Diagnostic Tests - Cotswold Cardiology
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Diagnostic Tests


An electrocardiogram, or ECG, is a noninvasive diagnostic test that detects electrical activity in the heart. An ECG produces a record of waves that relate to the electrical impulses that occur during each beat of a patient’s heart.

This test is performed by attaching electrical wires, called electrodes, to the arms, legs and chest. The ECG will begin recording your heart’s electrical activity, showing how quickly and regularly your heart beats, as well as any structural abnormalities in the chambers and thickness of the heart.

It is important to remain still during this test, as muscle movement may interfere with results.

Abnormal results from an ECG may indicate signs of a heart condition, which should be further investigated.

When would I get an ECG?

  •  Chest pain
  •  Shortness of breath
  •  Heart palpitations

Exercise Tolerance Test/ Exercise Stress Test

Stress testing, sometimes called an exercise or treadmill test, helps determine how well your heart handles work. Your body requires more oxygen as it works harder during the test. To compensate for this extra work, your heart must pump more blood. The stress test can show if the arteries that supply blood to the heart is reduced, and also helps your doctor determine the level of exercise appropriate for you.

What to expect during a stress test

  • You will be hooked up to equipment that will monitor your heart.
  • At first, you will walk slowly in place on a treadmill. Eventually, the speed is increased at a faster pace and the treadmill is elevated to produce the effect of going up a small hill.
  • You can stop the test at any time if necessary.
  • After the test, you will sit or lie down to have your heart and blood pressure checked.
  • During the test, your heart rate, breathing, blood pressure, electrocardiogram (ECG), and how tired you feel are monitored.

Healthy people who take the test are at very little risk. It’s about the same as if they walk fast or jog up a big hill. Medical professionals will be present in case something unusual happens during the test. All tests are carried out in the Cardiac Centre, so services are on hand immediately if you do become unwell.

When would I get a stress test?

  • To diagnose coronary artery disease.
  • To diagnose the cause of symptoms such as chest pain, shortness of breath or lightheadedness.
  • To determine a safe level of exercise for a patient.
  • To check the effectiveness of procedures done to improve coronary artery circulation in patients with coronary artery disease.
  • To predict the risk of dangerous heart-related conditions such as a heart attack.

The results of the exercise stress test can help guide further testing if it is thought to be necessary. For some patients a completely normal result will provide reassurance.


An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture is more detailed than a standard x-ray image. An echocardiogram does not expose you to radiation.

What to expect during an echocardiogram

  • A trained radiographer performs the test. Dr Hyde will interpret the results.
  • An instrument called a transducer is placed on your ribs near the breastbone and directed toward the heart. This device releases high-frequency sound waves. Images will be taken at other locations as well, including underneath and slightly to the left of your nipple and in the upper abdomen.
  • The transducer picks up the echoes of sound waves and transmits them as electrical impulses. The echocardiography machine converts these impulses into moving pictures of the heart. Still pictures are also taken.
  • A Doppler echocardiogram records the motion of blood through the heart.

How the test will feel

  • You will need to take off your clothes from the waist up and lie on an exam table on your back.
  • Electrodes will be placed on your chest to monitor your heart beat.
  • A gel is spread on your chest and the transducer will be moved over your skin. You will feel a slight pressure on your chest from the transducer.
  • You may be asked to breathe in a certain way or to roll over onto your left side. A special bed is used to help you stay in the proper position.

When would I get an echocardiogram?

The echocardiogram can help detect:

  • Abnormal heart valves
  • Abnormal heart rhythms
  • Congenital heart Disease
  • Damage to the heart muscle from a heart attack
  • Heart murmurs
  • Inflammation or fluid in the sac around the heart (pericardial effusion)
  • Infection on or around the heart valves (infectious endocarditis)
  • Pulmonary Hypertension
  • Ability of the heart to pump

24 hour blood pressure monitoring

Blood pressure is a major risk factor for heart disease. 24 hour monitoring is used to give an accurate indication of blood pressure when it is suspected that there may be an abnormal reading in the clinic due to ‘white coat syndrome’.

You will be given a wearable monitor and a cuff that will periodically take your blood pressure over 24 hours.

24 hour blood pressure monitoring is also used to check the success of medication for high blood pressure.

24 hour / 48 hour Holter monitoring

Palpitations or fast heartbeats are a common concern but very difficult to observe in the clinic. An ECG will often not ‘catch’ the rhythm of the heart even if a patient has symptoms.

A 24/48 hour ECG recorder (about the size of a small iPod) called a Holter monitor is fitted and can monitor the heart’s electrical currents and can help with diagnosis of abnormal heart rhythms.

If the symptoms are not recorded during the 24/48 hours of recording then the period can be extended in combination with using a small device you carry with you and activate at the time of symptoms (‘event recorder’).

It's time to focus on your heart health. Send us a message or call 01793 816062.