Ultrasound
of the heart and other examinations

A "good old" examination, but one that is still of crucial importance today, it is the starting point for a cardiological consultation. Using ten suction cup electrodes placed on the patient's chest and extremities, the ECG makes it possible to analyse the electrical signals coming from the heart and thus the heart rhythm, as well as to assess any abnormalities in electrical conduction corresponding to various diseases.

The ECG can help to detect :

• arrhythmias: abnormalities in the rhythm of the heart (palpitations, too slow, too fast, irregular beats);
• coronary artery disease: blockage of blood flow in the arteries of the heart (acute ischaemia, aftermath of a heart attack);
• cardiomyopathy: pathology of the heart muscle (dilation of the chambers or thickening of the walls of the heart);
• pericardial disease: inflammation or fluid in the sac around the heart.

A cardiac ultrasound or echocardiography, often referred to simply as 'echo', is an examination used to visualise the structures of the heart in real time. After the application of a lubricating gel, an ultrasound probe is passed over the chest by the cardiologist. This examination is painless and risk-free. No radiation is administered.

Ultrasound of the heart allows to:

• assess the contractile function and anatomy of the heart muscle;
• study the appearance and function of the heart valves;
• detect any abnormalities in the pericardium or large vessels.

This is an electrocardiogram performed during physical effort on a bicycle ergometer or treadmill. The doctor will monitor the ECG and blood pressure during the exercise.

The stress test allows to :

• obtain information on exercise capacity;
• detect or monitor the development of coronary artery disease or a heart rhythm disorder;
• monitor the effectiveness of a treatment.

The Holter electrocardiogram (Holter ECG) is a recording of the heart rhythm and heart rate over a long period of time, from 24 hours to several days. It is a painless and risk-free test that does not interfere with daily activities. A recording box is connected by cables to electrodes glued to the patient's chest, which pick up the electrical signal and transmit it to the box via the cables.

The Holter ECG is indicated to:

• identify cardiac rhythm or conduction disorders that occur occasionally and may be asymptomatic;
• investigate palpitations, fainting, loss of consciousness (syncope);
• monitor the effectiveness of antiarrhythmic therapy.

The vascular ultrasound of the neck is used to explore anatomical and functional caracteristics of carotid and vertebral arteries, allowing identification of early signs of atherosclerosis, cholesterol plaques or abnormalities of blood flow at this level. 

Ambulatory blood pressure measurement (ABPM) is a method that provides information on blood pressure changes in the context of the patient's daily life. Over a 24-hour period, the device measures blood pressure approximately every 15 minutes during the day and every 30 minutes during the night. The patient is usually asked to record the day's activities and efforts for the report to be complete.

ABPM is useful to:

• make a diagnosis of hypertension (HTN) vs. white coat syndrome;
• look for "masked" HTN if there is a combination of target organ damage and normotension in the practice;
• assess and monitor the effectiveness of antihypertensive treatment;
• look for hypotension.