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Cardiology examination

Everything about Cardiology Examinations

In Hungary, the death of every second person is caused by diseases of the cardiovascular system. The number of patients with coronary diseases is over 1 million. Early detection of heart diseases can be lifesaving; it is worth to take part in screening before complaints occur, because with appropriate therapy, pathological abnormalities detected in time can be treated effectively.
Cardiology examinations detect heart function disorders. Cardiovascular diseases include high blood pressure, stroke, as well as peripheral arterial occlusion.

When is it recommended?

You should visit a specialist if you experience the following symptoms:

  • dyspnoea, breathlessness, swelling of the feet;
  • dizziness, fainting;
  • chest pain, pressure in the area of the heart;
  • palpitation;
  • high or low blood pressure.
At what age is the examination recommended?

The incidence of heart and vascular diseases starts to increase over the age of 40. Regular screening is especially recommended for people in their 40s or 50s, also for people with a family history of accumulated cardiovascular diseases, and also for those with a family history of cardiovascular event that occurred at a young age (around the age of 50). It is recommended for young people who might have coronary abnormalities, for example active athletes. It is recommended for people with low/medium cardiovascular risks, regardless of age, and also for those who previously had heart surgery.

Are there any risks or side effects involved with a cardiology examination?

The examinations pose no (ECG, ultrasound) or minimal risk (exercise ECG test, transoesophageal echocardiography). The examinations do not have any side effects.

Types of cardiology examinations

TYPES OF CARDIOLOGY EXAMINATIONS AVAILABLE IN THE CENTRES OF AFFIDEA HUNGARY
Cardiology consultation
Echocardiography
Exercise ECG test
Isotope stress test
Echocardiography performed through the oesophagus (transoesophageal ultrasound)
Holter ECG examination
24-hour ambulatory blood pressure monitoring (ABPM) examination

CARDIOLOGY CONSULTATION

How is the examination performed?
The specialist reviews the medical history, performs a physical examination, ECG, echocardiography and measures the blood pressure. The duration of the examination is 20 to 30 minutes on average. The examination is not painful.
The booking time – with a referral, covered by public health insurance – is 1 to 2 weeks; in private care, in our private clinics, it is just a few days.
How should I prepare for the examination?
You should make preparations for an effective examination: make a list of your regular medications, bring your past medical records, discharge summaries and laboratory medical reports, not only the cardiology reports. Have an up-to-date laboratory medical report prepared and make notes of recent blood pressure values.

ECHOCARDIOGRAPHY
How is the examination performed?

During ultrasound imaging, animated images are made of the heart, the heart cavities, the walls surrounding them, the heart valves and the pericardium. The examination helps to detect wall motion disorders after infarction, scarring, heart valve diseases, potential blood clots, or fluid in the pericardium.
An echocardiography takes 20 minutes on average; it is absolutely painless, and it is performed in a supine position. The patient lies down in the bed with a naked chest; his/her skin is lubricated with a gel that promotes the propagation of ultrasound waves. The probe must be placed directly onto the skin, and at the end of the examination, the gel is wiped off.
The booking time – with a referral, covered by public health insurance – is 1 to 2 weeks; in private care, in our private clinics, it is just a few days.

How should I prepare for the examination?

Please bring your previous medical reports.

ECHOCARDIOGRAPHY PERFORMED THROUGH THE OESOPHAGUS (TRANSOESOPHAGEAL ULTRASOUND)

An advantage of this examination is that – with the help of the ultrasound probe introduced into the oesophagus – this examination enables the examination certain structural and functional details of the heart that would not be visible with an “external” examination, i.e. an examination performed through the chest wall. The cardiologist obtains an animation of the heart, and can study the cavities of the heart, the surrounding walls, the heart valves, the pericardium, and the large vessels.

How is the examination performed?

During the examination, the patient lies on the examination table with a naked chest. The ECG electrodes are put on his/her chest, and the patient has to swallow a tube (the probe), which is approximately 1 cm in diameter, to enable the examination of the heart through the oesophagus. The probe is introduced in local anaesthesia, and the examination is performed in mild narcosis. Sedatives will be given intravenously before the examination. The procedure is unpleasant, but not painful; patients usually experience less discomfort than expected.
The duration of the examination is 40 minutes including preparation; the examination itself takes 10-15 minutes.
The booking time – with a referral, covered by public health insurance – is 7 to 10 days; in private care, in our private clinics, it is just a few days.

