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Medical Conditions A - Z

Looking Into Your Heart

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Did you know that your heart is one of nature’s most amazing creations? It consistently pumps blood throughout every beating moment of your life without fail. This process never stops and is occurring right now even as you’re reading these words. In fact, the heart is one of the organs whose activities are mostly unnoticed, yet, when a problem presents itself, its reactions are easily felt. It therefore, is imperative that doctors are able to find out what exactly is wrong with the heart once a symptom has been experienced. Over the next few pages, we will show you some of the tools specialists use to help diagnose what might be wrong with our hearts.

CaptureDiagnostic tests for the heart can be broadly classified into two categories, “non-invasive” or “invasive”. These are important as they help the doctor determine whether a heart attack occurred, the extent of damage within a patient’s heart as well as the severity of Coronary Artery Disease (CAD) that a patient might be suffering from. Knowing what these tests involve and why they are being performed therefore helps you feel more confident about them and allows you and others to make an informed decision which could save someone’s life.

Invasive tests involve the insertion of catheters into the blood vessels of the heart for a closer look into and around the heart. While invasive in nature, these procedures are performed by specialists who will constantly be monitoring you throughout. So have no fear if you undergo these procedures. Remember, they help your doctor devise the best treatment plans for you.


Electrocardiogram (EKG/ECG) aka Electrocardiography

What this does: Records electrical activity of the heart such as timing and duration of each phase of the heartbeat.

Why is this done: An ECG provides two important kinds of information. Firstly, by measuring time intervals on the test, a doctor can find out how long it takes an electrical wave to pass through the heart. This information shows if the activity is too normal or slow, fast or irregular. Next, the test tells doctors if parts of the heart are too large or overworked.

Chest X-Ray

What this is: A test which most would have heard of, a chest X-ray is simply a picture of the chest. This show the location, size and shape of the heart as well as its blood vessels.

How is this done: The patient’s chest will be placed next to the X-ray film and they will then be asked to hold their breaths and be still for two to three seconds.  During this time, a beam of X-ray passes through the chest and an image is captured on a special photographic film.

Holter Monitors

What this is: A battery-operated device which records your heart activity (ECG) continuously for 24 to 48 hours or longer. It is the size of a small camera and has wires which attach small electrodes onto your skin.

Why is this done: While ECG testing lets the doctor look at activity within the heart, it is only during that window of time and abnormal heart symptoms may come and go. Therefore, monitoring over time while the patient goes about their daily activities may be required.

Cardiac Computed Tomography Scans

What this is: Also known as CT scans, these diagnostic imaging tests use X-rays to create 3-dimensional image of the heart to show any blockages a patient may have in their coronary arteries.

Why this is done: Dr Teo explains, “Such scans are recommended in selected patients when other tests such as ECGs do not provide enough information about a patient’s heart. They also provide additional information, like the amount of plaque build-up in a patient’s arteries or in some cases, the presence of scarring in the heart muscle caused by heart attacks.”


Electrophysiology Study (EP Study)

What this is: A detailed evaluation of the electrical activity in one’s heart. Catheters inserted into the body are guided by a fluoroscopy machine into the heart. These catheters sense the electrical activity of the heart and are able to stimulate increased heartbeats.

Why this is done: “EP studies are usually recommended when other tests, such as holter monitors, ECGs or angiograms are unable to provide enough information to thoroughly explain a patient’s abnormal heart rhythm. The test even allows a safe reproduction of an abnormal heart rhythm. From here, specialists are then able to provide adequate medications which can best control it”, explains Dr Abdul Razakjr, Specialist in Cardiology & Consultant, Raffles Heart Centre.


Transesophageal Echocardiogram (TEE)

What this is: The TEE test utilises ultrasound technology to provide a close look at the heart’s valves and chambers. This is done by placing the ultrasound equipment on an endoscope, a thin and flexible instrument, and guiding it down the patient’s esophagus. Once in position, pictures of the heart are obtained at various angles using ultrasound technology.

Why is this done: A TEE test is usually performed when a specialist needs to assess the overall health and function of the heart’s valves and chambers. A TEE allows for a closer look at the small and detailed structures of the heart as well as its associated vessels. This test also helps to check for abnormalities or diseases within the heart structure such as pericardial disease.