Common cardiac symptoms
Chest pain
What is Chest Pain?
Chest pain can range from mild discomfort to severe pain and can be a sign of a heart problem. It’s important to pay attention to the type, duration, and location of the pain.
Possible Causes Related to the Heart:
- Angina: Pain due to reduced blood flow to the heart muscle.
- Heart Attack (Myocardial Infarction): A blockage in one of the coronary arteries, leading to damage to the heart muscle.
- Pericarditis: Inflammation of the lining around the heart.
- Heart Valve Issues: Conditions affecting the heart valves can cause chest discomfort.
When to Seek Help:
Chest pain, especially when it is severe, comes with shortness of breath, nausea, sweating or pain radiating to the arm, jaw or back, should always be evaluated urgently. Call emergency services immediately. Advanced Cardiovascular Care provides rapid access chest pain assessment for urgent cases either remotely or via face to face consultations.
Breathlessness (Dyspnea)
What is Breathlessness?
Breathlessness, or dyspnea, is the feeling of not being able to breathe deeply or feeling out of breath. It can occur during physical activity or even at rest.
Heart-Related Causes of Breathlessness:
- Heart Failure: The heart is unable to pump blood effectively, leading to fluid buildup in the lungs.
- Coronary Artery Disease (CAD): Blocked or narrowed arteries can reduce blood flow to the heart, causing shortness of breath.
- Heart Valve Disease: Problems with the heart valves can interfere with normal blood flow, leading to fluid buildup.
- Arrhythmias: Abnormal heart rhythms can affect how the heart pumps, leading to breathlessness.
When to Seek Help:
If breathlessness occurs suddenly, is severe, or is accompanied by chest pain or swelling in the legs, seek immediate medical advice.
Dizzy Spells and Syncope (Fainting)
What are Dizziness and Syncope?
Dizziness or feeling lightheaded, along with fainting (syncope), can occur when the brain temporarily does not get enough blood.
Heart-Related Causes:
- Arrhythmias: Abnormal heart rhythms can cause a sudden drop in blood pressure and inadequate blood flow to the brain.
- Heart Failure: When the heart cannot pump blood efficiently, it may lead to dizziness or fainting.
- Heart Valve Disease: Conditions like aortic stenosis or mitral valve problems can reduce blood flow and cause dizziness or fainting spells.
- Orthostatic Hypotension: A sudden drop in blood pressure upon standing up, often linked to heart failure or medication use.
When to Seek Help:
If you experience frequent dizziness or fainting, especially with chest pain, shortness of breath, or palpitations, you should consult your doctor immediately.
Palpitations and Arrhythmias
What are Palpitations?
Palpitations refer to the sensation of feeling your own heart beating, often described as a fluttering, racing, or pounding heartbeat. This can be felt in your chest, throat, or neck.
Heart-Related Causes:
- Arrhythmias: Abnormal heart rhythms, including atrial fibrillation, atrial flutter, or ventricular tachycardia, can cause irregular heartbeats, leading to palpitations.
- Coronary Artery Disease: Narrowed arteries can lead to irregular heartbeats and discomfort.
- Valvular Heart Disease: Leaky or narrowed heart valves can cause abnormal heart rhythms.
- Heart Failure: A weakened heart can lead to irregular rhythms and palpitations.
When to Seek Help:
If you experience palpitations that are sudden, prolonged, associated with chest pain, dizziness, or fainting, it’s important to seek medical evaluation.
Lower Limb Oedema (Swelling)
What is Lower Limb Oedema?
Oedema refers to swelling caused by fluid buildup in the body’s tissues. When it affects the legs and ankles, it can indicate a problem with the heart’s ability to pump blood effectively.
Heart-Related Causes of Oedema:
- Heart Failure: When the heart is unable to pump blood efficiently, fluid can accumulate in the lower limbs and abdomen, causing swelling.
- Right-Sided Heart Failure: In this condition, the right side of the heart cannot pump blood to the lungs effectively, causing fluid to back up in the legs and feet.
- Cardiomyopathy: Diseases of the heart muscle that affect pumping ability can lead to fluid retention in the legs.
When to Seek Help:
If you notice persistent swelling in your legs, ankles, or abdomen, especially with shortness of breath, fatigue, or weight gain, consult your doctor. It may indicate heart failure or another serious heart condition.
If you experience any of these symptoms, it is essential to seek medical attention promptly. Early detection and treatment of heart-related issues can prevent complications and improve quality of life. Always consult your healthcare provider for a proper diagnosis and personalized care plan.
