Before an accurate diagnosis of heart failure is made, different tests are done in GP surgeries and hospitals to discover how the heart is performing and which parts of it are damaged. Tests make it possible to gather detailed information such as the size of the heart and which, if any, arteries are narrowed. Tests may also be done later on to see whether treatment is working and give doctors a better idea of what stage someone’s heart failure has reached (for more information see British Heart Foundation or Heart Failure Matters).
Many of the people we talked to remembered angiograms quite clearly (see ‘Angiograms and angioplasty’), but were less clear about electrocardiograms and echocardiograms and what they were used for. Some people had been told their heart was enlarged, and one man wondered if he could have another test to find out if his heart had returned to its normal size now that he was having treatment and feeling better.
Would like another test to find out if his enlarged heart has returned to its normal size.
Electrocardiograms (or ECGs) detect abnormalities in the heart beat by recording electrical activity and rhythm, as do exercise ECGs, usually undertaken on an exercise bike or treadmill. People varied in the length of time they could spend on a treadmill; some managed a couple of minutes before getting short of breath and one man, a retired farmer, walked for 10 minutes at a slow pace. ECGs also show if there has been previous damage to the heart, and one woman who had had a heart attack said she always carried her ECG printout with her to save time in case she ever needed emergency treatment.
He describes his experience of an electrocardiogram.
She carries a copy of her ECG printout with her in case of emergency.
The echocardiogram (‘echo’ or ‘heart scan’) is an ultrasound picture of the heart shown on a monitor which the patient as well as the doctor can see straightaway. Echos could be reassuring and people enjoyed being able to talk to medical staff involved with the procedure. Echos provide several measurements, including the ejection fraction (how much blood is being pumped out), which give doctors more detail about heart function. A retired doctor who was told he had heart failure after an echo said he wanted to know what a ‘normal’ ejection fraction was. He had asked his consultant and looked on the internet but had not found the answer. Others noticed that during the test they were able to hear as well as see the heart, which one woman thought others might find strange.
She describes an echocardiogram.
He wonders whether his ejection fraction was normal and what it meant.
Several people couldn’t remember which tests they had had and didn’t know either the names or purposes of the tests, though they appreciated that information from tests was useful to doctors.