When you have chest discomfort, palpitations, breathlessness or concerns about blood pressure, it can be difficult to know which test—or specialist appointment—you need. A cardiology consultation and diagnosis is the starting point for matching your symptoms and medical history with the right next steps. The aim is not to order every available test, but to build a clear picture and explain what the findings mean for you. Learn more about heart health checks, ECG and echocardiography in our guide to common investigations.
For people arranging care in October 2026, a useful way to think about the process is as a pathway: discuss the symptoms, choose investigations that answer a specific question, then consider treatment in light of the results. Dr. Chabok provides cardiology consultations, investigations and interventional care, with clinics listed in London and Harefield. The appropriate pathway depends on each person’s circumstances. For a closer look at these tests, read what to expect from an ECG and echocardiogram.
What happens during a cardiology consultation?
A consultation usually begins with a detailed discussion. Your cardiologist may ask when symptoms started, how often they occur, what brings them on, how long they last and whether anything makes them better or worse. Details such as a racing or irregular heartbeat, chest pressure on exertion, fainting, swelling or reduced exercise tolerance can help guide the assessment. Our guide explains when an echocardiogram may help with chest pain and how it can inform assessment.
You may also be asked about previous illnesses, medicines, smoking, family history and any earlier heart tests. A physical examination and blood pressure measurement may be appropriate. Bring a list of medicines and, if you have them, previous ECGs, scan reports or discharge letters. A record of when symptoms occur can also be helpful, especially if they are intermittent. You can also read our guide to private cardiology and heart checks for an overview of the assessment process.
The consultation is an opportunity to discuss your concerns and agree what should happen next. Depending on the information available, that may mean reassurance, a change in treatment, further investigation or referral for a procedure. A test is useful when it helps answer a clinical question; it is not automatically needed simply because it is available.
Which heart tests might be recommended?
ECG interpretation
An electrocardiogram (ECG) records the heart’s electrical activity using sensors placed on the skin. It can provide information about heart rate and rhythm and may show patterns that help a cardiologist assess symptoms or previous heart problems. An ECG is a short recording, so it may not capture an occasional palpitation. A normal result does not necessarily explain every symptom or rule out every heart condition.
ECG interpretation involves considering the tracing alongside your symptoms, medical history and examination—not reading it in isolation. If episodes come and go, a longer period of rhythm monitoring may be considered.
Echocardiography
An echocardiogram is an ultrasound scan of the heart. It shows moving images that can help assess the heart’s structure, pumping function and valves. It is different from an ECG: an ECG records electrical activity, while an echocardiogram uses ultrasound to produce images.
Echocardiography may be recommended when the assessment needs more information about the heart’s chambers, valves or pumping action. The result is interpreted with the reason for the scan in mind and alongside other findings.
Diagnostic angiography
Diagnostic coronary angiography is an invasive imaging procedure used to examine the coronary arteries, which supply blood to the heart muscle. A cardiologist introduces a thin catheter through an artery, commonly at the wrist or groin, and uses X-ray imaging and contrast dye to view the blood vessels.
It may be considered when symptoms or earlier tests raise concern about narrowing in the coronary arteries. Before the procedure, the clinical team should explain why it is being recommended, how to prepare, the potential benefits and risks, and what recovery may involve. The findings help inform whether medication, lifestyle measures, an intervention or another approach should be discussed.
When is angioplasty and stenting considered?
Angioplasty is a procedure to widen a narrowed section of an artery. In coronary angioplasty, a small balloon is inflated at the narrowed area. A stent—a small mesh tube—is often placed to help keep the artery open. Whether angioplasty and stenting are suitable depends on the location and extent of narrowing, symptoms, overall health and the alternatives available.
Angioplasty is not the same as diagnostic angiography. Angiography provides images to assess the arteries; angioplasty is a treatment intended to improve blood flow through a narrowed section. Sometimes an intervention may be discussed after the anatomy has been assessed, but the plan should be explained and agreed with the patient wherever the clinical situation allows.
Before deciding, ask what the procedure is intended to achieve, what other treatment options exist, what medicines may be needed afterwards and what follow-up is planned. Your cardiologist can explain how the findings relate to your symptoms and personal circumstances.
What is right heart catheterisation?
Right heart catheterisation is a procedure that measures pressures and blood flow on the right side of the heart and in the blood vessels leading to the lungs. A thin catheter is guided through a vein to the heart. It is different from coronary angiography, which focuses on the arteries supplying the heart muscle.
