Cardiac ScreenBalppa House
BMI Syon Clinic941 Great West Road
West Middlesex University HospitalTwickenham Road
When you have a resting ECG, you will be asked to lie down and relax for about five minutes. During this time, a series of electrodes, attached to your skin with small sticky pads, will be recording the electrical activity going on in your heart. The electrodes are just recording devices, which can’t send out any electrical impulses of their own, so you won’t feel a thing. The information they gather is transmitted back to the ECG machine, which will produce a chart or electrocardiogram showing how the electrical activity changes over time.
Echocardiogram (Ultrasound of the heart)
Evaluates the heart structures by the use of ultrasound, or high frequency sound wave, which creates graphic images of the heart. The primary role of echocardiography in clinical practice is a non-invasive and cost-effective answer to the structure and function of the heart muscle and valves. There is no preparation required for the test, it takes approximately 20-30 minutes and is painless.
Bubble saline contrast echocardiogram
A bubble saline contrast echocardiogram is a test often performed as part of a Patent Foramen Ovale (PFO) clinic review.
A PFO is a normal flap valve opening that occurs in the wall (atrial septum) of the heart that separates the right atrium from the left atrium (the top two heart chambers) while in the womb but usually closes spontaneously following birth. In a quarter of people it stays open and can intermittently allow blood flow to pass from the right atrium to the left atrium.
You will be asked to undress to the waist and then to lie on a couch. The doctor or sonographer will insert a thin, plastic tube (a cannula) into a vein in your left arm. No preparation is required for the test.
You may already have had an echocardiogram performed; a safe, non-invasive procedure that uses ultrasound waves to see the heart. A bubble saline contrast echocardiogram is similar but during this procedure a small sample of your blood will be mixed with a saline solution (sterile salty water) and injected through the thin plastic tube in your arm. You may be asked to hold your breath for a few seconds during the test. The injections will be repeated several times and the whole procedure will last approximately 30minutes.
This procedure gives much clearer images of the heart as the saline solution helps enhance the quality of the pictures.
Exercise Treadmill ECG
Evaluates the electrical activity of the heart, blood pressure and heart rate with exercise. It is a useful test to detect coronary artery disease (any blockages of the heart arteries) and response of heart rate or any electrical heart disturbances of the heart rhythm & blood pressure response to exercise. Please bring along with a pair of running shoes and jogging pants/shorts for the treadmill ECG. The test takes approximately 30 minutes.
Treadmill Exercise Echocardiogram
You will be asked to lie on your left side on an exam table for a resting echocardiogram (also called an “echo”). An echocardiogram is a graphic outline of the heart’s movement created from ultrasound vibrations echoed from the heart’s structures. The sonographer will place a wand (called a transducer) on your chest to view an outline of the heart’s movement.
After the echo test, you will exercise on a treadmill. The lab personnel will ask you to start exercising and will gradually increase the intensity of exercise. You will be asked to continue exercising until you are exhausted.
At regular intervals, the lab personnel will ask how you are feeling. Please tell them if you feel chest, arm or jaw pain or discomfort; short of breath, dizzy, lightheaded or if you have any other unusual symptoms.
The lab personnel will watch for any changes on the EKG monitor that suggest the test should be stopped.
When you cannot exercise any longer, you will get off the treadmill,* quickly return to the exam table and lie on your left side so the sonographer can perform another echocardiogram.
Your heart rate, blood pressure and EKG will continue to be monitored until the levels are returning to normal.
You will be encouraged to exercise until you are exhausted. It is normal for your heart rate, blood pressure, breathing rate and perspiration to increase.
As you stop exercising suddenly, it is normal to feel a little unsteady when getting off the treadmill and onto the exam table for the echocardiogram.
The appointment will take about 60 minutes. The actual exercise time is usually between seven and 12 minutes.
Cardiac Event monitor
Evaluates pathological electrocardiographic events over a period of a week to a month.
The eight – day cardiac event monitor is performed using the “Novacor R.Test Evolution”, which is a miniature ambulatory ECG recorder and is capable of memorising the most significant pathological events (symptomatic or silent), as well as the patient’s continuous heart rate.
