Information for patients This leaflet can be made available in other formats including large print, CD and Braille and in languages other than English, upon request. This leaflet tells you about different cardiac investigations (heart tests). Your doctor has advised you have one or more of these tests. Your appointment letter tells you which tests you are going to have, and whether you will need to attend the University Hospital of North Tees or the University Hospital of Hartlepool. Please bring with you a list of all the medications you are currently taking, either prescribed by your doctor or those you have bought yourself. An electrocardiogram (ECG) An ECG records the rhythm, rate, and electrical activity of your heart. Small electrodes (sticky pads with a special sensor) are put on your chest which are connected by leads to the ECG machine. The test does not hurt and only takes a few minutes. An exercise tolerance test (ETT) This is sometimes called a treadmill test. You will have an ECG, then while walking on a treadmill, further recordings are made of your heart. The treadmill starts at a gentle walking speed and increases gradually to a brisk walking speed against a slight gradient (hill). You will be supervised at all times. Your heartbeat and blood pressure will be checked throughout the test. This can last up to 1 minutes but will depend upon how you cope with the test. If you become tired, breathless or have chest pain during the test, the test may be stopped. This test may also be stopped if there are any changes to your heart trace, pulse and blood pressure. As chest pain often develops during exercise this test is a very good way to diagnose angina. You will need to wear loose clothing and comfortable shoes, for example, trainers or flat walking shoes. You should only have a light meal before your appointment. Med/371.3 (016) Page 1 of 6 For Review Summer 019
An echocardiogram This is an ultrasound scan of your heart (an examination using sound waves to make pictures of the inside of your body). This type of scan maybe uncomfortable but should not hurt. This will be carried out by an echocardiographer (someone trained to perform ultrasound scans on the heart). You will be asked to remove your clothing down to the waist and will be given a hospital gown to wear. You will be asked to lie on a couch, in a private room, and bare your chest. The echocardiographer will put gel on your chest and will then roll the ultrasound probe over the area. This will show a picture of your heart on the monitor of the ultrasound machine. This allows the cardiac team to check the condition of your heart. Gel is needed for the scan as it lets the ultrasound probe move smoothly over your skin and helps give better pictures. The gel may wet your clothes but will not stain them. This will take about 30 minutes. If you wish you may bring a friend or relative as an impartial observer (a chaperone ) to be present during your examination. A chaperone does not have to be medically qualified but will ideally be: sensitive, and respectful of your dignity and confidentiality prepared to reassure you if you show signs of distress or discomfort. Echocardiographer-led heart valve monitoring This is a clinic led by a specialist echocardiographer. During your appointment you will have an echocardiogram as described above. You will also have your height, weight, blood pressure and pulse taken. Your appointment may take up to 1 hour. You will still be under the care of your cardiologist who will be informed you have attended this clinic. If your scan shows changes in your measurements and/or your symptoms have changed, these will be reported back to your cardiologist who may wish to see you. If this is needed you will be sent an appointment through the post. If your scan shows no changes in your measurements and/or you have no changes in your symptoms you will be seen again in 1-3 years in the review clinic. Med/371.3 (016) Page of 6 For Review Summer 019
4, 48 or 7 hour ECG monitoring This records your heart rate and rhythm for 4, 48 or 7 hours. You will be asked to remove your clothing down to the waist. 3 disposable adhesive electrodes will be attached by wires to a small recorder which can be clipped to your clothing (trousers or skirt). It will take about 10 minutes to fit the monitor and you will need to wear it for 4, 48 or 7 hours. If you are an outpatient you will be told when you need to return the monitor to the department. Cardiomemo Cardiomemos are portable monitors that record your heart rate and rhythm. You will take the cardiomemo home and use it to record your heart and rhythm when you feel your symptoms (by placing the monitor on to the skin on your chest). If you have a hairy chest you may need to shave part of it to get a clear reading. The monitor makes several beeping sounds, which will be explained and demonstrated, to you by a cardiac physiologist during your appointment. The readings are stored in the memory of the monitor and then transferred to computer in the hospital, at a later date. You need to take care of the monitor and return it to the hospital on the date and time given. 4 hour blood pressure monitoring A blood pressure cuff will be applied to your upper arm. This is attached to a small monitor which is fitted on a belt around your waist. You will take the monitor home with you and return it the next day. It is important you relax your arm down by your side when you feel the cuff inflate (tighten). The monitor is programmed to inflate the cuff then record your blood pressure every 30 minutes from when you have it fitted, until late evening and then the cuff will inflate every 60 minutes until 7.00am the following morning. At 7.00am it will return to recording every 30 minutes until the monitor is removed. Pacemaker check It is very important to have regular follow-up appointments to have your pacemaker checked for the rest of your life. Appointments may be every 3-1 months, depending on the type of pacemaker you have. Med/371.3 (016) Page 3 of 6 For Review Summer 019