Cardiac investigations
Electrocardiogram (ECG or EKG)
What is an Electrocardiogram (ECG)?
An ECG is a non-invasive test that measures the electrical activity of your heart. It records the timing and strength of electrical signals as they travel through the heart muscle, helping doctors assess heart rhythm, detect abnormal heartbeats (arrhythmias), and identify heart damage.
Why is it Done?
An ECG is used to:
- Detect arrhythmias or irregular heart rhythms.
- Evaluate chest pain or discomfort.
- Diagnose heart attacks or signs of previous heart damage.
- Monitor heart function during treatment.
What to Expect:
The procedure is quick and painless. Small electrodes are placed on your chest, arms, and legs to record electrical signals from your heart. It typically takes only a few minutes.
Echocardiography (Echocardiogram)
What is Echocardiography?
Echocardiography is an ultrasound-based test that uses sound waves to create images of your heart’s structure and function. It provides real-time pictures of the heart’s chambers, valves, and blood flow, allowing doctors to assess heart health.
Why is it Done?
It is commonly used to:
- Evaluate the size and shape of the heart.
- Check for valve problems, heart failure, or congenital heart defects.
- Assess the heart’s pumping ability (ejection fraction).
- Detect fluid around the heart (pericardial effusion).
What to Expect:
You will lie on an exam table, and a gel will be applied to your chest. A technician will use a small device called a transducer to send sound waves through your chest. The test is painless and typically takes 30-60 minutes.
Stress Echocardiogram
What is a Stress Echocardiogram?
A stress echocardiogram combines an echocardiogram with a stress test. It evaluates how your heart functions under physical stress, usually by having you exercise on a treadmill or stationary bike. If you are unable to exercise, medication may be used to simulate stress on your heart.
Why is it Done?
This test is used to:
- Identify areas of the heart that may not be getting enough blood (ischemia).
- Assess heart function during exercise or stress.
- Help diagnose coronary artery disease or heart valve problems.
What to Expect:
You will undergo an initial echocardiogram while at rest, then exercise on a treadmill or receive a medication to increase your heart rate. Another echocardiogram will be done after exercise to evaluate heart function.
Transoesophageal Echocardiogram (TOE)
What is a Transoesophageal Echocardiogram (TOE)?
A transoesophageal echocardiogram is an imaging test where a small ultrasound probe is passed down your throat into the esophagus (the food pipe) to get a closer view of the heart. This approach provides clearer images of the heart, especially the heart valves and chambers, as it’s closer to the heart.
Why is it Done?
TOE is often used to:
- Evaluate heart valves, especially when the regular echocardiogram does not provide clear images.
- Assess heart function in patients with certain heart conditions (e.g., endocarditis or atrial fibrillation).
- Detect blood clots or other abnormalities in the heart.
What to Expect:
You will be given a sedative to relax and a local anaesthetic to numb your throat. The procedure takes about 20-30 minutes and is done in a hospital or clinic setting.
Exercise Treadmill Test (Stress Test)
What is an Exercise Treadmill Test?
An exercise treadmill test (also known as a stress test) monitors your heart’s response to physical activity. It involves walking on a treadmill while your heart rate, blood pressure, and ECG are continuously monitored.
Why is it Done?
This test is used to:
- Assess how your heart handles physical exertion.
- Identify heart problems such as coronary artery disease or arrhythmias.
- Determine the severity of heart disease or fitness level.
What to Expect:
You will start walking on a treadmill at a slow pace, which gradually increases in speed and incline. The test typically lasts about 10-15 minutes, and you will be monitored closely throughout.
CT Coronary Angiography (CTCA)
What is CT Coronary Angiography?
CT coronary angiography (CTA) is a non-invasive imaging test that uses a CT scan and contrast dye to create detailed images of the coronary arteries. It helps doctors detect blockages or narrowing in the arteries that supply blood to the heart.
Why is it Done?
CTA is often used to:
- Assess for coronary artery disease (CAD).
- Check for blockages or plaque buildup in coronary arteries.
- Evaluate chest pain, shortness of breath, or unexplained symptoms.
What to Expect:
You will receive an injection of contrast dye through an IV. You may be asked to hold your breath briefly while the images are taken. The test is usually quick, taking about 10-15 minutes.
Cardiac MRI Scan (CMR)
What is a Cardiac MRI?
A cardiac MRI uses strong magnetic fields and radio waves to create detailed images of your heart and blood vessels. It provides information about heart function, the condition of heart tissue, and the blood flow through the heart.
