Heart tests help to assess how the heart is working, detect rhythm disorders and changes in the structure and function of the heart, and see how the body responds to physical exertion. Baltic American Clinic performs electrocardiography (ECG), echocardiography with Doppler, Holter and Tonoport monitoring, cycle ergometry and cardiopulmonary exercise testing. The V-MAX testing system is also used to assess the function of the heart and respiratory systems. The cardiologist selects the tests you need individually, taking into account your symptoms, state of health and risk factors.
The possibility to see a specialist without a long wait.
From electrocardiography to exercise tests.
The doctor selects the tests you need based on your state of health.
From the cardiologist consultation and diagnostics to treatment and follow-up.
When are heart tests needed?
Heart tests may be recommended when you notice problems with how your heart is working, when heart disease is suspected, to monitor the course of a disease that has already been diagnosed, or as part of a preventive health check.
- Chest pain or pressure. Tests can help to assess possible causes of heart problems, especially if the symptoms are related to physical exertion.
- Palpitations and an irregular heartbeat. An electrocardiogram or long-term heart rhythm monitoring helps to detect rhythm disorders.
- Shortness of breath and tiring quickly. Echocardiography or exercise tests can help to assess heart function and the causes of reduced physical capacity.
- Dizziness or fainting. In certain cases the heart’s rhythm and conduction may need to be assessed.
- High or fluctuating blood pressure. 24-hour blood pressure monitoring can help to assess its changes during the day and night.
- Suspected heart valve disease. An ultrasound examination helps to assess valve function and blood flow.
- Diagnosed heart disease. Tests may be needed to monitor the course of the disease, the effectiveness of treatment and changes in heart function.
- Assessing physical capacity. Exercise tests help to determine how the heart and respiratory systems respond to physical exertion.
Not every patient needs all the tests. Whether they are needed, and to what extent, is assessed by the cardiologist.
Important: if you suddenly develop severe or prolonged chest pain, severe shortness of breath, lose consciousness or have other life-threatening symptoms, do not wait for a planned consultation – call 112.
Which heart tests are performed at Baltic American Clinic?
Resting electrocardiogram (ECG)
An electrocardiogram is a quick, painless and non-invasive test that records the electrical activity of the heart. The clinic performs a 12-lead resting electrocardiogram.
When is it performed?
An ECG may be recommended if you feel palpitations, a fast or irregular heartbeat, chest discomfort or dizziness, or if a heart rhythm or conduction disorder is suspected.
The test may also be performed to assess a heart disease that has already been diagnosed or before certain medical procedures.
What does it show?
An electrocardiogram helps to assess the heart rate, rhythm, the spread of electrical impulses in the heart and certain changes in the activity of the heart muscle.
The doctor interprets the recorded electrocardiogram, assessing possible rhythm, conduction and other changes.
A normal resting ECG does not always rule out heart disease. If problems occur only occasionally or during physical exertion, additional tests may be needed.
How is it performed?
The patient lies down on a couch. Electrodes are attached to the chest, arms and legs to record the heart’s electrical signals.
The test takes only a few minutes, is painless and does not require physical exertion.
How to prepare?
Special preparation is usually not needed. It is recommended to rest briefly before the test and to lie still and not talk during it.
Echocardiography with Doppler
Echocardiography, also called a heart ultrasound, is a non-invasive test that makes it possible to assess the structure and function of the heart in real time. Doppler imaging additionally provides information about blood flow in the chambers of the heart and through the valves.
When is it performed?
The test may be recommended when heart valve disease, heart failure, changes in the heart muscle or other structural heart diseases are suspected.
Echocardiography may also be needed if you suffer from shortness of breath, reduced exercise tolerance or swollen legs, or if the doctor hears a heart murmur.
What does it show?
- Size of the heart chambers. The dimensions of the atria and ventricles.
- Contraction of the heart muscle. How effectively the heart pumps blood.
- Condition of the heart valves. Whether the valves open and close properly.
- Blood flow. Its direction and speed, and possible signs of valve narrowing or leakage.
- Pericardium. Whether there is any fluid around the heart.
How is it performed?
The patient usually lies on their left side. The doctor applies ultrasound gel to the chest and examines the heart from different positions with a special probe.
The test is painless and no ionising radiation is used. How long it takes depends on the parameters assessed and the changes found.
How to prepare?
Special preparation is usually not needed. You can eat, drink and take your usual medicines unless the doctor has told you otherwise.
If you have results of previous echocardiograms, please bring them so that the doctor can assess any changes.
Holter monitoring – 24-hour ECG monitoring
Holter monitoring is long-term recording of the heart’s electrical activity with a portable device. Unlike a standard ECG, which records heart activity only for a short time, Holter monitoring makes it possible to follow the rhythm for a full 24 hours.
