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Specialist cardiac consultations and assessments

Hearts West is a multi-disciplinary specialist team offering a wide range of cardiology services and care. We provide 24-hour on-call services for all general practitioners and Armadale, Rockingham, Fiona Stanley and Mount Hospitals.

Our consulting rooms are fully equipped with state-of-the-art technology. Both public and private patients can be seen in our private rooms with the assurance of continuity of care as all our Cardiologists have positions in the public sector.

We place clear emphasis on giving our patients superior care and we take pride in providing our specialist cardiac services, which include:

Specialist Consultation

Each cardiologist is subspecialty trained but also offers a consulting service in general cardiology. Each cardiologist sees patients with a broad range of heart problems.

To see a cardiologist, a referral is required by your doctor or your local GP. An electronic referral can be downloaded from the “for doctors” tab.

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Electrocardiograph (ECG)

An electrocardiograph is a graph which records the electrical activity of the heart. It provides the doctor with information about a wide variety of cardiac diseases. 10 stickers are placed on the chest and on the limbs, which are then connected to the ECG machine, and a reading is taken. The test is completely non-invasive.

  • Duration

 The test will take approximately 10 minutes.

  • Preparation

 You will be required to remove your clothing from the waist up – please wear a two-piece outfit.

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Holter Monitor

A holter monitor is essentially an ECG, or a reading of the electrical activity of the heart, which records continuously throughout the monitoring period.

A technician will place 5 ECG electrodes on your chest, and attach a monitor which is small in size. The monitor will be worn on a lanyard with a pouch or attached to your belt.

There are two types of holter monitors:

  • Single Day monitor

The monitor is worn for 24 hours. You will not be able to take a shower/bath or go for a swim during the monitoring period.

  • Multiday monitor

The monitor is worn for up to 3 days, depending on what your doctor has requested. You will be given instructions on how to remove the monitor  to shower during the monitoring period.

 

  • Duration

It will take 15 minutes to fit the monitor.

  • Preparation

You will be required to remove your clothing from the waist up – please wear a two-piece outfit.

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Exercise Stress Testing

Exercise ECG testing, also called Stress Testing, is used to measure your tolerance to exercise under medically supervised conditions. The test gives us useful information about the response of your heart to exercise. We perform exercise stress testing if you have suspected coronary artery disease, if we know you have coronary artery disease but want to monitor your response to treatment, or to simply measure your exercise capacity in certain conditions.

Throughout the test a doctor and a technician will be present. Initially you will be attached to ECG electrodes, and a resting ECG will be taken. You will then begin to walk on a treadmill at a speed and incline set by the computer. It starts slowly, and throughout the test we will monitor your ECG and blood pressure.

The treadmill will increase in speed and incline every 3 minutes. The test will finish if you reach the limit of your exercise capacity or earlier if decided by the doctor.

A cardiologist will review the results, and will send the report electronically to your referring doctor, who will be able to discuss these results with you.

  • Duration

The test will take up to half an hour.

  • Preparation

You will be required to remove your clothing from the waist up. We recommend ladies to wear a supportive bra and a hospital gown will be provided.

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Transthoracic Echocardiogram

An echocardiogram is test that uses ultrasound to assess the structure and function of the heart. It similar to the ultrasound performed on pregnant women. You will be required to remove all your clothing from the waist up.

The sonographer will hook you up to an ECG, and place an ultrasound probe and gel at various places on your chest. During the study you will hear noises which reflect the blood flow through your heart. Ultrasound is a safe modality, and does not pose any risks to the patient.

  • Duration

The test will take up to 1 hour.

  • Preparation

You will be required to remove your clothing from the waist up (ladies will be supplied with a hospital gown), so please wear a two-piece outfit.

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Exercise Stress Echocardiogram

An exercise stress echocardiogram combines an exercise ECG with ultrasound images
of your heart to assess for changes to your heart’s function during exercise.

You will be hooked up to an ECG, and the sonographer will take baseline images of your heart before you commence exercise. You will be required to exercise on a treadmill, with the speed of the treadmill/resistance increasing gradually over time. You will cease exercising once you have reached the limit of your exercise capacity, or earlier if decided by the doctor.

Images of your heart will be taken at peak exercise, and then you will be allowed to recover to your resting state before the final images are taken. A continuous ECG recording and regular blood pressure readings are taken throughout the test A cardiologist is present for the duration of the test. They will rapidly review the results, and fax a report to your referring doctor, who will be able to discuss these results with you.

  • Duration

The test will take up to 30 minutes.

  • Preparation

You will be required to remove your clothing from the waist up (ladies will be supplied with a hospital gown), so please wear a two-piece outfit.

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Dobutamine Stress Echocardiogram

A dobutamine stress echocardiogram is similar to an exercise stress echocardiogram, however a drug is used to increase the heart rate in situations where exercising the patient is not an option.

