Worries about the heart are among the hardest to live with, and among the most worth having checked. If you are concerned about chest pain, palpitations, breathlessness or a family history of heart disease, our cardiology service offers a consultant-led review that includes an ECG and further testing where it is indicated.
Call 999 first
Chest pain or pressure that lasts more than a few minutes, spreads to the arm, jaw, neck or back, or comes with sweating, sickness or shortness of breath may be a heart attack. So may sudden severe breathlessness, or a collapse. These are emergencies: call 999 and do not wait for an appointment.
Reasons people come
- Chest discomfort on exertion, or chest pain that has been put down to something else but keeps returning
- Palpitations: a pounding, fluttering, racing or irregular heartbeat
- Breathlessness on exertion or when lying flat, or swollen ankles
- Dizzy spells, faints or blackouts
- High blood pressure or high cholesterol that is proving hard to control
- A heart murmur someone has heard
- Heart disease, sudden death or inherited heart conditions in the family
- A check before taking up strenuous exercise in middle age
What the assessment involves
The consultation takes in your symptoms in detail, your medical and family history, your medicines and your risk factors, followed by an examination: pulse, blood pressure, heart and lungs. An ECG records the heart's electrical activity through stickers on the chest, arms and legs. It takes a few minutes, is entirely comfortable and shows the rhythm and signs of strain or earlier damage. Blood tests for cholesterol, blood sugar, kidney and thyroid function are often added.
Further tests
An ECG taken at rest is a snapshot. Where your symptoms call for more, the cardiologist may recommend an echocardiogram (an ultrasound of the heart), a monitor worn for a day or longer to catch a rhythm that comes and goes, an exercise test or a scan of the coronary arteries. You are told why each is suggested and where it will be done, and if a test or a treatment is provided by a hospital, a referral is made.
What you take away
An explanation of what was found, an honest account of what it means, and a plan. For many people that is reassurance. For others it is treatment for blood pressure or cholesterol, a medicine for a rhythm problem, or changes that lower the risk: stopping smoking, moving more, eating differently, drinking less. A written summary can be shared with your GP.
Preparing for your appointment
Bring a list of your medicines, any previous ECGs, scan reports or hospital letters, and blood pressure readings if you take them at home. Note when your symptoms happen, how long they last and what you were doing. Wear a top that is easy to undo.
Common questions
My ECG was normal. Am I in the clear? A normal resting ECG is good news but does not rule out every problem, which is why the history matters as much as the trace.
Do I need a GP referral? Ask when you book: your insurer may require one. A GP appointment is a sensible first step if you are unsure where to start.
