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A full cardiac assessment involves a careful history, physical examination and additional tests in order to determine the correct diagnosis and guide treatment.

The heart consists of two pumps that function in parallel to push blood through your lungs and then around the rest of your body to provide oxygen and nutrients to your vital organs. Please follow this link to discover how the heart works. 

Heart disease can present acutely or can cause symptoms over a longer period of time. Sometimes evidence of heart disease can be discovered incidentally and may require further investigation.  

Symptoms could include chest pain, breathlessness, palpitations (awareness of your heart beating) and light-headedness or a transient loss of consciousness (syncope). 

Many simple tests can be used to assess different aspects of the heart. One of the first tests you will likely have is an electrocardiogram (ECG) which is often obtained before your consultation.

If symptoms are intermittent, a longer period of ECG monitoring (24 hours and even up to 30 days) may be needed using an ambulatory ECG (sometimes known as a Holter monitor). For even longer periods of recording, an implantable loop recorder can be inserted which can remain in situ for up to 3 years 

High blood pressure is a very important risk factor for developing heart disease. Before starting treatment, you may be asked to have a 24-hour ambulatory blood pressure monitor. 

If symptoms are related to exertion, then you may be asked to undergo a stress test or exercise tolerance test on a treadmill or upright bicycle with ECG monitoring. 

If you have symptoms of palpitations, light-headedness or even blackouts when you stand up or after standing for a period of time, you may be asked to undergo a head up tilt test which involves close monitoring of your ECG and blood pressure, while standing in a safely controlled environment.  

More complex imaging such as a CT scan, cardiac MRI and myocardial perfusion scan can also allow more detailed examination of the structure of the heart and its blood supply including how effective the blood supply is. These are performed in the radiology department.  

A catheter laboratory or cath lab is a dedicated room where invasive cardiac investigations and treatments take place. Fine wires and tubes can be directed via peripheral blood vessels into the heart, guided by real time x-ray imaging.  

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