When is it performed?
- Palpitations or episodes of irregular heartbeat keep recurring.
- You feel an unexplained fast or slow heartbeat.
- You have dizziness, weakness or fainting episodes and a link with the heart rhythm is suspected.
- The course of an already diagnosed rhythm disorder or the effectiveness of treatment needs to be assessed.
What does it show?
Holter monitoring records the heart rhythm day and night and helps to detect intermittent rhythm and conduction disorders, how often they occur and how long they last.
The doctor can also assess whether the symptoms the patient feels coincide with the recorded changes in heart rhythm.
How is it performed?
Electrodes connected to a small portable recording device are attached to the chest.
The patient wears the device for 24 hours and goes about normal daily activities, following the instructions given.
You may be asked to note the times of symptoms, physical activity or other significant events.
At the end of the recording period the device is removed and the collected data are analysed.
How to prepare?
It is recommended to shower before the test, because the device usually must not get wet while you are wearing it.
Wear comfortable clothes under which the recorder is easy to carry. Tell the doctor about the medicines you take, but do not stop them on your own.
Important: Holter monitoring records the heart’s electrical activity, not arterial blood pressure.
Tonoport monitoring – 24-hour arterial blood pressure monitoring
Tonoport monitoring is non-invasive monitoring of arterial blood pressure over 24 hours using a portable automatic measuring device. It makes it possible to assess changes in blood pressure during normal daily activities and sleep.
Unlike a single blood pressure measurement in the doctor’s office, 24-hour monitoring provides more information about blood pressure fluctuations at different times of the day.
When is it performed?
- Suspected arterial hypertension. When blood pressure readings are raised or fluctuate.
- Different measurement results. When blood pressure in the doctor’s office and at home differs significantly.
- Suspected “white coat” hypertension. When blood pressure rises in a medical setting but is normal in everyday surroundings.
- Suspected masked hypertension. When blood pressure is normal in the doctor’s office but may be raised in other circumstances.
- Assessing the effectiveness of treatment. When it needs to be determined whether the medicines taken provide adequate blood pressure control around the clock.
- Suspected night-time blood pressure disorders. When it is important to assess changes in blood pressure during sleep.
What does it show?
- Average 24-hour blood pressure. The overall level of arterial blood pressure during the monitoring period.
- Daytime and night-time blood pressure. Differences in readings during activity and rest.
- Blood pressure fluctuations. Episodes of increase or decrease.
- Night-time fall in blood pressure. Whether blood pressure falls during sleep as normally expected.
- Effectiveness of treatment. Whether the prescribed medicines help to keep blood pressure within the target range.
How is it performed?
A blood pressure cuff connected to a small portable recording device is placed on the patient’s upper arm.
The device automatically measures blood pressure at set intervals during the day and night.
During the test the patient can go about normal daily activities, following the instructions given. During a measurement it is recommended to stop for a moment and keep the arm still.
You may be asked to note the times of sleep, physical activity, taking medicines and symptoms.
At the end of the monitoring period the device is removed and the recorded data are analysed.
How to prepare?
- Wear comfortable clothes with sleeves that do not restrict the cuff on your upper arm.
- Keep the device away from water during the test.
- Follow your usual daily routine unless the doctor has told you otherwise.
- Tell us about any medicines you take that affect blood pressure.
- Do not stop or change your medicines on your own.
Important: Tonoport monitoring measures arterial blood pressure, while Holter monitoring records the heart’s electrical activity. These are different tests that can complement each other.
Cycle ergometry with report
Cycle ergometry is an exercise test that assesses how the heart responds to gradually increasing exertion. The test is performed while pedalling a special stationary bicycle, with the ECG recorded and arterial blood pressure monitored.
When is it performed?
- When heart problems that occur during physical exertion are suspected.
- To assess chest discomfort that occurs during physical activity.
- To investigate reduced exercise tolerance.
- To assess how the heart rhythm or blood pressure responds to physical exertion.
- In certain cases, to assess the effectiveness of treatment and a safe level of physical activity.
What does it show?
The test helps to assess exercise tolerance, changes in heart rate and blood pressure, rhythm disorders that occur during exertion and possible signs of insufficient blood supply to the heart muscle.
The doctor assesses the test results together with your symptoms, risk factors and the results of other tests.
How is it performed?
ECG electrodes are attached to the patient’s body and a blood pressure cuff is placed on the arm.
The patient pedals a special bicycle, and the load is gradually increased according to the set test protocol.
Throughout the test the ECG, heart rate, blood pressure and how the patient feels are monitored.
