We offer routine resting ECG (Electrocardiogram) (this is a very quick test that does not inflict any pain or discomfort on the patient – heart tracing test at rest) and in some cases are able to arrange 24 hour Ambulatory ECG or Stress or exercise ECG for our clients.
ECG helps to assess the electrical activity of the heart at rest to detect any heart muscle damage or any problems associated with the rhythm of the heart beat also called “arrythmias.”
In what circumstances do we routinely do resting ECG – heart tracing?
- When patient presents with difficulty breathing (DIB).
- When patient presents with chest pain – suspected angina.
- Fainting spell.
- When patient experiences palpitations – when you feel your heart pounding and sometimes can hear your heart beat.
In some cases ECG done at rest may fail to pick up any abnormality such as any evidence of narrowing of the blood vessels supplying the heart with oxygenated blood. In such cases we would recommend the 24 hour ambulatory ECG or Exercise or stress ECG which are more likely to identify such problems.
Resting ECG may help to determine if the patient is having a heart attack or had heart attack in the past; it may help us monitor the effect of certain treatment on the heart and or the effect of any abnormal electrolytes in the body such as the Potassium levels. In some cases if the heart muscles become thickened by disease this may be identified on the resting ECG.
24 Hour Ambulatory ECG
This involves attaching a machine to your waist and the leads from the machine attach to your chest with electrodes to record the rhythm of the heart (how the heart is beating) for 24 hours. The downside is that once you are hooked onto this machine you cannot get wet, so no showers or bathing or swimming until the machine is taken away for reading after the 24 hours.
In some instances we would need to carry out Exercise ECG using exercise bike or treadmill. During this procedure we are monitoring the following:
- The Blood Pressure
- The Heart rate (number of beats per minute)
- The Heart Rhythm
It measures the response of the heart rate and the blood pressure during period of exercise or exertion.
Ultrasound Scan (USS)
In some cases, we also Ultrasound tests or investigations to help identify the nature of and/or the cause of presenting symptoms. This uses sound waves to create images of organs and other structures in the body. This test is generally regarded as very safe and does not use any radiation.
It is generally cost effective in making diagnosis of certain common conditions including the following:
- Problems with the liver, gall bladder (especially stones in the gall bladder) and the pancreas.
- Problems with the thyroid gland.
- Diagnosing problems with enlarged lymph nodes.
- Problems with the kidneys, ovaries, testis, scrotum, bladder and the breasts.
- Identifying enlarged blood vessels such as abdominal aorta aneurysm (abnormally large blood vessels)
- Monitoring the well being of pregnant women and their unborn babies.
- Looking for foreign bodies anywhere in the body.
It is particularly useful in identifying whether a swelling is solid or contains fluid.
Echocardiogram is a special USS of the heart and is useful in detecting any abnormalities of the heart chambers or its valves.
USS can also be used in other more specialised areas including when placed in the vagina or rectum, when it may give us more information on the pelvic and reproductive organs.
If placed or swallowed in the throat or gullet, it may give us more information on the heart which lies just in front of the gullet.
We may request X-rays in certain instances to help us with our diagnosis of a condition. Some of the common X-rays we may request include X-rays of the chest, limbs, abdomen, neck, kidneys, ureters and bladder also called “KUB”. In some cases we may require specialised X-rays including DEXA scans for the diagnosis of bone disease such as OSTEOPOROSIS. Others include a Barium swallow and so on.
Although X-rays are generally quick and cost-effective, they have limitations and in some instances we may have to use contrasts and more sophisticated tests including CT or MRI scans.
If X-rays are repeated frequently, it can result in damage to the cells in the body and this potentially can result in the development of certain cancers. Pregnant women are advised to avoid X-rays for fear of causing abnormalities in the unborn baby.
Some of the common reasons for requesting X-rays include:-
- To diagnose abnormalities of the bone and teeth including broken bones and other bone abnormalities including bone tumour or swelling.
- To look at the joint spaces in certain joint problems including osteoarthritis.
- To determine if the heart is enlarged, as in some cases with heart failure.
- Certain changes in the density of the tissues may give us a clue of the suspected problem for example Lung tumour on CXR appears more dense than the normal air filled lung and may appear as a “shadow” with higher density on the X-rays. A breast tumour may appear denser than the normal breast tissue and again may show up as a “shadow” on x-ray of the breast.
- Collection of fluid in the Lung or the gut may appear a “grey shadows” as against the normal black of air filled chest or air filled gut.
In some cases we may request MRI scan of specific parts of the body to help us diagnose certain conditions. Detailed images of organs or tissues in the body can be obtained by using magnetic fields and radiowaves. It is commonly used to get the detailed picture of the brain and spinal cord and also ruptured ligaments in the case of joints.
MRI uses strong magnetic fields and in some cases may potentially displace certain metal implants in the body resulting in their malfunction.
For this reason before a patient is put on the MRI scanner, the radiographer MUST be made aware if the patient has any implant including:
- Defibrillator or pacemaker
- Any ear implant
- Surgical clips especially those used to repair brain aneurysm
- Any artificial heart valves
- Implanted drug infusion ports
- Artificial limbs or any metallic joint implant
- Any implanted nerve stimulators such as used to treat Parkinsons
- Pins, clips, screws, plates, stents, or any surgical staples
- In some cases if there is any doubt a conventional X-ray may have to be done to exclude any metallic implant prior to going on the scanner
Certain MRI scanners can feel claustrophobic and some patients do not find this comfortable. If you suffer with claustrophobia we do encourage you to discuss this with us prior to any request for an MRI scan.
Pregnant women should not be referred for MRI scan if it is avoidable for fear of any harm to the unborn baby.
Computed Tomography Scan (CT Scan)
We offer CT scan in some instances to help diagnose certain conditions.
This uses X-rays + a scanner and a computer to take and produce cross-section images of the different parts of the body.
It is a quick, painless test which can last about half an hour or sometimes slightly less.
The pictures are produced due to the differences in X-ray absorption and allows for CT scan to differentiate between various tissues such as fat, soft tissue, the brain or the fluid in the brain (cerebrospinal – CSF).
The pictures obtained vary in thickness from 1-10mm and the thinner the slices the better the pictures or images produced of the particular tissue or organ.
The images produced by the CT scan are superior to those obtained by Ultrasound scan (USS) and help diagnose certain conditions with a greater degree of certainty compared to the USS.
It is a relatively quick examination or test compared to an MRI scan.
Some of the drawbacks to the use of the imaging technique include the following:
- In some cases the plain CT scan may fail to provide the detailed information required making a diagnosis and in such cases we may require the use of ‘Contrast’ to help improve the images and differentiate between the various tissues. Unfortunately, some patients may react to this Contrast as most of the contrasts used are iodine based. Newer contrast agents are available such as the non-ionic contrasts which are less likely to result in an allergic reaction but are known to be generally much more expensive.
- CT scan entails exposure to a high level of radiation. Itt is generally stated that one CT scan of the chest is the equivalent of 350 Chest x-rays.
- There is a slight increased risk of childhood cancer and or leukaemia in pregnant Mothers who have had CT scan during their pregnancy.
Callthephysician.com offers advice on the report obtained from any of the tests detailed above.
Should you wish to discuss the report obtained through any of these tests, or seek further advice, please complete our booking form with details of your medical condition, symptoms and any medications you are currently taking, including herbal and over-the-counter (OTC) remedies.