Cardiovascular Assessments and Diagnostic Tools
The human heart is a complex and powerful organ
indispensable for maintaining life. It beats around 115,000
times each day, and we depend on it to pump 1,500-2,000
gallons (6,000-7,500 litres) of blood throughout our body
daily to sustain our life. Should a part of this complex
system of valves, muscles, and blood vessels fail, we refer
to it as cardiovascular disease.
Early detection of cardiovascular diseases is important as
it enables suitable lifestyle changes or treatments that can
prevent further health complications. There are a number of
several diagnostic and screening procedures available to
diagnose cardiovascular diseases at Pantai Hospitals.
What are the diagnostic and screening procedures for
the assessments of cardiological conditions?
Blood tests are performed to
analyse the level of
substances, such as
cholesterol, triglyceride,
vitamins, and minerals in
the blood.
Electrocardiogram (ECG) is a
test that measures the
electrical activity of the
heart at rest, using
electrode patches that are
temporarily attached to your
skin.
This data, which provides
information about a person’s
heart rate and rhythm, can
help a cardiologist to
determine:
- Abnormal heart
rhythms
(arrhythmias)
- Blocked or narrowed
arteries in the heart -
causes chest pain or
heart attack
- If a person has had a
heart attack previously
- A patient’s response to
certain treatments for
heart disease
Resting ECG
Resting ECG is a standard
ECG test that takes
approximately 5-10 minutes
to perform on a patient.
Electrodes patches are
attached to a person’s
chest, arms, and legs whilst
lying down to detect
electrical current generated
by the heart.
The person has to stay still
during the test because
electrical impulses
generated by other muscles
during movement could
interfere with those
generated by the heart.
Ambulatory ECG
Ambulatory ECG uses
electrodes connected to a
portable machine called the
Holter monitor. This type of
ECG is used to record the
electrical activity of a
patient’s heart over a
period of 24 hours or more.
The Holter monitor is a
small wearable electronic
device used to check heart
rhythm, usually after you
undergo an ECG, to give the
cardiologist a fuller
picture of your heartbeat
and heart condition.
A cardiologist may suggest
the use of a Holter monitor
if you show symptoms of
arrythmia (irregular
heartbeat), experience
unexplained fainting, or
have a heart condition that
increases the risk of
arrythmias.
Echocardiogram or echo test
is the study of the
structure and mechanical
function of the heart using
ultrasound (sound waves).
Echocardiograms show the
image of your heartbeat and
how well it pumps blood.
An echocardiography may be
recommended by your doctor
to look for abnormalities
with your heart's valves or
chambers or to detect
congenital heart defects
before birth.
Note: Echocardiogram is not
the same as
electrocardiogram (ECG). ECG
is a test that measures the
electrical activity of your
heart and checks its rhythm.
A stress test helps a
cardiologist to see how your
heart works during increased
physical activity (exercise)
or after medications.
A stress test requires a
person to pedal a stationary
bike or walk on a treadmill
for a specific amount of
time, or until they feel
exhausted.
The main reason a
cardiologist would recommend
a cardiac stress test is to
determine how well your
heart handles work or if you
display symptoms of coronary
artery disease or an
irregular heart rhythm.
Hence, a stress test has a
relatively different
objective compared to
resting ECG, which is used
to detect the activity of a
person’s heart at rest.
It can also show if blood
supply is reduced in the
arteries that supply the
heart and this helps a
cardiologist to identify the
exercise intensity level
that is appropriate for a
patient.
The nuclear cardiac stress
test is able to assess
myocardial blood flow, and
the contractility of the
heart at rest and during
exercise.
During this procedure, a
small amount of radioactive
tracer is injected into the
vein and images of the heart
are taken.
A nuclear stress test may be
required if you show
symptoms of heart disease
and may be recommended by a
cardiologist to in order to
diagnose coronary artery
disease or help develop a
suitable treatment plan.
A coronary angiogram may be
performed if a patient
experienced a heart attack
or angina. It helps doctors
determine the amount and
location of the clogged
coronary arteries.
TEE is a test where an
ultrasound probe called a
transducer is inserted into
the oesophagus to take
images of the heart. It can
help diagnose problems such
as congenital heart disease,
cardiomyopathy, and heart
valve disease.
A cardiologist may perform a
TEE if you are obese, have a
thick chest wall, have a
bandaged chest, or if you
are using a ventilator to
assist your breathing.
An implantable loop recorder
is a small device implanted
just under the skin of your
chest to monitor your heart
rhythm for up to three
years. It can capture
information that a standard
ECG or Holter monitor may
miss, such as heart rhythm
patterns that happen only
occasionally.
An implantable loop recorder
may be recommended by a
cardiologist if you have
arrhythmia, an unexplained
stroke, or an explained
fainting (syncope).
Cardiac catheterisation
helps to measure pressure
and blood flow in the heart.
This procedure involves the
insertion of a catheter (a
thin tube) through a blood
vessel in the groin or arm,
into the heart.
A cardiac catheterisation
provides information on the
functionality of the heart
and the procedure may be
performed to determine if
you have a disease of the
cardiac muscle, valves, or
coronary (heart) arteries.
During the scan, you will
lie on a table inside a CT
scanner. Inside the machine,
an X-ray tube rotates around
your body, collecting images
of your heart and blood
vessels.