How should I prepare for the examination?

At least 4 to 6 hours of fasting is required before the examination, and eating or drinking is not allowed 2 hours after the examination. Driving is only allowed the day after the examination. As sedative is administered for the examination; please come accompanied.

EXERCISE ECG TEST
How is the examination performed?

An exercise ECG test is only performed in conjunction with a cardiology consultation. This examination helps evaluate the effect of physical exercise and the accompanying increased oxygen demand on the heart. The examination takes approximately 20 minutes, during which the patient is asked to walk on a treadmill; first, at a slow pace, which is increased every 3 minutes. The aim of the examination is to achieve an age appropriate level of exertion, as assessed by the pulse-rate.

How should I prepare for the examination?

Please bring your previous medical reports and inform the examining physician about your regular medications. If a regular medication was skipped before the examination, please also bring them so that you can bring them after the examination. It is recommended to come in sporty clothes and comfortable shoes.

ISOTOPE STRESS TEST

Perfusion of the heart muscle is altered by certain diseases, such as coronary stenosis, heart attack, or heart failure. Access and absorption of isotope-labelled substances is changed in areas with altered function and perfusion. This examination enables the visualization of the muscles of the heart cavities. The examination is performed in two parts: first when the heart is at rest, and then on exertion.

How is the examination performed?

During the examination, electrodes are applied on the chest of the patient, which detect the electrical activity of the heart, and an ECG is performed. An isotopic tracer is administered to the patient as an injection, and images are taken 1.5 to 2 hours later. Two images are taken and when the second image is taken, a vasodilator agent is administered before injecting the isotope, under cardiology control.
The examination is not painful; only the administration of the injection might cause slight discomfort.
Scanning takes 2 to 3 hours for each scan.
The booking time – with a referral, covered by public health insurance – is 7 to 10 days; in private care, in our private clinics, it is just a few days.

How should I prepare for the examination?

Please come with an empty stomach on both occasions for the isotope stress test. You may drink water and eat food twenty minutes after the administration of the isotope. You may take your regular medications, antihypertensive drugs, except for those (e.g. Nitromin [nitroglycerin], Nitromint-retard [nitroglycerin], Betaloc [metoprolol], Betaloc-ZOK [metoprolol], etc.) altering the perfusion of the heart muscle. Please ask your physician about the medications that cannot be taken before the examination.

HOLTER ECG EXAMINATION

A Holter ECG examination records the electrical activity of the heart continuously, for 24 hours, while the patient carries out his/her daily routine. This method helps detect periodically appearing anomalies, for example arrhythmias.

How is the examination performed?

During monitoring, the measured data are recorded with the help of a small ECG device worn continuously for 24 hours. Wires connect to the electrodes on the chest from the device, which is hanged on the patient’s neck or attached to his/her belt. The Holter ECG device has a size of a pack of cigarettes. Wearing it does not disturb everyday activities, but care should be taken to avoid contact with water, even when showering, so taking a shower is forbidden for the time of monitoring.
The booking time – with a referral, covered by public health insurance – is 1 to 2 weeks; in private care, in our private clinics, it is just a few days.

24-HOUR AMBULATORY BLOOD PRESSURE MONITORING (ABPM) EXAMINATION

During blood pressure monitoring, the patient’s blood pressure is automatically measured for 24 hours, and the measured data are recorded.

How is the examination performed?

A blood pressure cuff, which has a size of a mobile phone, is put on the patient’s arm, and it is connected to a device that can be attached to the neck or waist. The cuff is placed over the clothing, so please wear a thin, long sleeved shirt for the examination. Setting the devices takes approximately 10 minutes. During the 24-hour monitoring, the patient should carry out his/her daily routine. The device must not get into contact with water and must not be taken off.
The booking time – with a referral, covered by public health insurance – is 1 to 2 weeks; in private care, in our private clinics, it is just a few days.