top of page
WHAT TESTS MAY BE NEEDED
Blood Pressure & Ambulatory BP
WHAT IS BEING TESTED?
The blood pressure is routinely measured in the clinic because high blood pressure (BP) is the most common risk factor for heart disease.
Measuring BP at regular intervals is necessary to make sure that treatment and lifestyle modifications are being effective, in order to achieve target BP goals.
HOW IS THE TEST PERFORMED?
BP measurement is performed by inflating and then gradually deflating a cuff that is wrapped around the arm. It is usually done while sitting.
Depending on the symptoms, BP may be measured in a lying down position and then standing position in some people.
WHAT IS "WHITE COAT HYPERTENSION"?
In some cases, BP measured in the clinic can be high even though the person does not have high BP disease.
This happens because of increased anxiety and fear that some people feel when they go to the doctor.
In order to get an accurate BP measurement in these people, self- measurement of BP at home or ambul ambulatory BP monitoring is recommended.
WHAT IS AMBULATORY BP?
In people with 'white coat hypertension' or day variations in BP, 'ambulatory BP monitoring' is done.
Here, a BP cuff that is worn through the day measures BP at regular intervals to provide accurate BP changes and patterns.
Test BP
Blood Tests
WHAT IS BEING TESTED?
High cholesterol and diabetes are common risk factors for heart disease, and their management is an integral part of complete cardiac care.
Therefore, blood tests for cholesterol (lipid profile) and diabetes (fasting and post-lunch blood glucose, and HbA1C) will usually be done during the initial evaluation and at regular intervals thereafter.
ADDITIONAL TESTS IN SOME CASES
In some people, additional blood tests such as hemoglobin and complete blood count may be required, if the doctor feels it is necessary, based on the details of the individual case.
Lastly, in some people, electrolytes or liver function tests may be included in the blood tests because they can be affected by BP medicines and cholesterol medicines, respectively.
Blood test
ECG & Stress Test
WHAT IS BEING TESTED?
ECG
The function of the heart is to pump blood to the whole body. This pumping action is controlled by the electrical activity of the heart muscles. An ECG measures this electrical activity.
The heart also requires oxygen and nutrients from the blood to work properly. In people with heart disease, blockages do not allow the heart to receive enough blood. This can causes changes in the electrical activity of the heart. This change is what doctors look for on the ECG.
Additionally, an ECG can reveal abnormalities of heart rhythm, presence of fluid around the heart, abnormal thickening of the heart walls and permanent heart damage from blockages.
Stress Test
In most patients, although the blockages reduce blood supply, the heart is able to function at rest. However, during physical activity and exercise, the heart requires more blood but cannot get it due to the blockages.
As a result of the high demand but low supply of blood, the electrical activity of the heart is affected. This change in electrical activity during physical activity is measured during a stress test.
HOW IS THE TEST PERFORMED?
ECG
During an ECG, patients usually lie on their back and electrodes are placed on the skin of the arms, legs and chest and a recording of the electrical activity is taken.
Stress Test
During a stress test, an ECG is recorded in the same manner, using electrodes, while the patient is walking/cycling and at rest.
WHAT PREPARATION IS NEEDED?
No specific prior preparation is required for these tests.
Test ECG and stress
Echocardiogram & Stress Echo
WHAT IS BEING TESTED?
Echocardiogram
An echocardiogram is like a sonography of the heart.
It allows the doctor to see the size, appearance and functioning of the heart's walls, chambers and valves, and structure of large blood vessels that enter and leave the heart.
It is used to evaluate permanent heart damage from blockages, decreased pumping activity of the heart (i.e., heart failure), abnormal thickening of heart walls, blood flow through the heart vales, narrowing or widening of heart valves, infection of heart valves, collection of fluid around the heart, presence of blood clots in the heart, abnormal connections between heart chambers and abnormalities of the large blood vessels that enter and leave the heart.
Stress Echo
A stress echo is similar to the ECG stress test in that it reveals what happens to the heart during physical activity or exercise.
When there is mismatch between the demand and supply of blood to the heart due to blockages, the movement of the heart walls decreases. This change is what doctors look for during a stress echo.
HOW IS THE TEST PERFORMED?
Echocardiogram
Depending on the reason for the echocardiogram, the doctor will decide which structures need to be seen most clearly. Based on this, he or she will recommend either a TTE or TEE.
During a TTE the heart is visualized by placing the echo machine's probe on the different areas of the chest.
During a TEE the heart is visualized by passing the echo probe through the throat and placing it in the foodpipe.
Stress Echo
During a stress echo, the heart visualized by placing the echo machine's probe on the chest, at rest and then immediately after the patient walks on a treadmill or cycles on a stationary bike.
WHAT PREPARATION IS NEEDED?
Echocardiogram (TTE) & Stress Echo
No specific prior preparation is required for these tests.
Echocardiogram (TEE)
One should not eat or drink anything for at least 6 hours before the test. If needed medicine must be taken with small sips of water more than 2 hours before the test.
ECHOCARDIOGRAM (TTE)
ECHOCARDIOGRAM (TEE)
Test echo and stess echo
Holter Monitor
WHAT IS BEING TESTED?
WHAT PREPARATION IS NEEDED?
In some cases, abnormalities may not be seen on the ECG taken in the doctor's clinic. This happens because the abnormal rhythm or abnormal function of the heart can be transient and it appears and disappears at random times through the day.
A holter monitor records the ECG through out day so that we can capture and diagnose these transient abnormalities.
HOW IS THE TEST PERFORMED?
For holter monitoring, electrodes are applied on the chest, similar to the way they are applied for an ECG. These are connected to a box with a battery that is worn by the patient so that the hearts electrical activity (ie, ECG) can be recorded continuously through the day.
No specific prior preparation is required for this test.
Test holter
Cardiac Catheterization & Coronary Angiography
WHAT IS BEING TESTED?
The degree of narrowing of the blood vessels of the heart, due to blockages, is definitively visualized during a coronary angiography/cardiac catheterization.
If a significant narrowing due to blockages is seen, the Cardiologist can often open up the blockages during the same procedure. This is called angioplasty.
Alternatively, the Cardiologist may recommend bypass surgery based on the degree, type and blood vessel with blockages.
HOW IS THE TEST PERFORMED?
This test is done by an Interventional Cardiologist in the Cardiac Cath Lab.
A catheter (tube) inserted through the wrist or the groin and advanced all the way to top of the heart. A dye is then injected into the blood near the opening of the heart's blood vessels. If a blockage is present, the degree of narrowing can be seen using x-ray.
Test angio
For the purpose of patient education, some images on this webpage have been adapted from the Patient Benefit Handbook provided by Hoechst Marion Roussel.
bottom of page