Dr. Richard Mansfield

Dr. Richard Mansfield

Note: I am happy to answer general questions regarding the content of this website, but I cannot give clinical advice. Such requests will not be answered.

Other cardiac tests

Ambulatory blood pressure monitor

Some patients only seem to have high blood pressure readings when they go to their doctor - this is often called 'white coat hypertension'. If this is suspected then a 24 -hour blood pressure monitor may be helpful. This involves a cuff being wrapped around the arm and the device automatically records the blood pressure at intervals during the day and the night to give average readings. This will help the doctor to decide on the need for treatment.

Tilt table study

A tilt table test is sometimes used to investigate the symptom of syncope. It is a very straightforward test and generally very safe. The patient is strapped to a special table, which is then tilted to a more upright position for around 30-45 minutes or until symptoms develop. Pulse rate and blood pressure are monitored throughout this motionless state. A positive result is indicted by a fall in heart rate or blood pressure with typical symptoms.

This test is often combined with carotid sinus massage, which involves gentle pressure being applied in a circular motion to one side of the neck then the other, to see how sensitive the cardiovascular reflexes are. This may result in the patient experiencing their typical symptoms.

Implantable loop recorder

If there is concern regarding the cause of palpitation or loss of consciousness, it may be appropriate to implant a small recorder under the skin on the front of the chest. This can monitor the heart rhythm for up to 3 years.

Electrophysiology study

In patients who are affected by specific cardiac rhythm disturbance it may be necessary to carry out an electrophysiological study. This is generally carried out under local anaesthetic with sedation. It is necessary to be starved before hand. This involves the placement of a number of tubes or electrodes via the veins in the groin or neck into the heart. Small electrical currents stimulate the heart in the hope that the rhythm disturbance (and symptoms) can be reproduced. This investigation is often combined with the treatment known as ablation therapy, which is when the abnormal electrical pathways are either burnt or frozen to stop them from causing palpitation.

Myocardial Perfusion Scan

This is a nuclear scan. This involves the injection of a small amount of radioactive tracer into a vein, which is subsequently taken up in the heart muscle. Patients are asked to exercise on a treadmill during this test or may have a drug administered to simulate the effects of exercise. The relative distribution of the radioisotope in the heart muscle may give an indication as to whether or not there is a problem with blood flow due to narrowing in a heart artery. This test is very safe with only a small exposure to radiation.

Cardiac CT

A CT scan of the heart can be used to assess the amount of calcium (which is like egg shell) in the coronary arteries. The amount of calcium is linked to the likelihood of angina and heart attacks. It is being used more as a screening test.

CT scanning can also be used to create an image of the heart arteries and may in some circumstances be recommended in place of a coronary angiogram.

Cardiac MRI scan

Cardiac magnetic resonance (CMR) imaging involves patients being placed within a magnetic field, which enables very detailed images of the heart to be generated. It does not use X-ray and is very safe. The scanner is a bit noisy but not uncomfortable. It is usual to have a dye injected into a vein at the same time. This helps to differentiate the exact cause of a heart problem.