Cardiology

An ECG is a test that records the heart’s electrical activity. During the test, a technologist will explain the procedure and place small sticky patches (electrodes) on your skin. To help the patches stick, your skin may be gently rubbed with fine sandpaper or shaved.

The electrodes are connected to a machine that records your heartbeat. You will lie still for a few minutes while the recording is made. A cardiologist will review the results and send a report to your doctor.

No special preparation is needed for this test. 

These tests help check for heart rhythm problems.  During the test, a technologist will explain the procedure and place small sticky patches (electrodes) on your skin. To help the patches stick, your skin may be gently rubbed with fine sandpaper or shaved.

The electrodes connect to a small device that records your heartbeat.

If you are using a Holter monitor, you will wear it for a set time and record any symptoms (like palpitations, chest pain or dizziness) in a diary, along with the time they happen.

If you are using a loop monitor, you will press a button on the device when you feel symptoms and write them down in your diary. You will be told when to remove the monitor and return it.

A cardiologist will review the results and send a report to your doctor. 

This test checks how your heart works during exercise. A technologist or doctor will explain the risks and benefits of the test and ask you to sign a consent form. Small sticky patches (electrodes) will be placed on your chest to monitor your heart rate and rhythm.

You will walk on a treadmill that slowly gets faster and steeper. Your heart rate and blood pressure will be checked throughout. You will be asked to keep going as long as you can.

Before your test:

• Do not eat, drink or smoke for two hours.  
• Do not take beta blockers, nitrates or certain calcium channel blockers for 48 hours (check with your doctor).
• Bring a list of your medications.
• Wear comfortable clothes and running shoes. 

An echocardiogram is an ultrasound of the heart. It shows live images of the heart muscle, chambers and valves to help your doctor understand how your heart is working. The test is painless and takes about 30 to 45 minutes.

A sonographer (a specially-trained technologist) will place sticky patches (electrodes) on your chest to monitor your heart rhythm.  

You will be asked to remove your clothing from the waist up and change into a hospital gown.  You will then be asked to lie on your left side. Gel will be applied to your chest, and a small device called a transducer will be used to take pictures of your heart. The room lights may be dimmed during the test.

If parts of your heart are hard to see, you may be given a small injection of a medication called Definity to improve the images and increase the accuracy of the test.

No special preparation is needed. 

This test combines an ultrasound of the heart with a stress test. It helps your doctor see how your heart works during exercise or when stimulated by medication. Images are taken before and during stress and compared to check for signs of blocked arteries.

Before your test:

• Do not eat, drink or smoke for two hours.
• Do not take beta blockers, nitrates or certain calcium channel blockers for 48 hours (check with your doctor or pharmacist).
• Bring a list of your medications.
• Wear comfortable clothes and running shoes if you are doing a treadmill or bicycle test.

On the day of your test:

A sonographer (a specially-trained technologist)  or doctor will explain the risks and benefits of the test and ask you to sign a consent form. Sticky patches (electrodes) will be placed on your chest to monitor your heart.  

If parts of your heart are hard to see, you may be given a small injection of a medication called Definity to improve the images and increase the accuracy of the test.

Exercise stress echocardiogram:

You will walk on a treadmill or pedal a bicycle. The speed, incline or resistance will increase gradually. Your heart rate and blood pressure will be monitored. You will be asked to keep going as long as you can. Ultrasound images will be taken before, during and/or after exercise.

Dobutamine stress echocardiogram:

If you cannot exercise, you will be given a medication called dobutamine to make your heart work harder. It is given over 15 to 20 minutes until you reach the target heart rate. If needed, another medication called atropine may be used to raise your heart rate. Images will be taken before and during the test. 

A TEE is an ultrasound test that looks at the heart from inside the esophagus (food pipe). It helps your doctor see parts of the heart that may not be clear on a regular echocardiogram. It may be used to check for blood clots, valve problems or issues with the aorta.

Before your test:

• Do not eat or drink for six hours.
• Bring a list of your medications.
• Arrange for someone to stay with you and take you home.

During your test:

A sonographer will explain the procedure and ask you to sign a consent form. You will get an IV and be asked to remove any dental appliances such as dentures. Your throat will be sprayed with numbing medicine, and you will receive a mild sedative to help you relax. A bite guard will be placed in your mouth.  

The doctor will gently guide the ultrasound probe into your esophagus while you swallow several times. The test takes about 15 to 20 minutes. Images and measurements will be reviewed by a cardiologist and a report sent to your doctor. 

After your test:

• Do not eat or drink for one hour.
• Do not drive or use heavy machinery for 12 hours.

A nuclear perfusion scan shows how blood flows to your heart muscle. The test is done in two parts—one while your heart is resting, and one while it is working hard. These parts are done on separate days.

Resting part:

A nuclear medicine technologist takes pictures of your heart while you are at rest.

Stress part:

A technologist or doctor will explain the risks and benefits of the test and ask you to sign a consent form.  

Electrodes will be placed on your chest to monitor your heart rate and rhythm. Your heart rate and blood pressure will be checked throughout.

You will walk on a treadmill.  If you are unable to exercise for any reason, you will be given a medication (dipyridamole or dobutamine) to make your heart work hard instead.  The test will start slowly and gradually.  The speed and incline will increase gradually.  You will be encouraged to exercise for as long as possible.  

Imaging:

For both parts, a small amount of radioactive medication (radiotracer) is injected into a vein. It travels to your heart and helps a special camera take pictures. The radiation is not harmful. You will need to lie still while the images are taken.

Before your test:

• Do not eat, drink or smoke for four hours.
• Avoid caffeine for 24 hours (coffee, tea, chocolate, cola).
• Do not take beta blockers, nitrates or certain calcium channel blockers for 48 hours (check with your doctor).
• Bring a list of your medications.
• Wear comfortable clothes and running shoes if you are doing the exercise test.
• Go to the Nuclear Medicine Department on the main floor.

Patient guide: Cardiac Perfusion Scan

A MUGA scan checks how well your heart pumps blood and looks at the size of the heart’s lower chambers (ventricles). During the test, a technologist will inject a small amount of radioactive medication (called a radiotracer) into a vein in your arm. This medication is not harmful, and it helps show how blood flows through your heart.

You will lie still on a table while a special camera (called a gamma camera) takes pictures of your heart.

No preparation is needed for this test. 

A pulmonary function test checks how well your lungs work. It measures how much air your lungs can hold and how well they move oxygen through your body. The test is painless and takes about 30 to 45 minutes.

During the test, a respiratory therapist will guide you through different breathing exercises. Some may be repeated up to eight times to get accurate results. After the test, a respirologist will review the results and send a report to your doctor.

Before your test:

• Do not smoke, vape or use a water pipe for one hour.
• Avoid vigorous exercise for one hour.
• Wear loose, comfortable clothing that allows your lungs to expand.

This test helps your doctor find out if you have asthma and how severe it is. Before the test, you will have a regular lung function test to measure your breathing.

During the test, you will breathe in small amounts of a medication called methacholine. This can cause changes in your breathing if you have asthma. Your breathing will be measured before and after each dose.

If you react to the methacholine, you will be given treatment to reverse the effect before you leave. The test usually takes between 30 minutes and one hour, depending on your response. 

This test checks if you might benefit from oxygen therapy. Some lung or medical conditions can make it harder for your body to absorb oxygen. The assessment may include one or more of the following:

• Arterial blood gas (ABG).
• Resting oximetry.
• Exertional oximetry.

The results may be used to support funding through the Ministry of Health.