Heart Tests & Treatment
Providing caring, compassionate and expert care to get you back to better health.
Heart Conditions
Coronary artery disease
High blood pressure means the pressure in your arteries is higher than it should be. Another name for high blood pressure is hypertension. … High blood pressure is a pressure of 130 systolic or higher, or 80 diastolic or higher, that stays high over time.
There may be no signs or symptoms that tell you your blood pressure is too high. High blood pressure left untreated causes a range of associated illnesses including strokes and heart attacks, and can weaken blood vessels, and your kidneys.
- SYMPTOMS- Often there are no symptoms. For very high blood pressure, people may experience severe headaches, visual changes, nause/vomiting, nosebleeds or even confusion. Other symptoms may include flushing, chest pain, shortness of breath, awareness of heavy heart beats and even feeling stressed or agitated.
WHAT SHOULD MY BLOOD PRESSURE TARGETS BE?
Normal- 120/80 mmHg
Elevated- 120-129/80mmHg
High- Stage 1- 130-139/80-89 mmHg
High- Stage 2- 140 and above/ 90 and above.
WHAT DO THE NUMBERS MEAN?
Top Number (Systolic) is the pressure in the arteries when the heart beats.
Bottom Number (Diastolic) is the pressure measured between heartbeats when the heart is relaxing.
LIFESTYLE CHANGES THAT LOWER BLOOD PRESSURE:
- Move More! Get regular physical activity.
- Lose weight. Even a kilogram or two may make a big difference!
- Focus on Nutrition. DASH diet (**LINK https://dashdiet.org/), and diets with vegetables and less red meat.
- Cut Salt. Aim for 1.5g of sodium per day or less.
- Limit Alcohol. For men, not more than 2 standard drinks per day, and women 1, although several alcohol free days per week may also make a big difference from a weight point of view!
- Don’t Smoke.
- De-stress.
Aortic stenosis
High blood pressure means the pressure in your arteries is higher than it should be. Another name for high blood pressure is hypertension. … High blood pressure is a pressure of 130 systolic or higher, or 80 diastolic or higher, that stays high over time.
There may be no signs or symptoms that tell you your blood pressure is too high. High blood pressure left untreated causes a range of associated illnesses including strokes and heart attacks, and can weaken blood vessels, and your kidneys.
- SYMPTOMS- Often there are no symptoms. For very high blood pressure, people may experience severe headaches, visual changes, nause/vomiting, nosebleeds or even confusion. Other symptoms may include flushing, chest pain, shortness of breath, awareness of heavy heart beats and even feeling stressed or agitated.
WHAT SHOULD MY BLOOD PRESSURE TARGETS BE?
Normal- 120/80 mmHg
Elevated- 120-129/80mmHg
High- Stage 1- 130-139/80-89 mmHg
High- Stage 2- 140 and above/ 90 and above.
WHAT DO THE NUMBERS MEAN?
Top Number (Systolic) is the pressure in the arteries when the heart beats.
Bottom Number (Diastolic) is the pressure measured between heartbeats when the heart is relaxing.
LIFESTYLE CHANGES THAT LOWER BLOOD PRESSURE:
- Move More! Get regular physical activity.
- Lose weight. Even a kilogram or two may make a big difference!
- Focus on Nutrition. DASH diet (**LINK https://dashdiet.org/), and diets with vegetables and less red meat.
- Cut Salt. Aim for 1.5g of sodium per day or less.
- Limit Alcohol. For men, not more than 2 standard drinks per day, and women 1, although several alcohol free days per week may also make a big difference from a weight point of view!
- Don’t Smoke.
- De-stress.
High Blood Pressure
High blood pressure means the pressure in your arteries is higher than it should be. Another name for high blood pressure is hypertension. … High blood pressure is a pressure of 130 systolic or higher, or 80 diastolic or higher, that stays high over time.
There may be no signs or symptoms that tell you your blood pressure is too high. High blood pressure left untreated causes a range of associated illnesses including strokes and heart attacks, and can weaken blood vessels, and your kidneys.
- SYMPTOMS- Often there are no symptoms. For very high blood pressure, people may experience severe headaches, visual changes, nause/vomiting, nosebleeds or even confusion. Other symptoms may include flushing, chest pain, shortness of breath, awareness of heavy heart beats and even feeling stressed or agitated.
WHAT SHOULD MY BLOOD PRESSURE TARGETS BE?
Normal- 120/80 mmHg
Elevated- 120-129/80mmHg
High- Stage 1- 130-139/80-89 mmHg
High- Stage 2- 140 and above/ 90 and above.
WHAT DO THE NUMBERS MEAN?
Top Number (Systolic) is the pressure in the arteries when the heart beats.
Bottom Number (Diastolic) is the pressure measured between heartbeats when the heart is relaxing.
LIFESTYLE CHANGES THAT LOWER BLOOD PRESSURE:
- Move More! Get regular physical activity.
