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What is ambulatory Blood pressure monitoring?
Ambulatory blood pressure monitoring (ABPM) measures blood pressure over a 24-hour period.
The ABPM device consists of a cuff that is placed around the patient's upper arm and connected to a small recording device worn on a belt or strap. The device is programmed to take multiple readings at regular intervals over the course of the 24-hour wear period, usually every 15 to 30 minutes during the day and every 30 to 60 minutes at night, while they go about their daily activities and sleep. The data is later downloaded and analysed.
What is the benefit of ambulatory blood pressure monitoring ?
ABPM is used to diagnose and monitor high blood pressure (hypertension), which is a common and serious health condition that can lead to heart disease, stroke, and other complications. ABPM provides more accurate and comprehensive information about a patient's blood pressure patterns than a single blood pressure reading taken in a healthcare setting. It can help healthcare providers to determine if a patient has hypertension, to rule out white coat hypertension (elevated blood pressure due to anxiety in a clinical setting) or masked hypertension (normal blood pressure in a clinical setting but elevated outside of it), and to determine if there is a need for adjustment of hypertensive medication.
What is an ambulatory electrocardiogram monitor / holter?
An ambulatory electrocardiogram (ECG) monitor or holter is a portable device that records the electrical activity of the heart over an extended period of time, typically 24 to 48 hours, or even up to several weeks.
The ambulatory ECG monitor is used to diagnose and monitor heart rhythm disorders.
What to expect during a holter?
During a Holter monitor test, you can expect the following:
Preparation: The healthcare provider will place small, adhesive patches (electrodes) on your chest, which are connected to a small, portable ECG recorder (Holter monitor) that you will wear during the monitoring period. The monitor is typically worn for 24 to 48 hours, although it can sometimes be worn for up to several weeks.
Recording period: You will be instructed to go about your normal daily activities while wearing the monitor. You may also be asked to keep a diary of your activities and symptoms during the recording period. The electrodes and monitor may cause some discomfort or irritation, but this should be minimal.
Removal of the monitor: After the recording period is complete, your cardiologist will review the data and analyze the results.
Follow-up: Your cardiologist will discuss the results of the Holter monitor test with you and make recommendations for further testing or treatment if necessary.
What is a Cardiac Magnetic Resonance Imaging (MRI)?
A cardiac MRI (magnetic resonance imaging) is a medical imaging technique that uses a powerful magnetic field to produce detailed images of the heart's structure, size, and function, including the heart muscle, chambers, valves, and blood vessels. It can also show areas of heart muscle inflammation, damage or disease.
What to expect during a Cardiac MRI?
During a cardiac MRI (magnetic resonance imaging) scan, you can expect the following:
Preparation: You may be asked to change into a hospital gown and remove any metallic objects as these can interfere with the MRI scan. You may also receive an injection of a MRI specific contrast dye to help produce clearer images of your heart.
Positioning: You will lie down on a padded table that slides into the MRI machine. You will be given earplugs to reduce the noise from the MRI machine, which can be loud and repetitive.
Scanning: During the scan, you will need to lie still and hold your breath for short periods of time. The MRI machine will produce a series of images of your heart, which can take up to an hour or more to complete.
Follow-up: After the scan is complete, you can return to your normal activities. The MRI images will be analysed by a radiologist, who will interpret the results and send a report to your cardiologist.
During the cardiac MRI, you should not experience any pain or discomfort. However, some people may feel anxious inside the MRI machine, which can be loud and confining. If you experience any discomfort or anxiety, you can notify the healthcare team.
What is a CT coronary angiogram?
A computed tomography coronary angiogram (CTCA) is a non-invasive medical test that uses computed tomography (CT) imaging to create detailed pictures of the heart and blood vessels. It can also produce three-dimensional images of the heart and coronary arteries that supply blood to the heart muscle.
CT coronary angiography can be used to diagnose and evaluate various heart conditions, such as coronary artery disease, congenital heart defects, and certain structural abnormalities.
What to expect during a CT coronary angiogram?
During a CT coronary angiogram (CTCA), you will be asked to lie on a narrow table that slides into a doughnut-shaped scanner. The CT scanner will take multiple X-ray images of your heart and blood vessels from different angles.
Here are the steps you can expect during the procedure:
You will be asked to change into a hospital gown and remove any jewellery or metal objects.