Why is it Done?
Cardiac MRI is useful for:
- Diagnosing heart conditions such as cardiomyopathy, heart valve disease, or heart muscle damage.
- Evaluating heart tissue after a heart attack.
- Assessing congenital heart defects.
What to Expect:
You will lie on a table that slides into a large MRI machine. The test is painless but can take up to an hour. You may need to hold your breath for short periods during the scan.
Diagnostic Coronary Angiogram
What is a Diagnostic Coronary Angiogram?
A coronary angiogram is an invasive procedure that uses contrast dye and X-ray imaging to examine the coronary arteries. It is the gold standard test for detecting blockages or narrowing in the arteries supplying the heart.
Why is it Done?
This procedure is typically used to:
- Identify coronary artery disease (CAD) and assess its severity.
- Help plan treatment, such as angioplasty or coronary bypass surgery.
What to Expect:
The procedure is done under local anesthesia and involves threading a thin tube (catheter) through an artery (usually in the groin or wrist) to the coronary arteries. The test takes about 30-60 minutes.
Coronary Stenting Procedure (PCI)
What is Coronary Stenting?
Coronary stenting is a procedure where a small, mesh tube (stent) is placed in a coronary artery to keep it open after it has been widened with a balloon (angioplasty). This is done to restore blood flow to the heart.
Why is it Done?
Stenting is typically used to:
- Treat narrowed or blocked arteries due to coronary artery disease.
- Prevent heart attacks or relieve symptoms like chest pain (angina).
What to Expect:
The procedure is minimally invasive and typically performed under local anesthesia. A catheter with a balloon is inserted into the blocked artery, and the stent is placed to keep it open. The procedure typically lasts 30-60 minutes.
Intracoronary Imaging (OCT/IVUS)
What is Intracoronary Imaging (OCT/IVUS)?
Intracoronary imaging, using either Optical Coherence Tomography (OCT) or Intravascular Ultrasound (IVUS), provides detailed images of the inside of the coronary arteries. It helps doctors see the size, shape, and plaque buildup in the arteries.
Why is it Done?
This technique is used to:
- Assess the severity and type of blockages in the arteries.
- Help guide stent placement or other procedures.
- Evaluate the effectiveness of treatments like stents or angioplasty.
What to Expect:
The procedure is performed during a coronary angiogram, using a special catheter equipped with a tiny imaging device. It takes 20-30 minutes.
Intracoronary Pressure Wire Study (iFR, RFR, FFR)
What is an Intracoronary Pressure Wire Study?
This test involves using a pressure wire to measure blood flow and pressure in coronary arteries during an angiogram. It helps doctors assess the significance of any blockages in the arteries.
Why is it Done?
It is used to:
- Determine whether a blockage is severe enough to require treatment, such as stenting or angioplasty.
- Guide treatment decisions in complex coronary artery disease cases.
What to Expect:
A catheter with a pressure wire is inserted into the coronary arteries through the groin or wrist. The test is typically done during a coronary angiogram and lasts about 20 minutes.
Permanent Pacemaker Implantation
What is a Permanent Pacemaker?
A pacemaker is a small device implanted under the skin that helps regulate your heart’s rhythm by sending electrical signals to the heart when it beats too slowly or irregularly.
Why is it Done?
Pacemakers are used to:
- Treat arrhythmias like bradycardia (slow heart rate).
- Prevent fainting, dizziness, or fatigue caused by irregular heart rhythms.
What to Expect:
The procedure is performed under local anesthesia and sedation. A small incision is made near your collarbone to insert the pacemaker. It typically takes 1-2 hours and requires a short hospital stay.
Implantable Loop Recorder (ILR)
What is an Implantable Loop Recorder (ILR)?
An implantable loop recorder is a small device placed under the skin of your chest to continuously monitor your heart’s rhythm over an extended period (usually up to 3 years). It records any abnormal rhythms (arrhythmias) and can be used when symptoms like fainting or palpitations are unexplained.
Why is it Done?
ILRs are used to:
- Detect intermittent arrhythmias that may not be captured on an ECG.
- Investigate unexplained fainting or dizziness.
- Monitor heart rhythm over time.
What to Expect:
The procedure is minimally invasive and performed under local anesthesia. A small incision is made to insert the ILR under the skin, and it typically takes less than 30 minutes.
These tests and procedures play a critical role in diagnosing and managing heart-related issues. Your doctor will help determine which one is best suited to your specific symptoms and needs.