An electrocardiogram or ECG (sometimes referred to as a “heart tracing” or an EKG) is a quick and painless procedure that shows the heart’s electrical impulses. This test can help to assess how well the heart is functioning by determining heart rate and rhythm, and by checking to see if the top and bottom of the heart are communicating well with one another. If a person has chest pain or palpitations, an ECG is helpful in determining if the heart is performing normally.

 For an accurate tracing to be obtained, it is asked that you do not apply any powders/olis/lotions to your chest, arms, and legs.  Exercise (such as climbing stairs) immediately before an ECG may significantly increase your heart rate.

What Happens During the Procedure

For this test, your chest must be bare; you will be asked to remove all clothing from the waist up before laying down on an assessment table. Self-adhesive electrodes (sometimes referred to as “stickers”) are affixed to your arms, legs and chest. You are usually required to remain still, and you may be asked to hold your breath for short periods during the procedure.

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How to Prepare for Your Appointment

There are no restrictions on food or fluid intake for this test. For an accurate tracing to be obtained, it is asked that you do not apply any powders/oils/lotions to your chest, arms, and legs.

A Holter Monitor is a continuous electrocardiogram (ECG) taken while you are performing your normal daily activities over a predetermined amount of time; C-diagnostics currently offers 24-hour holter monitoring.

This type of test is particularly useful for patients who experience recurring or intermittent symptoms such as chest pain, palpitations, or dizziness. As these can sometimes be caused by a change in the heart’s rate or rhythm, you will be given a diary and asked to track any symptoms you may have while wearing the monitor.  This way, as the HM records every single heartbeat in your day, we can compare your symptoms with the recording to see if they are related.

What To Expect For This Test

You will wear the HM for a period of 24 hours. At your application appointment, your skin will be cleaned with rubbing alcohol then lightly debrided by the technician; this is done to ensure that the monitor stays connected to your chest for the duration of the test. Self-adhesive monitoring electrodes (sometimes called “stickers”) will then be put on your chest. These electrodes attach to the HM wires, picking up the signals from your heart and transferring them to the portable monitor. The recording is later transformed into a report for your doctor to analyze.

A Patient Diary will be provided to you at the time of your appointment; this should be used to record any activities or symptoms you encounter while wearing the monitor.

Examples of activities include: exercise, stress, smoking, intercourse, sleeping, etc.

Examples of symptoms include: chest/arm/neck/face pain, palpitations (heart pounding or jumping), dizziness, nausea, shortness of breath, anxiety, etc.

Be sure to record ALL symptoms along with the time that they occur.

At your application appointment, you will also be instructed on how and when to remove the monitor from your torso. To ensure a complete test, it is important that you follow these directions carefully so that you do not remove the monitor too early. The monitor will need to be brought back to the C-era clinic on the next business day following your application appointment; though it may be dropped off by anyone, this should be a consideration while booking your appointment.

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How to Prepare for This Test

There is no specific preparation for this test, beyond wearing a loose-fitting shirt or blouse (no dresses, please). Just remember that once the Holter Monitor is applied, you will be wearing it for 24 hours and will not be able to remove it without impacting your test results. The recorder you will be wearing should not interfere with your normal routine, however, there are a few things to keep in mind while wearing it:

• You are asked not to tamper with the recorder in any way, including removing the battery cover or touching the wire connections.
• You will not be able to shower, bathe, or swim while wearing the monitor. This should be a consideration when booking your appointment so that you are able to plan your day accordingly.
• You should continue to take all prescribed medications as you normally would.
• Electric blankets, heating pads, waterbeds, and electric razors may interfere with the recording; we ask that you please avoid using these items while wearing the monitor. Note: cell phones, computers, game consoles, etc. will not cause interference with the monitor
• You should not pull on the electrode leads/wires or disturb the tape holding the electrodes against the skin; doing so will interfere with the recording to a degree that your test will need to be repeated. If the electrodes do come loose, secure them with tape. To ensure that the electrodes do not fall off or disconnect while you are sleeping, we recommend wearing a tight-fitting t-shirt or nightgown to bed.

A 24-hour ABPM is used to continuously assess blood pressure control during the activities of daily living. This test is often ordered to help your physician determine whether you have high blood pressure; it may also be used to confirm whether your medication(s) is working to properly control your blood pressure (BP).

For an ABPM, you will be given a portable automatic blood pressure unit that will automatically measure and store your blood pressure and heart rate readings for the entire day.

This test involves 2 appointments, the Application Appointment and the Removal Appointment. It is important for you to attend both days as a technician will confirm that the monitor is functional and has accurately recorded your blood pressure throughout the test.

What To Expect For This Test

At your Application Appointment, a technician will measure your upper arm to select and apply the right size of BP cuff. The cuff and a small monitor will be affixed to your arm and body; you will wear these continuously for at least 24 hours. The staff member attending to you will then use their stethoscope to listen to your blood pressure so that it can be compared to the monitor’s readings. This is done to ensure that the monitor is working properly before you leave the clinic.