The test is stopped when the planned goal is reached, or earlier if there are medical reasons to stop it.
After the exertion, the recovery of heart activity is monitored for some time.
How to prepare?
- Wear comfortable clothes that do not restrict movement and sports shoes.
- Avoid heavy meals and intense physical exertion before the test.
- Follow the instructions given when you book regarding caffeine and other preparation restrictions.
- Tell the doctor about the medicines you take, especially those that affect heart rhythm or blood pressure.
- Do not stop medicines on your own – if changes are needed, the doctor must tell you about them.
Cardiopulmonary exercise test
A cardiopulmonary exercise test is a comprehensive assessment of the heart, breathing and the body’s physical capacity. During the test the heart’s electrical activity is recorded and respiratory gases are analysed, making it possible to assess how the body takes up and uses oxygen during exertion.
Depending on the test protocol, the body’s energy expenditure may also be assessed.
When is it performed?
- When the causes of reduced physical capacity or shortness of breath are unclear.
- To assess the impact of certain heart and respiratory diseases on physical capacity.
- To monitor changes in physical capacity during treatment or rehabilitation.
- To assess how the body of people who do sport or are physically active responds to exertion, when such testing is medically appropriate.
What does it show?
- Oxygen consumption. How much oxygen the body uses during physical exertion.
- Physical capacity. The body’s ability to cope with increasing exertion.
- Heart response to exertion. Changes in heart rate and the ECG.
- Respiratory response. Ventilation and respiratory gas exchange parameters.
- Causes of exercise limitation. Whether reduced physical capacity may be related to the heart, the respiratory system or other factors.
How is it performed?
ECG electrodes are attached to the patient and a special breathing mask is fitted, through which inhaled and exhaled gases are analysed.
The physical load is increased gradually, and heart activity, breathing parameters and how the patient feels are assessed continuously throughout the test.
When the exertion ends, the body’s recovery is monitored, and the data obtained are analysed and reported.
How to prepare?
- Come in comfortable sportswear and sports shoes.
- Avoid intense physical exertion before the test.
- Follow the individual advice you are given about eating, caffeine and other stimulants.
- Tell the doctor about the medicines you take, any chronic conditions and recent symptoms.
- Do not change your medicines on your own.
V-MAX functional assessment
V-MAX is a testing system used to assess the function of the heart and respiratory systems and the body’s response to physical exertion. It makes it possible to analyse respiratory gas exchange and physical capacity parameters.
V-MAX testing is relevant for patients whose exercise tolerance needs to be assessed, and for physically active people who want to better understand their body’s capacity.
When is it performed?
- To assess aerobic physical capacity.
- To investigate reduced exercise tolerance.
- To assess how the heart and respiratory systems respond to exertion.
- To plan individual physical activity based on objective measures of the body’s capacity.
- To monitor changes in physical capacity when such assessment is medically justified.
What does it show?
- Oxygen consumption. The body’s ability to use oxygen during physical exertion.
- Maximal oxygen uptake (VO₂ max). A measure of aerobic physical capacity, if the conditions needed to determine it are reached during the test.
- Respiratory response to exertion. Changes in breathing rate, ventilation and gas exchange.
- Limits of physical capacity. The body’s response to increasing physical exertion.
How is it performed?
The course of a V-MAX assessment depends on the chosen test protocol. To assess the body’s response to physical exertion, respiratory gas analysis equipment is used and the physical load is increased gradually.
The data obtained are analysed to assess oxygen consumption, the respiratory response and physical capacity.
How to prepare?
- Wear comfortable sportswear and sports shoes.
- Avoid intense physical exertion before the test.
- Follow the advice given when you book about eating and caffeine.
- Tell the specialist about the medicines you take, any chronic conditions and changes in how you feel.
V-MAX is the name of a functional testing system, so its use can be part of a cardiopulmonary exercise test. The exact scope of the test is confirmed when you book.
Which heart tests do you need?
Different heart tests assess different aspects of heart function, so the most suitable tests are chosen individually.
The first step is a consultation with a cardiologist. The doctor will listen to your complaints, assess your medical history and risk factors and, taking your condition into account, prescribe the tests you need.
This avoids unnecessary tests, and diagnostics proceed step by step – from the initial assessment of your health to the diagnosis and treatment plan.
How to prepare for heart tests
Preparation depends on the test prescribed.
A resting ECG and a standard echocardiogram usually require no special preparation. For Holter and Tonoport monitoring it is important to make sure that you can follow the instructions for using the device while you wear it.
For cycle ergometry and the cardiopulmonary exercise test you need comfortable clothing, suitable shoes and to be prepared for physical activity.