- Lose weight. Even a kilogram or two may make a big difference!
- Focus on Nutrition. DASH diet (**LINK https://dashdiet.org/), and diets with vegetables and less red meat.
- Cut Salt. Aim for 1.5g of sodium per day or less.
- Limit Alcohol. For men, not more than 2 standard drinks per day, and women 1, although several alcohol free days per week may also make a big difference from a weight point of view!
- Don’t Smoke.
- De-stress.
Heart Failure
HEART FAILURE: Heart failure is a problem with the way your heart pumps. Systolic heart failure means the heart can’t pump enough blood out to the rest of the body where the heart chambers become weak over time. Diastolic heart failure means the heart chambers are stiff and fill with less blood than usual. ** number of Australians with it ** It is one of the leading causes of hospitalization in Australia.
SYMPTOMS – Symptoms may vary from person to person.
- Shortness of breath with activity or at rest.
- Extreme tiredness or weakness.
- Rapid changes in weight with swelling in the ankles, feet, legs, or tummy.
- Feeling light-headed.
- Rapid or irregular heart beat.
CAUSES:
Common causes include heart valve problems, heart attacks, sleep apnoea, heart rhythm disorders, diabetes, high blood pressure, family history, and heavy alcohol or drug use.
ATRIAL FIBRILLATION: Is a problem with the rate or rhythm of the heartbeat causing it to beat irregularly. This may increase the risk of blood clots forming in the heart chambers, which may cause strokes. It can be paroxysmal (coming and going), persistent (lasts > 1 week and may become permanent), or permanent. Sometimes people with atrial fibrillation may have undiagnosed obstructive sleep apnoea (** LINK).
Treatment can include rate or rhythm control using medications or electrical cardioversion (**LINK), anticoagulation using blood thinners to reduce stroke risk, lifestyle changes including weight loss and alcohol reduction, or catheter-based pulmonary vein ablations (**LINK).
SYMPTOMS- Fatigue, Shortness of Breath, Light-headedness or dizziness, awareness of heart fluttering or beating fast or irregularly, chest pain, or no symptoms.
High Cholesterol
HEART FAILURE: Heart failure is a problem with the way your heart pumps. Systolic heart failure means the heart can’t pump enough blood out to the rest of the body where the heart chambers become weak over time. Diastolic heart failure means the heart chambers are stiff and fill with less blood than usual. ** number of Australians with it ** It is one of the leading causes of hospitalization in Australia.
SYMPTOMS – Symptoms may vary from person to person.
- Shortness of breath with activity or at rest.
- Extreme tiredness or weakness.
- Rapid changes in weight with swelling in the ankles, feet, legs, or tummy.
- Feeling light-headed.
- Rapid or irregular heart beat.
CAUSES:
Common causes include heart valve problems, heart attacks, sleep apnoea, heart rhythm disorders, diabetes, high blood pressure, family history, and heavy alcohol or drug use.
ATRIAL FIBRILLATION: Is a problem with the rate or rhythm of the heartbeat causing it to beat irregularly. This may increase the risk of blood clots forming in the heart chambers, which may cause strokes. It can be paroxysmal (coming and going), persistent (lasts > 1 week and may become permanent), or permanent. Sometimes people with atrial fibrillation may have undiagnosed obstructive sleep apnoea (** LINK).
Treatment can include rate or rhythm control using medications or electrical cardioversion (**LINK), anticoagulation using blood thinners to reduce stroke risk, lifestyle changes including weight loss and alcohol reduction, or catheter-based pulmonary vein ablations (**LINK).
SYMPTOMS- Fatigue, Shortness of Breath, Light-headedness or dizziness, awareness of heart fluttering or beating fast or irregularly, chest pain, or no symptoms.
Heart Tests
Echocardiogram
A transthoracic echocardiogram (TTE) is an ultrasound of the heart. The hearts size, structure and function of various cardiac components can be assessed. The test is straightforward with a Cardiac Sonographer using a small handheld probe covered in water-soluble gel over the chest wall to generate real time images of the heart. The test can take up to 30 minutes to complete depending on complexity.
You may be referred for an echocardiogram if your physician detects signs and symptoms of heart disease such as a valve murmur, shortness of breath, heart failure or a congenital birth defect such as a hole in the heart.
Exercise Stress Echocardiogram
A stress echocardiogram is a functional ultrasound of the heart conducted before and soon after exercise. An ECG (electrical heart tracing) and cardiac ultrasound (on the chest) is performed at rest. After the resting images are taken, the patient is placed on a treadmill. The incline and speed of the treadmill is increased gradually increasing stress on the cardiovascular system. This is performed under full supervision and the test can be stopped at any time at the patient’s request.
During the test there is continuous monitoring of the ECG and serial blood pressure measurements are made. Once the treadmill component of the test is completed the patient is quickly transferred to the lying position and further ultrasound images are acquired to look at the motion of the heart muscle at peak heart rate. An abnormal test may indicate a problem with the coronary artery circulation.
