CARDIOLOGY SERVICES AND TESTS
GENERAL CARDIOLOGY SERVICES
Helping You Get Heart Healthy
Dr Ghosh is an expert in all aspects of general cardiology and sees patients with high blood pressure (hypertension), high cholesterol, chest pain, angina, palpitations, arrhythmias, shortness of breath, heart failure, valve disease and cardiomyopathies.
A tracing of the heart rhythm
12 stickers are put on the chest and body to do obtain a trace of the heart’s electrical rhythm. This can determine if there are any problems with heart rhythm (palpitations). Takes 1 minute.
WHAT IS CARDIO-ONCOLOGY?
Protecting Your Heart While You Fight Cancer
Cardio-Oncology is the care of heart problems in cancer patients. These problems may arise as a result of common cancer treatments e.g. anthracyclines (doxorubicin, daunorubicin), Herceptin (trastuzumab) and others (5FU, Velcade, Ibrutinib etc.) and radiotherapy.
Dr Ghosh is an expert in assessing patients from a cardiac perspective prior to the initiation of therapy and monitoring patients while they complete cancer treatment.
Using new techniques [advanced ultrasound scans of the heart (4D echocardiography), cardiac MRI and blood tests], Dr Ghosh aims to detect cardiac issues at an early stage of cancer treatment to enable the early initiation of heart treatments.
CARDIAC IMAGING (CARDIAC MRI AND ECHOCARDIOGRAPHY)
Getting An Accurate Picture of Your Heart
Dr Ghosh is an expert in cardiac imaging. Using cardiac MRI and echocardiography he can diagnose coronary artery disease, heart valve disease, previous heart attacks, heart muscle disease (cardiomyopathies). These tests can also help determine the potential risk of a future cardiac event.
24 HOUR TAPE/HOLTER MONITOR
24h heart rhythm monitor
3 electrodes are put on the chest and a monitor placed on a belt around waist. Monitors heart rhythm for 24h. Can also have tapes for 48h/72h/1 week. This is used when a patient complains of palpitations to determine if they correspond to an abnormal heart rhythm.
EXERCISE TREADMILL TEST (ETT)
Assessing exercise capacity
The patient runs on a treadmill with the aim of checking if exercise causes changes to the heart rhythm or blood supply of the heart. Takes 45 minutes and would be requested if a patient complains of tiredness, shortness of breath on exercise, chest pain, palpitations and collapse.
Longer monitoring of the heart rhythm
This device is used to monitor the heart rhythm for 2-4 weeks. The principle is the same as a Holter monitor but a Zio patch is more comfortable to wear for prolonged use.
Assessing heart stucture and function
An ultrasound examination of the heart looking at heart structure and function. The test assesses how well the heart is pumping and how the valves are working. It also looks at the size of different cardiac chambers and takes around 45 minutes to perform. This is requested when a patient complains of tiredness, shortness of breath on exercise, chest pain, palpitations and collapse.
Assessing effect of exercise on heart function and valves
If an echocardiogram is combined with exercise (on a bike) it is called a stress echo. This assesses how the heart copes with exertion and can also be used to test indirectly for problems with blood supply to the heart (i.e. test for angina or coronary heart disease). Takes around 1 hour and is requested if the patient has a diagnosis of heart failure, valve disease or previous heart attack.
Cardiopulmonary exercise test (CPEX or CPET)
Cardio-respiratory fitness assessment
The patient cycles on a bike wearing a mask while oxygen levels are assessed. The test may be combined with an echocardiogram. This test is used when a patient complains of shortness of breath to determine if the cause is cardiac, respiratory or decreased fitness levels. The test takes around 45 minutes.
CARDIAC MRI (CMR)
Imaging of heart structure and function
MRI scan of the heart (scanned in a tunnel-like structure). The test looks in more detail at heart structure and especially the characteristics of the heart muscle compared to an echo. It can determine the presence of previous heart attacks and inflammation of the heart. If the CMR has a stress component (optional) it can then also determine if there are ongoing problems with blood supply to the heart (i.e. test for angina or coronary heart disease). Takes around 1 hour. We can accommodate most claustrophobic patients. If the patient has metal in the body (e.g. knee replacement) we will need to take details of this before the scan.
Visual assessment of heart blood supply
This test takes places in a cardiac catheterization laboratory (cath lab). Under local anaesthesia a small tube is inserted via a blood vessel in the wrist or leg up to the heart. A dye is then used to take X-ray pictures of the blood supply of the heart. If required a stent (small metal tube) is inserted through the same tube to open up blocked heart blood vessels (angioplasty).
Imaging coronary arteries
A CT scan (doughnut-shaped machine) of the heart which looks to see if there are any blockages of the blood supply to the heart (causing angina or coronary heart disease). Can also looks at other large blood vessels. Takes around 10 minutes and is used if the patient is complaining of chest pain.