Tests and Investigation FAQs

Electrocardiogram (ECG)

What is an electrocardiogram?

  • An electrocardiogram is a diagnostic test which records the heart’s electrical conduction system. It provides information regarding heart rate and rhythm and can demonstrate prior damage to the heart, cardiac strain, a heart attack and various cardiac anomalies.

What is involved?

  • Adhesive electrodes are attached to the chest and limbs and connected to an ECG machine.

What should I wear?

  • Comfortable two-piece clothing as it is necessary to expose the chest. Small areas on the chest may need to be shaved in order to ensure adequate skin contact of the adhesive electrodes.

Transthoracic Echocardiogram (TTE)

What is a transthoracic echocardiogram?

  • An echocardiogram assesses the structure and function of the heart.  Using ultrasound waves, an echocardiogram produces images and moving clips of your heart to visualise the heart chambers, heart valves and blood flow through the heart.

What is involved?

  • A transthoracic echocardiogram involves exposing the chest. A cardiac sonographer applies an ultrasound probe with gel to your chest wall.  This allows visualisation of the heart structures and function.  The test will take 45 minutes.  A cardiologist will then analyse the echocardiogram pictures and clips and produce a report.

What should I wear?

  • Comfortable two-piece clothing as it is necessary to expose the chest. A gown will be provided for comfort and privacy.

Transoesophageal echocardiogram (TOE)

What is a transoesophageal echocardiogram?

  • Transoesophageal echocardiogram is a specialised form of echocardiogram which assesses specific abnormalities affecting the heart valves and chambers of the heart that are not able to be seen on a transthoracic echocardiogram.

What is involved?

  • The test is performed by a cardiologist with specialised training in cardiac imaging and an anaesthetist who provides sedation. An ultrasound probe is inserted into the oesophagus to obtain images of excellent clarity so that specific structures can be visualised.  The test takes 1 hour and is performed as a day case where patients are admitted to hospital that day, for the procedure.

What preparation is required?

  • Take all your regular medications on the day of your procedure.
  • Patients are required to fast for 6 hours before the procedure. If medications are due during their fast, these may be taken with a small sip of water.

What happens after the procedure?

  • You will not be able to drive following your TOE due to the administration of sedation. You will need to arrange for somebody to drive you home.

If you have any queries regarding your transoesophageal echocardiogram, please ring our reception staff who will liaise with your cardiologist about your procedure.

Stress Echocardiogram

What is a stress echocardiogram?

  • This is a test which combines an exercise stress test with transthoracic echocardiography. This test is ordered to evaluate exercise related symptoms such as shortness of breath or chest pain and to assess for the presence of cardiac (coronary) artery disease.  Cardiac valve function is also assessed.

What is involved?

  • This test involves taking a baseline ECG and echocardiogram (see above). You then begin exercising on a treadmill in the presence of a cardiac sonographer and a cardiologist.  The exercise will start at a slow pace and gradually increase in intensity.  The maximum intensity of exercise reached is graded to suit each person’s ability.  Your ECG and blood pressure are monitored continuously whilst you are exercising.  At the completion of exercise, a repeat echocardiogram will be performed and compared to your baseline study.  Your will then be monitored during your recovery.   If patients are not able to exercise, a medication can be given to simulate exercise called Dobutamine.  The entire test will take approximately 1 hour.  The treadmill exercise component is usually completed within 10 minutes.
  • Our stress echocardiograms are performed at the Peninsula Health Heart Service and are bulk billed.

What should I wear?

  • Adequate footwear for walking on a treadmill.
  • Comfortable two-piece clothing as it is necessary to expose the chest for both the ECG and echocardiogram. A gown will be provided for comfort and privacy.

What should I take?

  • A complete list of your medications.

What happens after the procedure?

  • Your cardiologist will discuss the test result with you and advise of any additional follow-up that is required.

If you have any queries regarding your stress echocardiogram, please ring our reception staff who will liaise with your cardiologist and/or Peninsula Health Heart Service regarding your stress test.

Cardiac CT

What is a cardiac CT?

  • This is a specialised CT (Computed tomography) which takes images of the arteries of the heart (coronary arteries). Dr Premaratne is the head of the Cardiac CT service at Peninsula Health.  They use a Siemens Force scanner, which is one of the most advanced scanners in the world.

What is involved?

  • This test involves a drip being inserted into the arm and intravenous contrast dye being administered to allow visualisation of the coronary arteries. A CT of the chest area is then performed.  The test and preparation takes 3 hours.
  • Please notify your cardiologist at the time of booking your cardiac CT if you have an allergy or have had a prior reaction to iodine, iodine containing foods (seafood) or contrast dye.
  • To optimise your cardiac CT images, patients also sometimes require a medication to slow their heart rate. This will be discussed with you before your cardiac CT.  A cardiac nurse at Peninsula Health will administer this medication if it is required.

If you have any queries regarding your cardiac CT appointment, please ring our reception staff who will liaise with your cardiologist and/or Peninsula Health radiology about your appointment.

Coronary Angiography, Angioplasty and Intervention

What is a coronary angiogram and angioplasty?

  • A coronary angiogram is a procedure performed to examine the blood vessels of your heart (coronary arteries). It will provide information regarding the blood vessels and any abnormalities that may be present including narrowing and/or blockages.  Images are acquired using contrast dye and X-rays.
  • Coronary angioplasty involves using a specialised balloon to open a blocked or narrowed artery. A stent can then be deployed to keep a blocked artery open.

What is involved?

  • You will be admitted to hospital either the day before or the day of your procedure.
  • A catheter will be inserted into an artery via either the wrist or the groin. Contrast dye will be injected via the catheter to allow visualisation of the coronary arteries.  X-ray images will then be acquired.

What preparation is required?

  • Your cardiologist will check your kidney function and blood clotting levels prior to your procedure.
  • You should not eat or drink for 4 hours prior to your procedure. Most medications can be continued however a few may need to be withheld.  Your cardiologist will discuss this with you prior to your procedure.
  • At the time of booking your procedure, please notify your cardiologist:
    • Of any allergies you have or if you have had any previous reactions to X-ray contrast dye, iodine or iodine containing food (eg seafood)
    • If you have kidney disease
    • If you are taking blood thinning or antiplatelet medications
    • If you are taking any diabetes medications containing metformin, empagliflozin (Jardiance) or dapagliflozin (Forxiga). Please note some diabetes medications contain combinations of drugs, please check the components of your medications.

What happens after the procedure?

  • Following the procedure you will receive compression on the site of your puncture (where the catheter was inserted into an artery), to stop bleeding.
  • You will not be able to drive following your procedure due to the administration of sedation. You will need to arrange for somebody to drive you home and to stay with you overnight.

If you have any queries regarding your cardiac angiogram, please ring our reception staff who will liaise with your cardiologist.