If you are unable to walk on a treadmill, your doctor may request a Dobutamine Stress Echocardiogram, with this test you are giving a injection which will gradually increase your heart rate in place of the treadmill.
Your doctor may request a stress echocardiogram to assess the likelihood of significant coronary artery disease. Stress echocardiography can also be used to assess the impact of exercise on diastolic function (how well the heart fills with blood before it is expelled), myocardial reserve (the ability of the heart to respond to exercise with increased contraction of the heart muscle), and the effects of exercise on valvular heart disease.
1. How do I prepare for a stress echocardiogram?
Wear light loose clothing for the test with good quality walking shoes.
It is important to cease any Beta Blocking medication prior to this test. If you do not cease your medication, your test will need to be rebooked. If you have any queries about this, please contact us prior to your appointment date for clarification.
2. How long does the test take?
The test can take from 30 minutes to one hour depending on the complexity of the study.
3. What happens after the test?
After the images have been acquired a Cardiologist with a speciality in echocardiography will review your images and generate a formal report for the referring doctor. This will be sent direct to your doctor for their consideration. Your doctor will advise you of the results and determine what treatment – if any – is required. Showers are available onsite
Transoesophageal Echocardiogram
A transesophageal echocardiogram (TOE) is an ultrasound of your heart. This test involves passing a very small ultrasound probe which is attached to a thin tube into the mouth and down into the esophagus. Because the esophagus is close to the chambers of the heart very high resolution images of the heart can be obtained.
Your doctor may request a TOE if they are concerned about clots in the heart, pre surgical assessment of valvular abnormalities, infection, determining if there are holes in the heart or another heart condition.
In order to prepare for a TOE, you will be required to fast (nil by mouth / no food or fluids) for 6 hours prior to the test. Regular medication may be taken with a very small sip of water. If you are on warfarin, we will need a copy of your most recent INR level. If you have difficulty swallowing, or have a known issue with your esophagus (web, stricture etc) please notify the doctor prior to the test commencing.
Local anaesthetic is sprayed onto the back of the throat to numb and suppress the gag reflex. A cannula is inserted into a vein in the arm and mild twilight sedative (Midazolam) is introduced. The ultrasound tube is then passed into the mouth and is swallowed into the esophagus. Detailed images of the heart are taken by a Cardiologist with a specialty in echocardiography and a full assessment of the clinical indication is undertaken. When finished, the probe is withdrawn and the test is completed.
You will be required to recover onsite for at least an hour whilst the effects of the sedation and throat anaesthetic wear off. No food or fluids can be consumed during this period. After an hour, a sip test can be performed with a very small quantity of water to test that the swallowing action has returned to normal.
The cardiologist who has performed your test will generate a report for the referring doctor and the results can be discussed directly with your doctor.
Q. Is the test safe?
A. Yes, medical ultrasound technology has been used for over 50 years and is a proven safe imaging technology that does not use ionising radiation. Very rarely damage to the esophagus can occur when passing the ultrasound probe into the esophagus. Discuss any concerns you have with the cardiologist prior to the test.
Q. How do I prepare for a echocardiogram?
A. In order to prepare for a TOE, you will be required to fast (nil by mouth / no food or fluids) for 6 hours prior to the test. Regular medication may be taken with a very small sip of water. If you are on warfarin, we will need a copy of your most recent INR level. If you have difficulty swallowing, or have a known issue with your esophagus (web, stricture etc) please notify the doctor prior to the test commencing.
Q. How long does the test take?
A. The test can take up to 60 minutes depending on the complexity of the study
All non-invasive diagnostics are performed on Level 8 at St Vincent’s Clinic in the Cardiac Investigations facility.
Heart Treatments
TAVI
TAVI stands for Transcatheter Aortic Valve Implantation. It’s a procedure that helps to improve a damaged aortic valve. During a TAVI procedure, an artificial valve made of natural animal heart tissue (usually from a cow or a pig) will be implanted into your heart.
Cardiac Angioplasty and Stenting
Coronary angioplasty and stenting are procedures that opens narrowed or blocked coronary arteries. In this procedure, your doctor will widen your blocked artery with a balloon (angioplasty) and a small, wire mesh tube (stent).
Mitral Valve Interventions
A mitral valve clip repairs your damaged mitral valve without the need for open-heart surgery. A small metal clip, about the size of a large staple, is attached to your mitral valve via a vein in your leg. The clip stays there permanently and helps your valve to function properly again.
Coronary Angiogram
A coronary angiogram is a procedure which looks closely at your coronary arteries to see if they are narrowed or blocked. It uses a special type of X-ray dye.
Septal Defect Closures
Septal defects are openings in the wall (septum) of your heart. They are congenital, meaning you’re born with them. If you have an ASD, the opening occurs in the septum between both top chambers of the heart (atria).