Onsite Cardiac Investigations

The Cardiologist may recommend further tests depending on the individual patient’s needs and concerns. These tests are usually carried out off site and may be invasive. Further tests and procedures may include:

Echocardiography (Echo)

An echocardiogram, or simply an “echo”, is a sonogram of the heart. Echocardiography is a procedure that uses high frequency sound waves (ultrasound) to take moving pictures of the heart. It is a painless procedure, which can provide a wealth of helpful information, including the size and shape of the heart (internal chamber size quantification), pumping capacity, and the location and extent of any tissue damage. The patient is asked to remove their clothing from waist up and lie on an examination table. A gown is provided for comfort. Electrodes and gel are placed on the chest and then the transducer is applied with some pressure. The test usually takes 30-40 minutes.Back To Top

Stress Testing

Cardiac stress testing is used to measure the heart’s ability to respond to external stress in a controlled clinical environment. Cardiac stress tests compare the coronary circulation while the patient is at rest with the same patient’s circulation observed during maximum physical exertion, by exercise on a treadmill, showing any abnormal blood flow to the heart’s muscle tissue. The level of mechanical stress is progressively increased by adjusting the difficulty (steepness of the slope) and speed. The test administrator examines the symptoms and blood pressure response with use of ECG (Electrocardiogram). Comfortable clothing (removable from waist up) and comfortable shoes are recommended. The test usually takes 20-30 minutes.Back To Top

Stress Echocardiography (Stress Echo)

A Stress Echocardiogram utilizes ultrasound imaging of the heart to assess the wall motion in response to physical stress. It is essentially a Stress Test combined with Echocardiography so that structural differences can be compared. First, images of the heart are taken “at rest” to acquire a baseline of the patient’s wall motion at a resting heart rate. The patient then walks on a treadmill to increase the heart rate. Finally, images of the heart are taken “at stress” to assess wall motion at the peak heart rate. Comfortable clothing (removable from waist up) and comfortable shoes are recommended. The test usually takes 30-45 minutes. Certain medications must be stopped a day or two in advance of this test, your Cardiologist will inform you, if necessary.Back To Top

24-hour Holter Monitor

A Holter monitor is a portable device for continuously monitoring various electrical activity of the cardiovascular system for at least 24 hours. Its extended recording period is useful for observing occasional cardiac arrhythmias, which would be difficult to identify in a shorter period of time with an ECG. It takes approximately 10 minutes to attach the monitor. Please note that you cannot take a shower or bath during these 24 hours. Loose clothing is recommended.Back To Top

Heart Event Monitor

Event monitors are small, portable medical devices that record the heart’s electrical activity, most often used to diagnose arrhythmias. Arrhythmias are problems with the rate or rhythm of the heartbeat. Event monitors are similar to an ECG (electrocardiogram). You can wear one while you do your normal daily activities. This allows the monitor to record your heart for a longer time than an ECG. Although similar, Holter and event monitors aren’t the same. A Holter monitor records your heart’s electrical activity the entire time you’re wearing it. An event monitor records your heart’s electrical activity only at certain times while you’re wearing it.Back To Top

Ambulatory Blood Pressure Monitor

Ambulatory blood pressure monitoring (ABPM) measures blood pressure at regular intervals over 24 hours. It is believed to be able to reduce the “white coat hypertension” effect in which a patient’s blood pressure is elevated during the examination process due to nervousness and anxiety caused by being in a clinical setting. 24-hour, non-invasive ambulatory blood pressure monitoring allows estimates of cardiac risk factors including excessive blood pressure variability known to increase risks of a cardiovascular event. Loose clothing is recommended. It takes approximately 10 minutes to attach the monitor.Back To Top

Electrocardiography (ECG)

Electrocardiography (ECG) is an interpretation of the electrical activity of the heart as detected by electrodes attached to the chest and recorded by a device external to the body. The recording produced by this non-invasive procedure is termed as electrocardiogram (also ECG). ECG is used to measure the rate and regularity of heartbeats, as well as the size and position of the chambers, the presence of any damage to the heart, and the effects of drugs or devices used to regulate the heart, such as a pacemaker. The test time is approximately 10 minutes. An ECG is taken for every patient prior to consultation. Comfortable clothing (removable from waist up) is recommended.Back To Top

Pacemaker Check

A Pacemaker check is performed at regularly intervals (6-12 months) on patients with pacemakers to ensure proper lead function & battery status or whenever a patient has symptoms related to the pacemaker. The test time is approximately 10 minutes. No preparation necessary.Back To Top

Coronary Angiography

Coronary angiography is a specialised X-ray test to find out detailed information about coronary (heart) arteries. It is mainly used if a patient has angina to assess the extent and severity of the angina. It involves a procedure called catheterisation.  A coronary catheterisation is a minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter. Therefore, coronary angiography can show the exact site and severity of any narrowing of the coronary arteries. This helps the doctor to decide on what treatment you may need. Please contact the hospital regarding preparation requirements.Back To Top

Coronary Angioplasty

A coronary angioplasty is a procedure used to widen blocked or narrowed coronary arteries. A short wire-mesh tube, called a stent, is inserted into an artery to allow blood to flow more freely through it. Coronary angioplasty is sometimes known as per cutaneous coronary intervention (PCI). It is commonly used to treat people who have angina. Angioplasty can also be used to help in emergency situations, such as when a person has a heart attack. It is a minimally invasive procedure as it does not involve making major incisions in the body. Please contact the hospital regarding preparation requirements.Back To Top

Coronary artery bypass surgery (CABG)

Coronary artery bypass graft (CABG) surgery, or commonly known as heart bypass, is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries or veins from elsewhere in the patient’s body are grafted to the coronary arteries to bypass the narrowing and improve the blood supply to the coronary circulation supplying the heart muscle. In general, CABG improves the chances of survival of patients who are at high risk. Please contact the hospital regarding preparation requirements.Back To Top


A pacemaker is a medical device that uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart. The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart’s native pacemaker is not fast enough, or there is a block in the heart’s electrical conduction system. A pacemaker is typically inserted into the patient through a simple surgery using either local or general anaesthetic. Please contact the hospital regarding preparation requirements.Back To Top


Cardioversion is a medical procedure by which an abnormally fast heart rate (tachycardia) or cardiac arrhythmia is converted to a normal rhythm, using electricity or drugs. Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart, at a specific moment in the cardiac cycle. The patient is given a short-acting general anaesthetic or heavy sedation for the duration of the procedure. A doctor puts electrodes, stuck to large sticky pads, on the chest. The electrodes are connected to a defibrillator machine and give one or more controlled electric shocks to the chest wall. The whole procedure usually lasts about 10 minutes. Please contact the hospital regarding preparation requirements.Back To Top

Transesophageal Echocardiography (TOE)

This is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient’s oesophagus. This allows image and Doppler evaluation from a location directly behind the heart. Transesophageal echocardiograms are most often utilized when transthoracic images from a standard echocardiogram are suboptimal and when a more clear and precise image is needed for assessment. Conscious sedation or localized numbing medication may be used in order to make the patient more comfortable during the procedure. Please contact the hospital regarding preparation requirements.Back To Top