout the test. Whilst lying down, resting ultrasound images are obtained by placing a probe on various areas of the chest. In order to place the heart under ‘stress’, you will go on a treadmill to increase your heart rate. The exercise consists of increasing both speed and incline every 3 minutes. After completing as much of the exercise as possible, the treadmill will be stopped abruptly in order to quickly take another set of ultrasound images of the heart, while it is still beating fast.
This allows us to evaluate pre-exercise and post-exercise contraction of the heart muscle.

This test is used to rule out any possible underlying cardiac conditions that may be causing symptoms of chest pain and palpitations. Please bring a change of clothes that you feel comfortable exercising in. A gown will be provided, as clothing from the waist up must be removed. The test can take 30 – 50 minutes, reporting often takes a little longer.

Stress Echocardiogram- Dobutamine

This test is used to compare the function of the heart at rest and also under stress, by gradually infusing a short-acting medication called Dobutamine. Electrodes are placed on your chest and connected  to wires in order to monitor your heart rate (Electrocardiogram) throughout the test. Whilst lying down, resting ultrasound images are obtained by placing a probe on various areas of the chest. The medication is given via a needle into the hand or arm, using an incremental protocol, which is increased every 3 minutes until the desired heart rate is reached. If the heart rate is not achieved using this medication alone, another drug, Atropine, may also be administered to increase the heart rate.It may also be necessary to use a dye contrast to enhance the ultrasound images.

Once the infusion of Dobuamine is stopped, the heart rate returns to normal, and monitored for approximately 10 minutes afterwards. This test is specifically for patients who are unable to exercise for any reason (i.e. injury). The test usually takes between 30 -60 minutes, reporting often takes a little longer.

Cardiopulmonary Exercise Test

This is a non-invasive test that we use to simultaneously measure cardiovascular and respiratory systems during exercise to assess a patient’s exercise capacity.  It involves exercising on a bicycle attached to an ECG to monitor heart rate and a face mask to assess your breathing. See respiratory services for full information.

Ajmaline Provocation Test

You may have this test if there is any suspicion you have Brugada syndrome. You will be attached to an ECG machine and at the same time given an injection of a short acting drug called Ajmaline. The drug may provoke ECG changes if you have this condition.  After the test you need to remain on cardiac monitoring for about 1 hour, so you would be admitted as a day patient for this.

Meet the Team

Team

Blood Management

Our blood management services apply across all aspects of cardiac and thoracic care

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Counselling Services

Our psychosexual clinical nurse specialist is available to support all our cardiac and thoracic patients

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Symptom Control

Our symptom control team are here to help you manage symptoms, especially if you have heart failure or lung disease

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Dietetic Support

Our dieticians play a crucial role in the care of all cardiac and thoracic patients               

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Contact Us

London Bridge Hospital

Appointments

Tel: 03331 308 177

General Enquires

Tel: 020 7407 3100

Tax: 020 7234 2019

info.lbh@hcahealthcare.co.uk

27, Tooley Street
London SE1 2PR

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