The system consists of a unit weighing about 40g, and by using a lightweight neck cable,which can be worn by the patient unobtrusively and without any discomfort. The R.Test Evolution is connected to the patient by a system of electrodes and a neck cable.
Cardiac events are memorised by the R.Test Evolution and then transferred by a decoder, to a computer for interpretation
Ambulatory ECG : An ambulatory electrocardiogram (EKG or ECG) records the electrical activity of your heart while you do your usual activities. For this test, you wear a lightweight, battery-operated tape recorder (monitor). It attaches to a strap that goes round your neck or around your waist. The recorder is connected by wires to small pads or patches (electrodes) taped to your chest. These detect the electrical signals from your heart. It will record any abnormal heart rhythm /Palpitations or any arrhythmias. No preparation is required for the test. You will be connected to the machine for 24-72 hours and you can remove it whilst having a bath or shower and thereafter reconnect in back on.
Spirometery Lung function: is the most common of the lung function tests. These tests look at how well your lungs work. Spirometery shows how well you breathe in and out. Breathing in and out can be affected by lung diseases such as chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis and cystic fibrosis.
How is it done?
You will have your weight and height measured. For the Spirometery itself, you need to breathe into the Spiro meter machine. First you breathe in fully and then seal your lips around the mouthpiece of the Spiro meter. You then blow out as fast and as far as you can until your lungs are completely empty. This can take several seconds. You may also be asked to breathe in fully and then breathe out slowly as far as you can.
Chest x ray is a painless, non-invasive test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels
Ambulatory Blood Pressure Monitoring (ABPM) is when your blood pressure is being measured as you move around, living your normal daily life. It is normally carried 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 small enough that you can go about your normal daily life and even sleep with it on.
The machine then takes blood pressure readings at regular intervals throughout the day: usually, every 15-30 minutes during the daytime and 30-60 minutes at night. You will need to keep the monitor on through the night – you could put the machine under the pillow or on the bed while you sleep.
Because the test is being carried out to find out what your normal daily blood pressure is, it is important to carry on with your normal routine and do all the things you would normally do. The only things you should avoid doing for the day are swimming and having a bath or shower.
At the end of the 24 hours you can remove the machine and cuff and give it back to the hospital or surgery. The machine will have stored all your readings and these will then be analysed.
The Kidney /Renal Profile consist of:
Sodium, Potassium, Chloride, Urea, Creatinine, Bicarbonate and estimated GFR
The Liver function Profile consists of:
Alkaline Phosphate, Alanine Aminotransferase, Aspartate Aminotransferase, Total Protein, Bilirubin and Albumin
Fasting Blood Glucose (Sugar) profile consist of:
Blood Glucose and Glycated Haemoglobin A1c (HbA1c) (average plasma glucose concentration).
Red cells live for 8 -12 weeks before they are replaced. By measuring the HbA1C it can tell you how high your blood glucose has been on average over the last 8-12 weeks. A normal non-diabetic HbA1C is 4.2-6.4%
C’Reactive Protein (CRP):
Blood test to identify inflammation or infection in the body.
Total/ Whole/ Full Blood Count
Blood test to determine general health status and to screen for a variety of disorders, such as anaemia and infection, inflammation nutritional status and exposure to toxic substances
Thyroid-Stimulating Hormone (TSH)
Blood test to check for a raised TSH level indicating a “lazy” thyroid gland
Vitamin D, or the sunshine vitamin, is actually a hormone produced by the skin. It plays a part in bone health and can be a determinant factor in developing many diseases because of its role in inflammation. Vitamin D’s involvement in calcium and phosphorus uptake and absorption also make vitamin D a major component of nervous system functioning.
Cholesterol: Measure the risk of cardiovascular disease, the lower the cholesterol value gets, the lower the risk of cardiovascular disease.
HDL Cholesterol : Measures ‘good cholesterol’ that helps protect from heart disease.
LDL Cholesterol: Measures ‘bad cholesterol’ that collects in the walls of blood vessels, causing the blockages of artery.
Triglycerides: important to human life and are the main form of fat in the body and are used to provide energy to the body. High triglyceride levels have been linked to a greater chance for heart disease and diabetes.
57-61 Newington Causeway
BMI Syon Clinic
941 Great West Road
West Middlesex University Hospital