At each appointment the physiologist will analyse the pacemaker data and collect information about the state of the battery, the pacemaker leads and other information stored in the pacemaker. If needed the pacemaker can be re-programmed to the best settings for your condition. Each follow-up appointment will take about 15-0 minutes. Loop Recorder Check It is very important to have your follow-up appointment with the physiologist at a clinic. Your wound will be checked and information will be downloaded from the implantable loop recorder (ILR) to check it is working properly. This will be about 5 weeks after your procedure. You may attend a clinic appointment after contacting the physiologist if you have activated your ILR and need the information reviewing. Each follow-up appointment will take about 15 minutes. What should I do if I cannot attend my appointment? If you wish to cancel or change your appointment please ring the number on your appointment letter or card between 8.30am and 5.00pm, Monday Friday. Please give as much notice as possible so we can offer your appointment to another patient. Please only rearrange your appointment if it is absolutely necessary. The Trust is only able to allow 3 rebookings. This is due to the difficulties we face in making sure you are seen within the Government target of 18 weeks. If you repeatedly cancel your appointment you may be referred back to your GP. When will I receive my test results? The recording of your tests will be analysed (checked) and the results given to your consultant or doctor. This may take about - 3 weeks. Teaching health professionals North Tees and Hartlepool NHS Foundation Trust is a teaching organisation. We could not train future nurses, doctors and other health professionals without the co-operation of patients. Teaching takes place in all areas of our hospitals and is a valuable part of training. You may meet students in various stages of their training and they may sometimes be present during your appointment, or involved in your care. Med/371.3 (016) Page 4 of 6 For Review Summer 019
Occasionally, there are school leavers attending for work experience before they attend Medical/Nursing University courses. If you do not want students to be involved in your care please tell us; this will not affect the care you receive. Contact numbers University Hospital of North Tees Cardiac Investigation Unit telephone: 0164 64500 Monday - Friday, 9.00am - 5.00pm University Hospital of Hartlepool Cardiac Investigation Unit telephone: 0149 549 Monday - Friday, 9.00am - 5.00pm Further information is available from: NHS Choices telephone: 111 (when it is less urgent than 999) Calls to this number are free from landlines and mobile phones or via the website at www.nhs.uk Med/371.3 (016) Page 5 of 6 For Review Summer 019
This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Quality Assurance Team, University Hospital of North Tees or email: patientinformation@nth.nhs.uk. Comments, Concerns, Compliments or Complaints We are continually trying to improve the services we provide. We want to know what we re doing well or if there s anything which we can improve, that s why the Patient Experience Team is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. If you would like to contact or request a copy of our PET leaflet, please contact: telephone: 0164 64719 Monday Friday, 9.00 am 4.00 pm Messages can be left on the answering machine and will be picked up throughout the day. freephone: 0800 09 0084 Mobile: (can use text): 0779 506 1883 Email: patientexperience@nth.nhs.uk Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person. telephone: 0164 617617 4 hours a day, 7 days a week The Patient Experience Team is available to discuss your concerns in person Monday Friday, 1.30 pm 4.30 pm. The office is based at the University Hospital of North Tees. It is near the lifts in the main tower block. Data Protection and use of patient information The Trust has developed a Data Protection Policy in accordance with the Data Protection Act 1988 and the Freedom of Information Act 000. All of our staff respect this policy and confidentiality is adhered to at all times. If you require further information please contact the Information Governance Team. telephone: 0164 833551 or email: information.governance@nth.nhs.uk University Hospital of North Tees, Hardwick, Stockton-on-Tees. TS19 8PE University Hospital of Hartlepool, Holdforth Road, Hartlepool. TS4 9AH Telephone: 0164 617617 Fax: 0164 64089 Med/371.3 (016) Page 6 of 6 For Review Summer 019