An intravenous cannula (IV) is inserted in your hand or forearm, and is connected to an infusion pump (“drip”) containing Dobutamine. Dobutamine is a drug which stimulates the heart to pump faster and harder, similar to the effects of exercise but with you resting on the bed. Continuous ECG recordings will be made until the end of the test, and Dobutamine will be given at increasing doses every three minutes until your heart rate reaches the required level. At the end of each stage, your blood pressure is taken, the ECG is printed, further ultrasound images are taken.

A cardiologist is present for the duration of the test, and report the study within 24-36 hours. The report will be sent electronically and/or by fax to the referring doctor, who will be able to discuss these results with you.

  • Duration

The test will take up to 1 hour

  • Preparation

You will be required to remove your clothing from the waist up (ladies will be supplied with a hospital gown), so please wear a two-piece outfit.

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Transoesophageal Echocardiogram

A transoesophageal echocardiogram (TOE) is an ultrasound of the heart that is performed via the oesophagus. This test usually provides excellent images of the heart, and gives additional information to a standard echocardiogram.

A TOE requires fasting 6 hours prior to the procedure. You will be admitted to the ward for the day, as you will be given a sedative. A local anaesthetic spray is used to numb the throat. The cardiologist will then place a probe down your throat that will rest in your oesophagus. Ultrasound images are taken from various places in your oesophagus and stomach.

Patients are usually able to go home on the same day, however you must ensure that you have someone to drive you, as you will not be allowed to drive until the next day.

  • Duration

The test will take up to 1 hour

  • Preparation

You will be required to remove your clothing from the waist up (ladies will be supplied with a hospital gown), so please wear a two-piece outfit. A TOE requires fasting 6 hours prior to the procedure.

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Blood Pressure Monitor

Your blood pressure will be monitored every 30 minutes during the day and every hour at night for a 24 hour period.

A technician will place a blood pressure cuff to your upper arm and attach a monitor. The monitor will be placed in a bag that can be worn around your neck or arm like a small handbag. During the period of monitoring you will be unable to take a shower or bath.

At the end of the monitoring period, the device is returned to us, and the recorded information will be downloaded digitally and read by a consultant cardiologist.

  • Duration

It will take approximately 10 minutes to fit the monitor.

  • Preparation

It is advised you wear a loose fitting top or a two piece outfit so this can be fitted.

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Pacemaker Clinic

Hearts West has regular clinics to provide follow up for patients with permanent pacemakers, implantable defibrillators and implantable loop monitors. The clinics are run in Galliers specialist hospital and Murdoch hospital, enabling easy access to patients in the south eastern metropolitan region. The clinics are supervised by a cardiac electrophysiologist.

Pacemakers are used to treat slow heart rhythms and defibrillators are used to life threatening rapid heart rhythms. Once implanted,  patients will require regular follow up to monitor the devices and leads. The follow up is performed with special programmers.

Patients who would like to be followed up at the clinic, are welcome to attend, however will first need a referral from the implanting hospital and their family doctor. It is important that patients still see there regular cardiologist / physician for ongoing review.

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Cardiac Resynchronisation

During cardiac resynchronisation therapy a medical device is implanted which resynchronises the contractions of the heart’s ventricle. Tiny electrical impulses are sent to the heart muscle which help the heart pump blood throughout the body. It is a more advance type of permanent pacemaker, able to improve heart failure symptoms in some patients.

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ELECTROPHYSIOLOGY STUDIES INCLUDING ARRHYTHMIA ABLATION

Electrophysiology studies test the electrical activity of your heart to find where an arrhythmia (abnormal heart rhythm) is coming from. Once it is located, the abnormal rhythm can be permanently eliminated by ablation (a small targeted area of heart scarring by heat or extreme cold).

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CORONARY ANGIOGRAPHY, ANGIOPLASTY, STENTING AND TRANSRADIAL

An angiogram is a procedure used to determine which arteries supplying the heart have become narrowed. It also gives information about the heart function as well as blood pressure and the oxygen levels in the heart. An angioplasty is a procedure to expand the narrowed arteries following the findings of an angiogram. It involves inserting a small inflatable balloon into the narrowed artery and sometimes a stent (tube of expandable mesh) is inserted into the narrowing. The procedure can now be done through the wrist (transradial approach) in the majority of patients.

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PERCUTANEOUS CLOSURE OF PFO AND ASD

A communication between the top chambers of the heart (the atria) can lead to strokes, right sided heart failure, abnormal heart rhythms and shortened life span. A patent foramen ovale (PFO) is a permanently open flap like structure whist an atrial septal defect is a gap in the wall. Closure is recommended in certain circumstances and in a good proportion of cases, can be performed through a small tube via the groin (percutaneous).

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PERCUTANEOUS VALVULOPLASTY, ALCOHOL SEPTAL ABLATION AND MITRACLIP

Are specific therapies for abnormal cardiac valve disease and thickened heart muscle. The ability to treat these conditions through a tube via the groin (percutaneous) have allowed more patients to be treated who were once considered high risk for cardiac surgery.

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