Echocardiogram (Ultrasound)
An Echocardiogram, or simply Echo for short, is an Ultrasound scan of the heart which is used to look at the structure and function of the heart and help your doctor understand how your heart is pumping. The test is completely painless and non-invasive, often being completed within 30-45 minutes, but this may be longer if your doctor needs some more information.
Transthoracic Echocardiogram (TTE)
A Transthoracic Echocardiogram (or TTE) is a routine ultrasound scan that takes images of the heart through the chest (thorax). The procedure is completely non-invasive and pain-free, although you might feel some pressure from the scanning probe at times during the scan, just so we can obtain the very best quality images to produce a report with.
The scan is usually carried out by a specialist, known as an Echocardiographer or Sonographer who will also write the report. They are usually a Cardiac Physiologist, but they may not be. Please be aware that while the sonographer will be conducting the test, they cannot tell you what the results mean for you or indicate any potential treatments which can only be advised by your consultant who will review your results and update you on your next steps and recommended treatment.
For the test, you will need to remove your upper clothing and will be offered a gown to wear during the test. You may be required to lay on your left for some parts of the examination, but if you are not able to do this, please let us know.
You do not need to do anything to prepare for the test, and you can eat and drink as normal. If you are taking any medications, please ensure you know what you take as the sonographer may ask this during the test. You can find out more about having an Echocardiogram below.
Stress Echocardiogram (Stress Echo)
A Stress Echocardiogram looks at the function of the heart when put under stress and looks for any
changes in the heart function when put under stress. A Stress Echocardiogram is a useful diagnostic
tool for patients who experience symptoms upon exertion and can give some indications about the
condition of the coronary arteries, heart valves, or heart chambers. The information gained from this
test will allow your doctor to plan the best possible treatment options for you.
There are numerous ways of conducting a Stress Echo test which include physiological stress
(i.e. exercising to increase the heart rate) or pharmacological stress (using medications such as
Dobutamine). At Heartsure, we are very fortunate to be working alongside Dr. Andrew Marshall, Consultant Cardiologist and specialist in Cardiac Imaging, who leads our Stress Echocardiogram service. Other tests can be used to see the effect of stress on the heart, but these may be invasive or use radiation, which a Stress Echo does not use.
During the procedure, a few images of the heart will be taken at rest to assess your heart's function and structure before exercise. Like a normal Echocardiogram, you will be asked to remove your clothes from the waist up in order for us to access the chest area and take pictures. Gowns will be provided to allow you to cover up during the scan if you wish. You may be asked to lay on your left side so that we can obtain clearer pictures. Please let us know if you have any concerns about this.
After the initial images are taken, one of our Physiologists or Nurses will direct you onto the treadmill where the exercise aspect of the test will take place. You will be asked to exercise on the treadmill for a short amount of time in order to increase your heart rate. The amount of time exercising will depend on your level of fitness and your condition. Your target heart rate is calculated using your age and whether or not you take any cardiac medication. Each stage of the exercise test lasts 3 minutes, increasing in speed and incline as each stage advances.
Once the target heart rate is achieved, then you will be asked to return to the couch as quickly as possible in order to take repeat images immediately post-exercise. Ideally, images should be taken as soon after exercise as possible in order to determine the function of the heart at maximal exercise.
Throughout the test, blood pressure and oxygen saturation measurements will be taken and monitored at regular intervals. This determines whether any symptoms arise as a result of a drop in blood pressure or oxygen levels. Once the test is completed and all the images have been taken, the doctor will give a short summary of the test. The results will be sent to your referring doctor following the test.
The test takes around 30-45 minutes in total. You may be asked to wait a while after the test to recover before you go home. Unless you have been advised by your doctor, you can continue your day as normal following the test.
Please follow the instructions below prior to your test, failure to do so may mean having to postpone your appointment:
1. If you are taking Beta-blockers, calcium channel blockers, or anti-anginal medication such as Ivabradine, you MUST stop
taking these 48 hours before your appointment, unless you have been told otherwise by your doctor. These medications prevent your heart rate from increasing. Please take all other medicines as normal.
2. If you are not able to exercise, please inform us as soon as possible. It may not be possible to conduct the test at Heartsure if you are not able to exercise on the treadmill.
3. Please wear comfortable clothing that you are able to exercise in. We advise you to have only light food before the test.
DVLA Information - Medical Fitness
The Driver and Vehicle Licensing Agency (DVLA) may require you to undertake one or more cardiac tests to determine medical fitness to drive, especially for professional drivers who drive for organisations such as the DVLA, public services, TfL, and others. The DVLA must ensure you are able to meet their requirements as outlined in their guidelines to declare you medically fit to drive.
Common tests that the DVLA requests include but are not limited to Exercise Tolerance Tests (Exercise ECG), Echocardiograms, and Stress Echocardiograms. At Heartsure, we are proud to support professional drivers and others who require medical fitness testing. To find out more, click here or go to www.heartsure.co.uk/dvla
How to be referred
GP or Other Healthcare Professional:
If your GP or other healthcare professional wishes to refer you to us, they can do this by sending us a referral letter or by using our Diagnostic referral form here. The completed referral form or letter should be sent securely to info@heartsure.co.uk so that we can offer you an appointment.
Please indicate to your doctor if you will be funding this care yourself or if you wish to utilise any Private Health Insurance. Please read below for more information.
Self Referral:
If you wish to have an appointment for a diagnostic test but you have not been referred by your GP or someone else, you can get in touch and refer yourself to us using the Patient Self Referral form here or simply by contacting a member of our team.
If you have any symptoms, past diagnoses, family history or other information that you wish to tell us about, please fill this in as it will help us to arrange the best possible appointment for you. If you wish to use private health insurance to cover the costs of your care, your insurer may not cover your care unless you are referred by a healthcare professional, and so it is advised to confirm this with your insurance provider prior to referring yourself.
Covering your care
Heartsure offers some of the most competitive prices for the area. Please read below about the options of cover that you have available either through health insurance or funding your own care, and the costs associated.
Private Health Insurance:
Heartsure accepts patients from all major UK insurance companies. If you are wishing to use your health insurance policy to cover the cost of your diagnostic tests at Heartsure, please check with your policy to ensure you are covered. Alternatively you can contact your insurance company for more information. A list of all insurance companies that we are registered with can be found here.
If you cannot find your insurance provider on the list above, please contact us. Please note, failure to confirm your care with your insurance company and obtaining an authorisation code could result in the costs of any appointments not being covered. In these circumstances, it remains your responsibility to make payments for any appointments or services that have been completed. For more information, please go to our Private Health Insurance page which you can find here.
Self Funding:
Heartsure makes it easy for you to pay for any services that you have undertaken. We offer the following payment methods:
• Card - we accept all major card providers and are able to take card payments at the clinic if you wish.
• Bank Transfer - all of our bank details are provided on our invoices. If you require any further information, please contact us.
• Online payments - we are able to facilitate easy online payments through iZettle. We will attach a payment link to each invoice, and you are welcome to use this as a safe and secure way to pay
If you wish to self-fund your care, or someone is covering your care for you, you/they must complete our 'Fees and Insurance' form to confirm a commitment to pay the full fees. Our fee schedule can be found here, which should be used only if you are 'self-funding'. For more information about Self-Funding, please find our Self-Funding page which can be found here. For those patients who have health insurance, please see the information above.
More information:
For more information about Echocardiograms, find a detailed guide here.