Clinical Screening by a Cardiologist (“Heart Checks”)
Clinical screening involves tests to look at the structure, electrical rhythm and function of your heart by a cardiologist (heart doctor) who has expertise in inherited heart diseases.
Why is clinical screening important
Due to the risk to family members, we advise all first-degree relatives (children, parents, siblings) of someone who has an inherited heart disease to be assessed by a cardiologist. A visit to the cardiologist must include a clinical history being taken, physical examination, and some tests such as those described below.
What types of tests may be involved
An ECG is a recording of the heart rhythm that involves placing ECG electrodes (stickers) on the arms, legs and across the chest. A recording is then made showing the electrical activity of the heart. The test takes 5 minutes.
An echocardiogram is an ultrasound of the heart that allows the cardiologist to look at the structure, size and contraction, valves and flow of blood through the heart. This takes about 30-40 minutes.
This test assesses how the heart responds to exercise (i.e. when your heart is required to work harder than normal). This requires you have an ECG while walking and running on a treadmill. Blood pressure is monitored during and after exercise and sometimes the amount of oxygen in the blood. In some cases an echocardiogram will be done before and after exercise. This test takes around 30-40 minutes.
A Holter monitor is a small mobile ECG recorder that is carried around for 24 to 48 hours. It examines the electrical activity of your heart throughout the day. The recorder is small and has ECG electrodes (stickers) that attach to the chest. You will be asked to keep a record of any symptoms (such as palpitations or dizziness) that you have through the day so the cardiologist can match these symptoms to the heart rhythm at the time. The monitor will take approximately 15 minutes to fit and will need to be returned upon completion.
Cardiac Magnetic Resonance Imaging (cMRI)
A cMRI allows the cardiologist to look at the structure of your heart in great detail. It allows cardiologists to evaluate parts of the heart that may not be as clearly visible in other tests such as an echocardiogram. You will need to remove all jewellery and other metal objects for the test. The cMRI takes about 45 minutes.
What if nothing shows up in clinical screening?
If a cardiologist examines an at-risk relative and nothing is found (i.e. the heart is structurally normal and has a normal rhythm). Then it is possible that they do not have the heart problem in the family. However since we cannot discount this completely, it is important that first-degree family members continue to be checked on a regular basis. This is because some of these conditions can present later in life. How often a person should be checked is based on age but generally should be carried out AT LEAST once every 2-3 years (and in some cases yearly).