Before the test it is recommended to:
- Tell us about the medicines you take. Some medicines may affect test results.
- Bring the results of previous tests. They help to compare changes in heart function.
- Report changes in your health. Especially if you have recently developed new chest pain, shortness of breath, fever or other acute symptoms.
- Follow the instructions for the specific test. They may differ depending on the type of test and your state of health.
When may heart tests not be performed or be postponed?
Not every test can be safely performed on every patient.
A resting ECG and echocardiography are non-invasive tests that usually have few restrictions. Holter and Tonoport monitoring may be made more difficult by skin reactions to the electrodes or cuff and by practical circumstances of using the devices.
Exercise tests have more safety restrictions. They may not be performed or may be postponed in acute or unstable heart conditions, certain severe rhythm disorders, acute infections or other medical contraindications.
Before an exercise test the doctor assesses your state of health and decides whether the test is safe to perform.
Frequently asked questions
Do I need a doctor’s referral for heart tests?
No, a doctor’s referral is not required. At Baltic American Clinic a referral does not affect the price of paid services. If you do not know which tests you need, it is recommended to book a cardiologist consultation first. Bring any results of previous tests to the consultation.
Which heart test may the doctor prescribe if I feel palpitations?
The first test is often a resting electrocardiogram. If palpitations occur only occasionally, the doctor may recommend Holter monitoring, which records the heart rhythm for 24 hours. The need for the test is decided during the consultation.
What is the difference between an ECG and echocardiography?
An ECG records the heart’s electrical activity, while echocardiography uses ultrasound to show the structure of the heart, the contraction of the muscle, valve function and blood flow. The tests assess different aspects of heart function.
What is the difference between Holter and Tonoport monitoring?
Holter monitoring records the heart’s electrical activity and helps to detect rhythm disorders. Tonoport monitoring measures arterial blood pressure at set intervals around the clock. Both tests may be prescribed to assess different parameters of the heart and circulatory system.
Do I need Tonoport monitoring if I measure my blood pressure at home?
Not always. However, 24-hour blood pressure monitoring can provide additional information about changes in blood pressure during the day and night, especially if home readings vary a lot or the effectiveness of treatment needs to be assessed. The need for the test is decided by the doctor.
Does echocardiography show blocked coronary arteries?
A standard echocardiogram does not directly show narrowing of the coronary arteries in the way that dedicated vascular imaging tests do. However, it may reveal certain changes in heart function that lead the doctor to recommend further tests.
Can I work during Holter and Tonoport monitoring?
You can usually go about your normal daily activities unless the doctor has told you otherwise. However, you need to keep the devices away from water, follow the instructions for use and avoid activities that could damage the devices.
Can I sleep with a Holter or Tonoport device?
Yes. Both devices are designed to record readings during sleep as well. The Tonoport cuff inflates periodically at night, so it may briefly disturb your sleep.
Are cycle ergometry and the cardiopulmonary exercise test the same thing?
No. Both tests assess the body’s response to physical exertion, but the cardiopulmonary exercise test also analyses respiratory gases and oxygen consumption. It therefore provides more detailed information about how the heart, lungs and the body’s physical capacity work together.
How does a V-MAX assessment differ from a cardiopulmonary exercise test?
V-MAX is a functional testing system that can be used for cardiopulmonary testing. These names therefore do not necessarily mean two different procedures. The exact scope of the test is determined by the assessment the doctor prescribes.
Can heart tests be performed while taking blood pressure-lowering medicines?
Most tests can be performed while taking your usual medicines, but some medicines may affect the results of exercise tests. Whether your medicines need to be changed is decided by the doctor. Do not stop them on your own.
Are heart tests painful?
A resting ECG, echocardiography and Holter monitoring are usually painless. During Tonoport monitoring the cuff periodically squeezes the upper arm and may cause brief discomfort. During exercise tests you may feel tired or breathe faster.
Can heart tests be done without a cardiologist consultation?
Some tests can be performed on the recommendation or prescription of another doctor. However, if the need for testing has not yet been determined, it is recommended to book a cardiologist consultation first. The doctor will assess your condition and prescribe the tests you need.
When are heart test results available?
The time it takes to receive results depends on the test. Resting ECG and echocardiography findings are usually assessed during the test or shortly afterwards. Holter, Tonoport and exercise test data may need additional analysis. The exact time for the results is given when the test is performed.
Price of heart tests
The price of heart tests depends on the type and scope of the test prescribed.
If an additional specialist consultation, other diagnostic tests or procedures are needed for the test, they are charged separately according to Baltic American Clinic’s current price list, unless they are included in the chosen service.
The need for tests, their scope and any additional costs are discussed with you before they are performed.