A specialist may recommend this test when direct pressure measurements are needed to investigate a particular heart or circulation question. The reason for the test, how it is performed and what the measurements can show should be discussed in advance. Its role is specific: it is not a routine test for every person with chest symptoms or palpitations.
How can an implantable loop recorder help with palpitations?
An implantable loop recorder is a small device placed under the skin to monitor the heart’s rhythm over an extended period. It can be useful when symptoms such as palpitations, unexplained fainting or episodes of dizziness are infrequent and shorter monitoring has not captured an event. The device records rhythm information that can be reviewed by the clinical team.
Insertion and explant are separate parts of the device pathway. Insertion places the monitor under the skin; explant means removing it, for example when monitoring is complete or the device needs to be taken out. Your specialist can explain how the device is activated and reviewed, what to do if symptoms occur and when removal may be considered.
Making sense of results and next steps
Tests provide pieces of information, not a diagnosis in isolation. A cardiologist considers results alongside your symptoms, examination, risk factors and any previous investigations. Some findings may support a clear diagnosis; others may lead to further assessment or monitoring. If a result is reassuring, ask what it does—and does not—tell you, and what to do if symptoms change.
Before you leave a consultation, it can help to confirm:
- What is the main question the recommended test is intended to answer?
- How should I prepare, and are there medicines I should discuss beforehand?
- When and how will I receive the result?
- What are the possible next steps for each likely result?
- Who should I contact if symptoms worsen or I have concerns?
These questions can make a complicated pathway easier to follow. If you are seeking a specialist assessment, Dr. Chabok’s listed clinics in London and Harefield offer a setting to discuss symptoms, investigations and treatment options. The right combination of care will depend on your individual assessment.
When to seek urgent help
Do not wait for a routine appointment if you may be having a medical emergency. Call 999 for severe or persistent chest pain, especially if it spreads to the arm, back, neck or jaw, or occurs with shortness of breath, sweating, nausea or collapse. Follow emergency-service advice. For symptoms that are new, worsening or worrying but do not seem immediately life-threatening, seek prompt advice from an appropriate healthcare professional.
Frequently Asked Questions
What should I bring to a cardiology consultation?
Bring a current medicines list, relevant medical records and previous heart-test results if available. Notes about when symptoms happen, how long they last and what seems to trigger them can also help.
Does a normal ECG mean my heart is healthy?
A normal ECG is useful information, but it is only a short recording and does not rule out every heart condition. Your cardiologist interprets it alongside your symptoms and may recommend other assessment if needed.
What is the difference between angiography and angioplasty?
Diagnostic angiography produces images of the coronary arteries to look for narrowing. Angioplasty is a treatment that widens a narrowed artery, often with a stent. They are related but serve different purposes.
Is right heart catheterisation the same as coronary angiography?
No. Right heart catheterisation measures pressures and blood flow on the right side of the heart and towards the lungs. Coronary angiography images the arteries that supply the heart muscle.
Why might someone need an implantable loop recorder?
It may be considered when symptoms such as palpitations or unexplained fainting occur intermittently and shorter-term monitoring has not captured them. A specialist can advise whether longer-term monitoring is appropriate.
When is an implantable loop recorder removed?
An explant removes the device, often when the monitoring period is complete or there is another clinical reason to take it out. The timing and arrangements should be discussed with the team responsible for your care.
Frequently Asked Questions
What should I bring to a cardiology consultation?
Bring a current medicines list, relevant medical records and previous heart-test results if available. Notes about when symptoms happen, how long they last and what seems to trigger them can also help.
Does a normal ECG mean my heart is healthy?
A normal ECG is useful information, but it is only a short recording and does not rule out every heart condition. Your cardiologist interprets it alongside your symptoms and may recommend other assessment if needed.
What is the difference between angiography and angioplasty?
Diagnostic angiography produces images of the coronary arteries to look for narrowing. Angioplasty is a treatment that widens a narrowed artery, often with a stent. They are related but serve different purposes.
Is right heart catheterisation the same as coronary angiography?
No. Right heart catheterisation measures pressures and blood flow on the right side of the heart and towards the lungs. Coronary angiography images the arteries that supply the heart muscle.
Why might someone need an implantable loop recorder?
It may be considered when symptoms such as palpitations or unexplained fainting occur intermittently and shorter-term monitoring has not captured them. A specialist can advise whether longer-term monitoring is appropriate.
When is an implantable loop recorder removed?
An explant removes the device, often when the monitoring period is complete or there is another clinical reason to take it out. The timing and arrangements should be discussed with the team responsible for your care.