For Patients – SQ Cardiology

Holter monitor information
What is a Holter Monitor?
A Holter Monitor is a portable electrocardiogram (ECG) used to continuously monitor a patient's heart for 24 or 48 hours.
Why is a Holter Monitor Test Performed?

A Holter Monitor is used to assess the rhythm of the heart as the patient goes about their normal daily activities. A Holter Monitor is often used to assess whether a rhythm disturbance is responsible for a patient’s symptoms.
It can also be used to assess the effectiveness of medications on the heart rate and / or heart rhythm.
Preparation for Holter Monitor Use

On the day of the test,we recommend the following

There is no specific dietary preparation for the test

Bath or shower before your appointment as you will not be able to do so while the monitor is on.

Please do not use body lotion on your chest - this may interfere with the adhesive electrodes.

You will be asked permission to perform the test
What to Wear for Holter Monitoring

When you enter the test room patients are required to:

The Technician will talk you through the process.

A loose-fitting shirt or button up shirt, pants with pocket (to put the machine in)
Patients are prepared for the test by having:

Electrode sites on the chest are thoroughly cleansed with alcohol wipes and “skin sandpaper” is used to rough up the skin surface for better traction.

Some men require a small amount of shaving to ensure good electrical contact between the electrode and skin which can be hampered by bodily movement during the test

Adhesive electrodes are then attached to the chest

The electrodes are connected to leads

The leads provide the signals for the ECG to record

These leads are then connected to a small monitor (about 8cm x 5cm x 2cm), which is then worn around the neck or in your pocket.
When wearing a Holter Monitor, please do not:

Tamper with the leads or battery as this may erase data from the device.

Bath / swim / shower with the monitor on - you cannot get the monitor wet.

Sleep on an electric blanket which is switched on. This will interfere with the recording. If desired, it is okay to turn an electric blanket on to warm up the bed before hopping in - if is turned off before you get in.

Use any device which puts electrical current through your body during the monitoring period as this may erase data. This includes devices such as a TENS or Interferential machine, or a “Circulation Booster”

24 Hour Ambulatory Blood Pressure

24HR ambulatory blood pressure monitoring is a method to measure blood pressure on a continuous basis. Your BP is measured even as you sleep. The ongoing data helps your Cardiologist get a more accurate picture of your blood pressure numbers. PRIOR to attending appointment Please shower before you arrive, you cannot remove the equipment. Wear a comfortable shirt, you can change your pants .

Exercise stress Echocardiogram (Treamill)
What is an Exercise Stress Echocardiogram?

An exercise stress Echocardiogram at SQ Cardiology is performed is on a treadmill. We perform exercise stress testing alone or with echocardiography (cardiac ultrasound) at the same time – this is called exercise stress echocardiogram

Why do I need a cardiac exercise stress Echocardiogram?
Your doctor may recommend a cardiac stress test to for various reasons.
What are the risks of having a cardiac exercise stress test?
A cardiac exercise stress test is non-invasive and very safe. You’ll be accompanied by a cardiologist who will monitor your health and check for any concerns during the test.

How do I prepare for an exercise stress Echocardiogram?
You can prepare for your cardiac exercise stress test by:

Wearing loose, comfortable clothing, a good pair of walking shoes.

You can eat drink and take you regular medications.

We ask you to complete a Consent form before the test.

A Cardiologist supervises this test
What happens during a cardiac exercise stress Echocardiogram?

During your cardiac exercise stress Echocardiogram, you’ll be required to walk on a treadmill for as long as you can. Every 3 minutes, the speed, incline and resistance of your treadmill will increase, up to 15 minutes maximum.

During the test, our Cardiac Sonographer and Cardiologist will monitor your ECG, heart rate, blood pressure and heart rhythm. They will stop the test if:

You cannot continue to walk on the treadmill for any reason

You develop severe chest pain

Your blood pressure is becoming a concern

The ECG shows your heart isn’t getting enough oxygen

You develop significant heart rhythm disturbances
The test takes less than 40 minutes in total.

What happens after a cardiac exercise stress Echocardiogram?

After you complete your cardiac exercise stress Echocardiogram, you’ll be monitored until your heart rate returns to its normal resting rate. Your test results will be explained to you verbally, the comprehensive report will be filed at SQ Cardiology and a copy will be sent to the referring Doctor and any others at request

Echocardiogram information
An echocardiogram (echo) or echocardiography is the term given to the ultrasound examination of your heart. It is a test in which high frequency sound waves are used to create a moving picture of your heart to detect structure and function of the heart.

Why is an echocardiogram done?
You may be asked to have an echo for many different reasons to assess to heart structure and function.
Preparation
No preparation is required for the test.

How is the test performed?

A trained and accredited Cardiac Sonographer will be performing the test. An instrument (transducer) that transmits and receives high frequency sound waves will be placed in various positions on your chest. These different positions allow the sonographer to examine the entire heart from multiple angles and directions. The transducer picks up the echoes of the sound waves and transmits them as electrical impulses. The echocardiography machine then converts these impulses into moving pictures. A cardiologist will provide the final report of the findings.

What should I expect?

You will be required to be bare chested but will also be given a front opening gown to wear and then lie down on an examination table. ECG electrodes will be placed on your chest and then you will be asked to roll onto your left-hand side. The transducer will be placed on your chest to take the pictures.

Ultrasound gel is used to improve contact and imaging quality. The transducer (see picture above) will be applied firmly against the chest wall to obtain the pictures, the Sonographer will ask you if this causes discomfort. A number of sites are utilised: the left side of the chest adjacent to the sternum (breast bone), the area under the left breast, the upper abdomen and the base of the neck. You may hear noises that sound a bit like a washing machine, this represent the magnified ultrasound signal of blood flowing through the heart chambers and valves and is completely normal. The scanning time will be approximately 40 minutes and may vary depending on the findings.

You will at times be asked to take a deep breath in, or to hold a breath out, this will only last approximately 5 seconds at time. The Sonographer will guide you through this at the time.

Once finished you will be given a towel to wipe off any gel that you may still have on your chest and to redress. There are showers available at most sites if you require one.