Patient Information

Risk Assement

What is a cardiac risk assessment?
This is a group of tests and health facts that are used to assess your chance of having a heart attack.

What is included in a cardiac risk assessment?
Perhaps the most important indicators for cardiac risk are those of your personal health history, which are are all important in determining your risk:

• age
• family history of heart disease
• weight
• smoking
• lifestyle history
• blood pressure
• diabetes

Tests that are used to check if you are at risk of heart disease can be either 'invasive' (involves injection of substances into the body) or 'non-invasive' (readings are taken externally only).

• Non-invasive tests include electrocardiogram (ECG), exercise stress test, CT scan, and echocardiogram.
• Invasive tests include cardiac catheterization - where dye is injected into the arteries so that blood flow can be observed and any obstructions in the blood vessels identified.
• In terms of blood tests, the lipid profile is the most important blood test for risk assessment.

How is the lipid profile used?
The lipid profile measures:

• cholesterol
• triglycerides
• HDL ("good" cholesterol)
• LDL ("bad" cholesterol).

Triglycerides are the major form of fat found in the body and their function is to provide energy for the cells. If your cholesterol or triglyceride results are outside their 'normal' ranges, your risk might be increased. In this case changes to diet and exercise habits, and/or medication, may be required to reduce the abnormal levels and hence reduce your risk of having a heart attack.

What other tests are used to assess cardiac risk?
Other blood tests that may be used to assess your risk of heart disease include:

• homocysteine (an amino acid that comes from the normal breakdown of proteins in the body)
• lipoprotein a, Lp(a)
• high-sensitivity C-reactive protein (hsCRP)

Raised levels of any of these may indicate increased risk of having a heart attack, and allow preventative measures to be taken, for example by changes to diet and exercise habits.

How is treatment determined?
Treatment will be based on many factors – including the results of the above tests and your family and personal medical history.

Is there anything else I should know?
Eating a healthy diet and exercising are important in reducing:

• blood pressure
• cholesterol
• triglycerides

There are also drugs (known as statins) that are effective in lowering cholesterol. There are some forms of raised cholesterol or triglycerides that are genetically inherited and cannot always be lowered sufficiently by diet and exercise. These usually require treatment with lipid-lowering drugs.

Echocardiogram

This is an ultrasound of the heart, which gives us information on the function of the heart muscle, heart size, valves and any other structural abnormality of heart. The test takes approximately 15-20 mins. It is a painless & easy test.

Exercise ECG

The exercise test is performed either on a treadmill or a bicycle. The patient is attached to ECG leads with some electrodes attached to the chest to record a Electrocardiogram (ECG). Heart rhythm, blood pressure and the heart rate are monitored. This test gives us the information about any significant blocking of the arteries. The test also provides information on the response of blood pressure & heart rate on exertion. The test time is approximately 20-30 mins. The patient would be comfortable in running shoes and jogging pants.

Cardiac Event Monitor / Cardiomemo

The Cardiac Event monitor is a small machine (size of a match box), which is worn round the neck with two chest electrodes to record any abnormal heart rhythm. The monitor is connected to the patient for eight days. The monitor should only be removed while having a bath / shower. The monitor is very compact and easy to use. The machine is programmed to record abnormal rhythms with or without patient trigger.

24 Hour Ambulatory ECG

This is a machine the size of a walkman which is attached to the patient’s waist and the leads are attached to the chest with some electrodes to record the heart rhythm for 24 hours. The patient will not be able to have a bath / shower for the time the machine is attached on them The patient should be advised to wear loose and comfortable clothes. The time to connect the patient to the monitor is approximately 5-10mins.

24 Hour Ambulatory BP

This is a machine the size of a walkman which is attached to the patient ‘s waist. A blood pressure cuff is attached to the patient’s arm to record the blood pressure for 24 hours. The patient will not be able to have a bath / shower for the time the machine is attached on them. The patient should be advised to wear loose and comfortable clothes. The time taken to connect the patient to the monitor is approximately 10-15mins.

Pacemaker Check

The test is performed at regularly intervals (6-12 months) on patients with pacemakers to ensure proper lead function & battery status or whenever patient has symptoms related to the pacemaker. The test time is approximately 10-15 mins.

Note:

Patients can continue with their medications & eat as usual for all tests, unless advised otherwise by the doctor. All the procedures will be explained to the patient in more detail at the time the test is performed, but in case of any queries:

please do not hesitate to contact us.