Many heart problems only show themselves under exertion, which is exactly when a resting scan won't catch them. We asked Professor Wei Li, a consultant cardiologist and Professor of Practice based at Royal Brompton Hospital and Imperial College London, to explain how echocardiograms and stress echo testing work, what they can detect, and why they're used as part of a Lumen health assessment.
I carry out echocardiograms and stress echocardiograms for Lumen clients.
An echocardiogram uses ultrasound technology to look inside the heart, not just at its surface. The heart has four chambers - left and right sides - and four valves. Using ultrasound alongside Doppler technology, we can assess how well all four valves are functioning, as well as the contractility of the myocardium (the heart muscle itself).
Echocardiograms and stress echo sit alongside other cardiac imaging, such as a CT coronary angiogram, depending on which Lumen package you choose. Together, they build a fuller picture of heart health than a resting check alone.
A stress echocardiogram combines a standard echocardiogram with an exercise stress test. That means we can assess the heart and myocardial function not only at rest, but also during and after physical stress. This lets us detect myocardial and valve dysfunction that may only appear with exertion, along with any symptoms a patient experiences during exercise.
Yes - it's especially sensitive at detecting a blocked artery that's restricting blood supply to the heart muscle.
Most of our Lumen clients are healthy individuals having what is essentially a health check. We're assessing not just their cardiac function at rest, but how it behaves under stress. We typically exercise clients to their maximum exercise tolerance and check their cardiac function for any physiological changes under stress that could affect that tolerance.
It's very safe. Echocardiography uses ultrasound technology, so there's no radiation involved. During the exercise stress test, a cardiologist is usually present to supervise, and the patient's ECG and blood pressure are continuously monitored throughout. It's a very safe environment.
Definitely - the exercise stress test is specifically designed to assess a patient's fitness level. We use the Bruce protocol, which increases both the treadmill speed and incline in stages, so the patient's heart rate rises accordingly. We typically test towards each patient's age-predicted maximum heart rate.
The first benefit is testing the patient's fitness level. The second is testing for potential underlying disease, particularly ischaemic heart disease. Many patients have no symptoms until the disease has developed to a fairly severe degree. With stress testing, we can pick up minor changes that let us identify problems at a much earlier stage.
A resting ECG can miss problems that only appear under exertion. Stress echocardiography is designed to catch exactly that, often before any symptoms appear.
Book a health assessment with Lumen Harley Street and discuss the possibility of including cardiac stress testing as part of your visit.
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