An intravenous (IV) line will be inserted into your arm, through which contrast material will be injected.
Electrodes will be attached to your chest to monitor your heart rate and rhythm.
You will be asked to hold your breath for a few seconds at a time during the scan.
During the procedure, you may feel a warm sensation as the contrast material is injected into your vein.
The CT scanner will make a series of clicking and whirring noises during the procedure, which is normal.
After the procedure, you can usually go home the same day, and you will be advised to drink plenty of fluids to help flush the contrast material from your body.
What are the risks of a CT coronary angiogram?
Like any medical procedure, a CT coronary angiogram (CTCA) carries some risks. However, these risks are generally low, and most people do not experience any complications. Some of the potential risks include:
Allergic reaction to contrast material: Some people may have an allergic reaction to the contrast material used during the CTCA. This can range from mild itching to a severe allergic reaction known as anaphylaxis, which is rare.
Kidney problems: In rare cases, the contrast material can cause kidney problems in people who have pre-existing kidney disease or who are taking certain medications.
Radiation exposure: CT scans use X-rays, which can expose you to a small amount of radiation. However, the amount of radiation used in a CTCA is typically low, and the risk of radiation-related problems is generally very small.
Pregnancy risks: If you are pregnant, there is a small risk that the radiation from the CTCA could harm your developing fetus.
Other risks: There is a small risk of bleeding or infection at the site where the IV line is inserted into your arm.
What is an echocardiogram?
An echocardiogram is an ultrasound test that uses sound waves to create detailed images of the heart's structure and function. Echocardiograms are used to diagnose and monitor various of heart conditions, such as heart valve problems, heart muscle diseases, and congenital heart defects.
What to expect during an echocardiogram?
During an echocardiogram, you will be asked to lie down on an examination table, typically on your left side. The technician will apply a gel to your chest, which helps the sound waves to travel through the skin. The technician will then place a handheld device called a transducer on your chest and move it around to get different views of your heart.
You may be asked to hold your breath or change positions during the test to get better images. The test is painless and usually takes about 30 to 60 minutes to complete. After the test, the gel will be wiped off your chest, and you will be able to resume your normal activities immediately. Your doctor will review the images and discuss the results with you.
What is a stress echocardiogram?
A stress echocardiogram (also called an echocardiographic stress test) is a diagnostic medical test that combines an exercise stress test with echocardiography (ultrasound of the heart). The test is designed to evaluate how well your heart functions during physical activity, and aims to detect problems with the heart's blood supply or certain heart valve abnormalities.
What to expect during a stress echocardiogram?
During a stress echocardiogram, you can expect the following:
Preparation: You will be asked to change into a hospital gown and remove any jewellery or clothing that may interfere with the ultrasound. Electrodes will be attached to your chest to monitor your heart's electrical activity.
Baseline echocardiogram: You will receive an echocardiogram to establish a baseline measurement of your heart's function at rest.
Exercise or pharmacological (medication) stress test: You will either walk on a treadmill or have a medication infused through a drip tube to simulate exercise. All this will occur while being monitored for changes in heart rate, blood pressure, and symptoms.
Echocardiogram during stress: When your target heart rate is achieved, the technician will perform another echocardiogram to assess the blood flow and function of your heart under stress.
Recovery period: You will continue to be monitored as your heart rate returns to normal.
The entire test typically takes 45 to 60 minutes
What are the risks of a stress echocardiogram?
A stress echocardiogram is generally considered a safe procedure, but as with any medical test, there are some potential risks. These may include:
Abnormal heart rhythms (arrhythmias) during or after the exercise portion of the test.
Low blood pressure or dizziness during or after the exercise portion of the test.
Chest pain or discomfort.
Very rarely, heart attack or stroke.
It's important to note that these risks are rare and the benefits of the test typically outweigh the risks. Additionally, the test is performed under the supervision of trained medical professionals who are equipped to handle any complications that may arise. Your doctor will review your medical history and assess your overall health to determine whether the benefits of the test outweigh the risks for you. If you have concerns about the risks of a stress echocardiogram, be sure to discuss them with your doctor before the test.
What is an electrocardiogram?
An electrocardiogram (ECG) is a non-invasive test that measures the electrical activity of the heart. This test involves attaching small electrodes to the skin on the chest, arms, and legs, which detect and record the electrical signals produced by the heart.