As a CT scan is able to
provide detailed images of
the heart and its arteries
quickly, it may be performed
for multiple reasons, such
as to detect and diagnose
issues with the heart valve,
blockage of the arteries,
tumour or masses, congenital
heart disease or to
determine the heart disease
risk.
A cardiac MRI creates
detailed images of your
heart by using a magnetic
field and computer-generated
radio waves.
A cardiologist may suggest a
cardiac MRI to obtain a
better look at the cardiac
muscles, heart chamber sizes
and function, and the
connecting blood vessels to
assist in making a
diagnosis.
Interventional cardiology
evaluates blood flow and
pressure in the coronary
arteries and heart chambers
using specialised imaging
and other diagnostic
techniques.
This area of medicine may be
applied if you have
abnormalities that impair
the function of the
cardiovascular system, which
require treatment.
Cardiac electrophysiology is
the study of the rhythm of
the heart, to detect
abnormal heartbeat
(arrhythmia).
It involves the insertion of
special tubes (catheters)
into an artery or vein to
monitor your heart's
electrical activity and
assess its response to
different stimuli.
A cardiologist may use
cardiac electrophysiology to
locate where any irregular
heart rhythms are occurring.
What are the treatment options for cardiological
conditions?
Atherectomy
An atherectomy is a procedure that is performed to
remove plaque from blood vessels using a catheter
with a sharp blade on the end. The catheter is
introduced into the artery through a minor puncture,
and the procedure is carried out under local
anaesthesia.
You may require the atherectomy surgery if your
arteries become too narrowed or clogged due to
plaque build-up within the arterial walls. When
arteries become clogged, blood cannot reach the
tissues to nourish them, producing cramping and
weakness in your lower extremities’ muscles.
Defibrillator
A defibrillator is a device that delivers an
electric shock or pulse to the heart in order to
restore a regular heartbeat. It is used to prevent
or treat arrhythmias, which are irregular heartbeats
that are either too slow or too fast. A
defibrillator can also help the heart beats again if
it suddenly stops beating.
There are different types of defibrillators
including automated external defibrillators or AEDs
(can be found in public places), implantable
cardioverter defibrillators or ICDs (are surgically
placed inside the body), and wearable cardioverter
defibrillators or WCDs (rest on the body).
Angioplasty
Angioplasty is a procedure that is performed to
widen narrowed or clogged coronary arteries, which
are the main arteries of the heart. This is done
typically through the use of a balloon to
dilate/open a narrowed or clogged artery, or by
inserting a stent (a short wire-mesh tube) into the
blocked artery.
Angioplasty is used to treat the build-up of plaques
in blood vessels of the heart (known as
atherosclerosis).
You may require angioplasty treatment if you have:
- Tried medications or lifestyle changes, but
without any improvement
- Worsening chest pain (angina)
- A heart attack
- Learn more about angioplasty
Pacemaker
A pacemaker is a tiny device that is surgically
implanted in the chest to aid in the regulation of
the heartbeat and prevent the heart from beating too
slowly.
Your cardiologist may suggest a temporary pacemaker
if you have a slow heartbeat (known as bradycardia)
following a heart attack, surgery or medication
overdose but your heartbeat is otherwise anticipated
to recover.
There are different types of pacemakers including:
- Single chamber pacemaker
- Dual chamber pacemaker
- Biventricular pacemaker
Cardiothoracic surgery
Cardiothoracic surgery is a separate medical
specialty in Malaysia. The surgery mainly includes
organs in the thoracic cavity (chest) including the
heart, lungs, major blood vessels, trachea, and
oesophagus.
Cardiothoracic surgeons work closely with
cardiologists to care for patients with heart, lung
and/or chest conditions.
Cardiothoracic surgeons are trained to perform
surgery on the heart, lungs, trachea (windpipe),
esophagus, chest wall, and diaphragm. These include
lung resection, coronary artery bypass surgeries,
heart valve surgeries, aortic surgeries, vascular
stenting, heart and lung transplants and others.
This surgical specialty is dedicated to the surgical
treatment of diseases, trauma, and congenital or
acquired deformities to the heart and its vessels.
Some diseases that can benefit from cardiothoracic
surgery include coronary artery blockages, valvular
disorder, and congenital heart defects such as
atrial or ventricular septal defect.
Our cardiothoracic patients are treated by our
specialised team of cardiothoracic surgeons,
cardiologists, anaesthetists, and intensivists who
are dedicated to providing quality care and
treatment of the heart.
Learn more about
cardiothoracic surgery.
Book an appointment at Pantai Hospitals
A dedicated and expert team of cardiologists at Pantai Hospitals is available for consultation to provide
the best care and assistance to patients through heart health screening, diagnosis, and treatment. Get
in touch with us to book an appointment with a
cardiologist today.
Pantai Hospitals have been accredited by the Malaysian Society for Quality in
Health (MSQH) for its
commitment to patient safety and service quality.
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Blood tests
Electrocardiogram (ECG)
Holter monitor
Echocardiogram (Echo test)
Stress test
Nuclear cardiac stress test
Coronary angiogram
Transoesophageal adult
echocardiogram (TEE)
Implantable loop recorder
Cardiac catheterisation
Cardiac computerised
tomography (CT) scan
Cardiac magnetic resonance
imaging (MRI)
Interventional cardiology
Electrophysiology study
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