Cardiological Standard Examinations

• 12-channel-resting-ECG (“normal“ ECG while resting)
• cycle ergometry (stress-ECG with bicycle)
• 24h-Holter-ECG (portable long-term-ECG over a 24-hour period)
• 24h-RR (24-hour blood pressure measurements)
• transthoracic echocardiography (heart ultrasound)
• exercise echocardiography (cardiac ultrasound under medically induced stress)
• transoesophageal echocardiography (echo device is introduced through oesophagus)
• pace maker and defibrillator control

Ergometry

Literally: “measurement of labour“.

Painless examination, no need for an empty stomach. For the test a stationary bike is used, where pedalling resistance is gradually increased while registering blood pressure and ECG.

Used to check heart circulation when constriction of heart arteries is suspected (coronary heart disease), as well as to monitor blood pressure and pulse behaviour under stress and also physical capacity.

ECG (electrocardiogram)

Registers electrical activity of the heart. Pain-free test, no need for an empty stomach. Using electrodes placed on skin (suction or adhesive electrodes) electrical flow of the heart is measured and recorded on a strip of paper. Serves to detect dysfunction of “the heart’s electrics“ (Rhythm, impulse formation/conduction, indirect measure for circulatory disturbances).

Long-term-ECG  (known as Holter-ECG after its inventor)

This is a small cell-phone-sized, portable ECG device which continuously records your heart rhythm throughout a 24-72-hour period. Pain-free examination, no need for an empty stomach.

By the end of the recording period device memory is analysed by a computer and the ECG evaluated by me. Serves to detect irregular heartbeat (e.g. atrial arrhythmias, extra systoles, etc.).

Blood Pressure Measurment

An inflatable upper-arm cuff artificially constricts the brachial artery, slowly deflating air from the cuff until the stethoscope detects a pulse (upper systolic blood pressure) which then subsides (lower diastolic blood pressure). Pain-free examination, no need for an empty stomach.

As the values of an in-surgery reading are not entirely trustworthy (white coat effect, fear of examination) I naturally offer 24 h blood pressure measuring as well.

24h-Blood Pressure Measuring

A small portable device with an upper arm cuff measures blood pressure 24 hours at intervals (many automatic individual readings throughout one day and one night). I then evaluate the results in my surgery.

Electro Cardioversion

In superficial short anaesthesia (as in gastrointestinal endoscopies)  with sufficient spontaneous breathing a short electrical impulse from outside is emitted towards the chest wall; this takes place under continuous monitoring (ECG, oxygen saturation, blood pressure) and serves to treat heart arrhythmia, e.g., a severely irregular and fast heartbeat (in many cases atrial fibrillation ) and to turn it once more into a normal beat (sinus rhythm).

This is an examination that requires an empty stomach (min. 6 hours prior to examination), and also that 24 hours before examination I inform you in writing following an extensive conversation. For this examination specific requirements apply (medication, laboratory values). It is conducted under full anaesthesia, followed by a monitoring phase after examination and subsequent complete driving ban for the entire day.

Echocardiography

= Ultra sound of the heart

A pain-free, radiation-free examination, no empty stomach required.

An ultrasound probe scans the heart from outside, while the body is in a left lateral position. You can observe the entire procedure on screen, I will explain what you see to you and you are welcome to ask any questions you like.

Echocardiography serves to detect dysfunctions of the “heart mechanism“ and to check the heart’s pumping function and its valves.

Stress Echocardiography

=Cardiac ultrasound  using Dobutamine, a medication that severely increases heartbeat, simulating physical exercise (adrenaline-like stress).

Under good sonographic conditions (depends on build, potential pre-existing conditions/surgeries in the chest area) this is a highly accurate and complex method to detect insufficient blood supply of the cardiac muscle due to congested coronary arteries (when coronary heart disease is suspected). The examination is performed under continuous monitoring (ECG, oxygen saturation, blood pressure).

This is a pain-free examination, that requires an empty stomach (min. 6 hours prior to examination); also, that I inform you in writing 24 hours before examination following an extensive conversation and for which apply specific requirements (medication, laboratory values). No sleeping medication required.

Transoesophageal Echocardiography

(TEE or transoesophageal echrocardiography)

= Cardiac ultrasound of the heart with probe introduced through oesophagus. 

Considered one of the less pleasant examinations in cardiology, because a tube of a small diameter has to be swallowed, after the examiner has placed it into the oesophagus -it allows to look at the heart “from the back“. One major advantage is the excellent quality of images which allow for reliable evaluation of e.g. blood clots or bacterial deposits on the cardiac valves (endocarditis). Certain types of heart defects are also clearly visible with TEE. 

This is a pain-free examination which requires an empty stomach (min. 6 hours prior to examination); and that I inform you in writing following an extensive conversation and for which apply specific requirements (medication, laboratory values). During examination, an anaesthetic spray is applied to the throat to make it easier to swallow the probe –therefore you need to abstain from drinking and eating for at least 2 hours after examination.

No sleeping medication used. In specific cases and on patient’s express request this examination will be carried out using Midazolam (Dormicum) through intravenous access; however, this requires a subsequent short monitoring phase and a subsequent complete driving ban for the day.