The ECG machine then converts these signals into a visual representation of the heart's electrical activity and this representation is known as an ECG waveform.
The ECG waveform provides important information about the heart's rhythm, rate, and pattern of electrical flow. It can help diagnose a variety of heart conditions, including arrhythmias (irregular heartbeats), heart attacks, and other problems that may manifest as abnormalities in the electrical activity of the heart.
What is a treadmill stress test?
A treadmill stress test is a diagnostic tool used to evaluate the electrical activity of the heart during exercise, which helps to diagnose or exclude coronary artery disease or irregular heart rhythms (arrhythmias) .
What might you expect during a treadmill stress test?
During a treadmill stress test, you can expect the following:
Preparation: Before the test, you will be asked to change into comfortable clothing. Electrodes will be attached to your chest, arms, and legs to monitor your heart rate and rhythm. Your blood pressure will also be taken, and a baseline electrocardiogram (ECG) will be recorded.
Exercise: You will then be asked to walk or run on a treadmill while the speed and incline gradually increase. The goal is to reach your target heart rate or until you reach a certain level of fatigue.
Monitoring: Throughout the test, your heart rhythm, blood pressure, and ECG will be closely monitored for abnormalities. The medical team will be looking for any signs of chest pain, shortness of breath, irregular heart rhythms or other symptoms that may indicate a problem with your heart.
Cool down: After the test, you will be asked to cool down by walking slowly on the treadmill or standing still. Your heart rate and blood pressure will continue to be monitored until they return to baseline levels.
Results: Once the test is completed, the results will be analysed by your cardiologist. Depending on the results, further testing or treatment may be recommended.
A treadmill stress test typically takes around 30-60 minutes to complete.
What are the risks of a treadmill stress test?
A treadmill stress test is generally considered a safe and non-invasive procedure. However, as with any medical test, there are some risks involved which include:
Chest pain or discomfort: Some people may experience chest pain or discomfort during the test.
Irregular heartbeat: There is a small risk of developing an irregular heartbeat or arrhythmia during the test.
Heart attack: Although rare, there is a small risk of experiencing a heart attack during the test. This is more likely to occur in people with a history of heart disease or other risk factors.
Dizziness or fainting: Some people may experience dizziness or lightheadedness during the the test is completed.
Injury: There is a small risk of injury from falling off the treadmill or tripping during the test. However, this is rare and can usually be prevented by following the instructions of the medical team conducting the test.
What is a tilt table test?
A tilt table test is a medical diagnostic test that is used to evaluate the cause of fainting or near-fainting spells (syncope). During the test, the patient lies flat on a special table that is positioned upright to simulate standing. Heart rate, heart rhythm and blood pressure are monitored continuously.
Tilt table testing can help doctors identify the underlying cause of fainting, with the focus on the diagnosis of vasovagal syncope which is a faint triggered by prolonged standing or unpleasant stimulus. It is a safe and non-invasive test that can provide valuable information for the diagnosis and treatment of syncope.
What might you expect during a tilt table test?
If you are scheduled to undergo a tilt table test, here is what you can generally expect:
Preparation: You may need to avoid eating or drinking for several hours before the test, as instructed by your healthcare provider.
Procedure: During the test, you will lie flat on a special table that can be tilted upright. The table will be tilted gradually to simulate standing, while your heart rate and blood pressure are monitored continuously. You will be securely strapped to the table to ensure your safety.
Duration: The test can take up to an hour, with possible need for medication being administered under the tongue or through your veins.
Symptoms: You may experience symptoms such as dizziness, lightheadedness, or fainting during the test. This is common, and your healthcare team will be present to monitor your symptoms and keep you safe.
After the test: After the test, you will be monitored for a short period to ensure that you are feeling well enough to leave. Your healthcare provider will review the results of the test with you and discuss any next steps, such as additional testing or treatment.
What are the risks?
Tilt table testing is generally safe, but there is a small risk of fainting or falling during the test. Your healthcare team will be present throughout the test to ensure your safety and comfort.
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If you or a loved one requires consultation for any heart matters, contact The Heart Specialist Clinic today to schedule an appointment with our experienced cardiologists.
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3 Mount Elizabeth #14-10
Mount Elizabeth Medical Centre
Singapore 228510