Throughout this test, a BP measurement will be taken every 30 minutes (during the day and throughout the night).  The monitor will beep prior to obtaining daytime measurements to let you know that a reading is about to occur; monitors are not programmed to beep during nighttime readings. While wearing the monitor, you will be asked to go about most of your normal daily activities, however, you will be required to stop what you are doing when a reading is being taken until the cuff flattens. This will help to ensure that the readings the monitor reports are accurate and not from movement.

Blood pressure does tend to vary throughout the day; this can be based on your mood/stress levels, activities, or intake of certain food or medications. You will be given a diary at your Application Appointment to record any activities and symptoms that may occur while wearing the monitor; this will be further explained during your appointment.

You are required to wear the monitor back to the clinic for your Removal Appointment where a trained staff member will compare the monitor reading to a blood pressure taken with their stethoscope. This is to confirm that the monitor has continued to accurately measure your blood pressure throughout the whole test.

After your Removal Appointment, the data from the monitor will be uploaded and sent to your doctor; a final report will be generated and should arrive at your family physician’s office within 10 days.

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How to Prepare for this Test

There is no specific preparation for this test. For both appointments, it is asked that you wear a loose-fitting blouse, T-shirt, or short sleeved shirt. Long sleeves and dresses are not recommended.

Just remember that once the monitor is applied, you will be wearing it for 24 hours. This means that you will NOT be able to take a shower or bath while wearing the monitor, however, you are encouraged to continue with all other regular activities, so long as you record them in your diary.

An echocardiogram uses ultrasound waves to assess the heart. A technician places a probe, called a transducer, at various locations on the chest. This probe directs sound waves toward the heart that “bounce back” and create a picture on the monitor. The picture is then recorded for analysis by a cardiologist. The recording shows the heart muscle, valves, and the passage of blood through the heart. The entire procedure takes between 30 minutes to an hour to complete. You will lie on a bed during the test. A gel is applied to the front of your chest to improve the transmission of the ultrasound waves. The probe will be moved over your chest to look at various portions of your heart. You will experience no pain, however, as the probe must be pressed firmly against the chest wall to see your heart, you may feel some pressure or tenderness.

This test is administered by North West Cardio Diagnostics (NWCD), located onsite within C-diagnostics.

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Cardiopulmonary Exercise Testing (CPET) is a non-invasive method used to assess the performance of the heart and lungs at rest and during exercise. You may have heard this type of test referred to as a “VO2 test.” CPET is a type of exercise stress test that gathers information about both the heart and the lungs to understand if the body’s response to exercise is normal or abnormal. It does this by measuring the amount of oxygen and carbon dioxide that you breathe in and out with a special mask and sensor.

These tests are conducted by a Registered Respiratory Therapist (RRT) and either a cardiology technician or a nurse or paramedic; a physician will oversee your test for safety and will be present during your appointment to answer any questions you may have.

What to Expect During This Test

Your visit will begin with a technician obtaining your height and weight. Next, you will be taken to the treadmill lab where the CPET and treadmill machines are located. Your test will begin performing a spirometry test (above) to determine how much air your lungs can hold. Then, you will have your blood pressure (BP) and electrocardiogram (ECG) obtained; these will be monitored throughout the duration of the CPET.

Once all of your baseline measurements have been taken, you will be fitted for a CPET Face Mask. This mask is fitted snugly to the face to ensure that your oxygen and carbon dioxide measurements are accurate. This can make wearing glasses difficult during the test and may be uncomfortable for those with claustrophobia. This will be discussed with you prior to booking your appointment. If you have any concerns about the mask or the CPET equipment, please speak with your physician before booking.

After you have been attached to the machine, the test will begin:

• You will begin with a 5-minute period of rest with the mask in place. Then you will move to the treadmill.
• The treadmill will begin slowly and gradually increase its speed.
• Your goal is to exercise for as long as physically possible. Unless it is deemed unsafe to proceed, we will not stop your test until you tell us that you are too tired to continue.  Your ECG and BP will be monitored throughout the entire test to ensure that you are safe.
• When you are done on the treadmill, you will rest for another period of 5-minutes while we monitor your breathing, BP, and ECG.

How to Prepare for This Test

• Take all of your regularly scheduled medications and inhalers before this test.
• Do not engage in strenuous exercise within 24 hours prior to the test.
• Do not exercise at all within 12 hours prior to the test 
• Avoid alcohol, caffeine, tobacco, and other stimulants within 8 hours prior to the test.
• Avoid medications that can make you drowsy within 8 hours prior to the test.
• Please dIt is preferred that subjects do not eat anything for 3 hours before the exercise test. 
• Wear loose fitting, comfortable clothing that will permit you to move your legs freely.
• Wear athletic shoes appropriate for exercise.

A staff member will call you 3-5 days before your CPET test to review all instructions with you and to answer any questions you may have.