Got Symptoms? What To Do Next?

Once the patient reported that they have all the symptoms, they then will be referred to a Cardiologist for further checkup and diagnosis to determine that if they suffer from arrhythmia. The patient will undergo series of diagnosing process such as:

Blood Test 

figure 1. Blood is drawn from a patient

 Blood will be drawn from their vein and sent to lab to check the level of substances in the blood such as potassium. Potassium is an electrolyte that sends electrical impulses in the heart for them to beat and pump the blood throughout the body (University of Maryland Medical Center, 2015). High level of potassium increases the chances of getting an arrhythmia because it sends excessive electrical impulses (Nhs.uk, 2015). 

Electrocardiogram (ECG) 

figure 2. Patient undergoing ECG

This is a standard cardiology tool for recording heartbeats and its rhythm. It uses electrodes that act as a sensor to detect the electrical activity of the heart. These electrodes are attached to certain parts of the chest. Patterns seen on the ECG could tell if there is a presence of arrhythmia through the irregular waves that the heart created (Heartrhythmcharity.org.uk, 2015). 

Holter Monitor 

figure 3. Holter Monitor with ECG reading

This is a portable ECG device that the patient attaches to their chest and it records the patient’s heart rhythm as they go through their daily routine. They are asked to wear this device for a day or more to see if they need to undergo more tests before the cardiologist finally could determine what kind of treatment or medication that they need (Heart.org, 2015). 

Event Monitor 

figure 4. An event monitor placed on patient

 

figure 5. Example of Event monitor

This portable device has a similar function like a Holter Monitor, but the only difference is that the patient will be asked to press a button on this device if they experience arrhythmic symptoms so the cardiologist could check the heart rhythm at the time of the symptom occurred (Bcpa.co.uk, 2015). 

Echocardiogram 

figure 6. Patient being diagnosed

This is another type of cardiology tool. It is a noninvasive test that uses sound waves to produce images of the patient’s heart’s size, structure and motion by placing a transducer, a hand-held device on the chest (Mayoclinic.org, 2015). 

Ambulatory Electrocardiogram

This device has a similar function as the Holter Monitor, where it tracks the heartbeat of the patient but it is used only for 24 hours (WebMD.com, 2015) 

If the arrhythmia did not show up during those tests, the cardiologist will try to trigger the arrhythmia using as follows:

Stress Test 

figure 7.  Patient being assessed

During a stress test, the patient will be asked to run on a treadmill or ride a stationary bicycle as their heart activity is being monitored. The cardiologist may use a drug instead to stimulate the heart in a way that is similar to exercise if the cardiologist found out that the patient’s coronary artery disease caused the arrhythmia, and they appeared to have a difficulty in exercising, (Nhs.uk, 2015). 

Tilt Table Test 

figure 8.  Process of Tilt Table Test

This type of test is only used if the patient had a near fainting spell. The patient will be laid flat on a table as their heart rate and blood pressure are being monitored. Along the way, the table will be tilted to a standing position. The cardiologist will observe how their heart and nervous system respond to the change in angle (Nhs.uk, 2015). 

Electrophysiological Testing And Mapping. 

figure 9. Placement of Catheter in the heart

figure 10.  Electrophysiological test and Mapping in process

In this test, the cardiologist will insert a thin thread, flexible tubes called catheter that are tipped with electrodes through the patient’s blood vessels that are connected to variety spots in their heart. The electrodes are used to map the spread of electrical impulses throughout the patient’s heart. The cardiologist may also use the electrodes to stimulate the patient’s heart to beat at rates that may trigger or halt an arrhythmia. This enables the cardiologist to see the location of the arrhythmia and determine what may be causing it (Nhs.uk, 2015).