Angiogram

An angiogram is used to demonstrate the anatomical features and functions of the heart and blood vessels.

For coronary angiography, a specially shaped catheter is inserted via the femoral artery. Under X-ray screening (fluoroscopy), it is then manipulated into the desired coronary artery. Radio opaque contrast medium is then injected into the artery through the catheter and a cinefilm (moving image) is taken of the X-ray image.

A right heart study may also be performed by inserting a Swan-Ganz catheter via the femoral vein, and feeding it into position in a pulmonary artery. Pressure within the pulmonary artery, right atrium and right ventricle can then be measured.

Both of these procedures are performed with full ECG and blood pressure monitoring throughout the duration of the procedure.

Cardiac event monitoring

This test records the rhythm of the heart for a period of 7 to 14 days as prescribed by your doctor.

The monitor is the size of a beeper that you can remove and apply as required.  If you experience light-headedness, heart palpitations, skipped beats, or dizziness, you simply push the button to record or monitor the incident.

This information is sent via a telephone line to the office where it is printed out and evaluated.

Echocardiogram

The Echocardiogram (TTE) directly images your heart. It demonstrates the pumping action, evaluates the function of the heart valves and detects anatomic abnormalities in the heart.

The heart is imaged by an ultrasound transducer, which is held against the chest wall in different positions.

No preparation is required for the test, which takes about 45 minutes.

Electrocardiogram (ECG)

The electrocardiogram records the electrical activity of your heart and provides information about your heart’s rhythm, anatomy and function.

It is a simple, safe and painless test taking less than 10 minutes to complete. No preparation is needed.

Electrophysiology study (EPS)

An EPS is a special test to study the electrical impulses that make your heart beat. There are many indications for EPS, but syncope (fainting) and slow and fast heart rates are the most common.

During the EPS, plastic coated wires called electrode catheters are inserted into the right side of your heart from a blood vessel in your groin. These catheters sense the impulses from your heart, and can be used to stimulate the heart rate.

By making different parts of your heart beat at the speed we want, we are able to measure which direction the electrical impulses move around your heart and this will tell us if the electrical circuit in your heart has a specific problem.

In some instances, catheter ablation therapy will be used to try and correct your arrhythmia problem.

Holter monitor

This is a continuous ECG recording over a period of 24 hours or more as you go about your daily living. It is designed to evaluate and detect any arrhythmia (palpitations) of the heart.

The Holter monitor is a small portable recorder that is attached to you by several chest electrodes.

You will be able to undertake normal activities while the monitor is attached, however, you will not be able to take a bath, shower, or get your chest area wet during the 24-hour test. Therefore we suggest you have a shower before you come in.

Your ECG will be recorded for 24 hours, and you will be asked to return the following day to have the monitor removed.

The information is downloaded to a computer and analysed. The report is then sent to the referring doctor.

Stress echocardiogram

A stress echocardiogram is a combination of a treadmill test with an echocardiogram.

While exercising, your heart is monitored on an ECG machine, which displays the electrical activity of your heart's response to the exercise. The echocardiogram requires you to lie on your left side while images are acquired of your heart. The images acquired before you exercise (resting echo) will be compared to the images immediately after you exercise (echo at peak – exercise heart rate).

If you are unable to exercise, a dobutamine stress echocardiogram may be used. Dobutamine is put into a vein and causes the heart to beat faster. It mimics the effects of exercise on the heart.

The test evaluates your heart under conditions of physical stress and also provides information about the condition of your heart and its blood supply.  Additionally, it can evaluate abnormalities of cardiac rhythm. Your blood pressure will also be measured regularly during the test.

Transoesophageal echocardiogram (TOE)

Transoseophageal echocardiography (TOE) is an invasive test that is performed to provide your doctor with high quality pictures of your heart. It evaluates heart chamber size and pumping action, valve appearance and function and the blood flow through the heart.

The ultrasound images of the heart are taken from your oesophagus (food pipe), which lies next to the heart. TOE provides more detailed images compared to echo pictures obtained from the chest surface, where the picture quality may be variable.

The procedure involves numbing the back of the throat with a local anaesthetic spray. You will be fitted with a mouth guard. An intravenous tube (IV) will be inserted in your arm to allow medication to be given to you. You will be given medicine to sedate you and help you relax.

When you are relaxed, the probe is placed gently into your mouth and passed down your oesophagus to the area close to the heart, and images are obtained. After the test is completed, the probe is removed and the IV taken out of your arm. You will then rest for 1-2 hours before you can go home.

How to prepare for this test

Do not eat or drink anything for six hours prior to the test. You may take your normal medications with a sip of water unless your doctor instructs you to do otherwise. If you are taking insulin, please consult your family doctor for special instructions.

You must arrange for someone to take you home after the test. As you will be given medication to relax you, you will probably be sleepy for some time after the test. It is unsafe to drive a car or use heavy machinery until the day following your procedure.

The back of your throat may still be slightly numb after the test, so you should wait two hours before you sip some water. You should only try to eat solid foods when you can drink normally and your throat is feeling normal.

Referrals

For patients

In an emergency, call 000 and ask for an ambulance.

Otherwise, you need a referral from a GP, specialist or other health professional to access this service.

For health professionals

Address referrals to A/Prof Omar Farouque, Director, Cardiology.

A request for admission indicates a high degree of urgency.

For urgent referrals, call Switchboard on 03 9496 5000 and ask for the Cardiology registrar.

Prevocational doctors program (PGY1)

Cardiology

Phone: 03 9496 5527

Fax: 03 9496 6630

Open hours: Monday to Friday 8am to 4.30pm

Location

Ward 5 North
Level 5, Austin Tower
Austin Hospital 
145 Studley Rd 
Heidelberg VIC 3084

Postal address

Cardiology
Austin Health
PO Box 5555
Heidelberg Victoria 3084