Chest discomfort, breathlessness, palpitations or a high blood pressure reading can raise difficult questions: what is causing the symptom, which test is appropriate, and what happens next? A private cardiology consultation and diagnosis is a structured way to explore those questions, using your medical history, examination and tests chosen for your individual concerns. Learn more about how ECG and echo heart checks can help assess different symptoms.
The aim is not to order every available investigation. It is to match the next step to the clinical question. An ECG records the heart’s electrical activity; an echocardiogram assesses its structure and function; angiography looks for narrowing in the coronary arteries; and other procedures can investigate pressure in the heart or episodes of an abnormal rhythm. Dr Chabok provides cardiology consultations, investigations and treatments, including interventional procedures, at clinics in London and Harefield. Our guide to a private ECG and echocardiogram explains what to expect during these tests.
Start with the symptoms and the story behind them
A cardiology assessment usually begins with a conversation. Your cardiologist may ask when symptoms started, how long they last, what brings them on, and whether anything makes them better or worse. Details such as whether chest discomfort occurs during exertion, whether palpitations begin and stop suddenly, or whether breathlessness is worse when lying down can help guide the investigation. For chest discomfort, read more about when an echocardiogram may help clarify the cause.
Your medical history also matters. The discussion may cover existing conditions, medicines, previous test results, smoking, and family history of heart disease or sudden cardiac problems. A physical examination and blood pressure measurement may help put the symptoms in context. Bring a current medicines list and any relevant letters or test reports if you have them. Explore our guide to private cardiology heart checks for an overview of assessment options.
Symptoms alone do not confirm a diagnosis. For example, palpitations can occur with different heart rhythms, while chest discomfort can have cardiac and non-cardiac causes. The purpose of assessment is to consider possible explanations, identify signs that need prompt attention and decide whether further testing is useful.
ECG and echocardiography: different tests, different questions
What does an ECG show?
An electrocardiogram, usually called an ECG, records the heart’s electrical signals through electrodes placed on the skin. A resting ECG is quick and can provide information about heart rate and rhythm, as well as electrical patterns that may support a diagnosis. It is a snapshot: if an intermittent rhythm problem is not happening during the recording, a short ECG may not capture it.
ECG interpretation means assessing the tracing alongside your symptoms and clinical history. A finding should not be interpreted in isolation, and a normal resting ECG does not rule out every heart condition. If symptoms come and go, your cardiologist may consider longer-term rhythm monitoring, including an implantable loop recorder in selected cases.
What is an echocardiogram?
Echocardiography uses ultrasound to create images of the heart. It can assess features such as the heart’s chambers, pumping function and valves. It does not use X-rays. The type of echocardiogram and the information it can provide depend on the clinical question and the images obtained.
An ECG and an echocardiogram are not interchangeable. One records electrical activity; the other examines structure and movement. They may be used together when a clinician needs to understand both rhythm and heart function.
Diagnostic angiography and angioplasty: finding and treating a narrowing
Coronary diagnostic angiography is an imaging procedure used to examine the arteries that supply the heart. A fine tube called a catheter is guided through a blood vessel, commonly from the wrist or groin, and contrast dye is used to make the arteries visible on X-ray images. It may be considered when symptoms or earlier assessments suggest coronary artery disease and more detailed information is needed.
Diagnostic angiography is not the same as angioplasty. Angiography shows the coronary arteries; angioplasty is a treatment that may be performed to improve blood flow through a suitable narrowed section. During angioplasty, a small balloon is inflated at the narrowed area. A stent, a small mesh tube, may be placed to help keep the artery open. Whether treatment is appropriate depends on the findings, symptoms, overall health and discussion of the available options.
Before an invasive procedure, the clinical team should explain why it is being considered, how to prepare, what alternatives may be available and what the relevant risks are. These can include bleeding or bruising at the access site, reaction to contrast dye, and other less common but more serious complications. Kidney function, allergies and medicines may be relevant to planning. Ask your cardiologist what the procedure is expected to clarify in your particular case.
Right heart catheterisation: measuring pressures and blood flow
Right heart catheterisation is a procedure used to measure pressures in the right side of the heart and the blood vessels leading to the lungs. A catheter is introduced through a vein and guided into position. Depending on the reason for the test, measurements may help assess how the heart and circulation are working.
This is different from coronary angiography, which focuses on the arteries supplying the heart muscle. Right heart catheterisation may be considered when a clinician needs direct pressure measurements that cannot be answered adequately by other tests. The reason for the procedure and what its results could mean should be discussed beforehand.
Implantable loop recorder insertion and explant
An implantable loop recorder, or ILR, is a small device placed under the skin of the chest to record heart rhythm over an extended period. It may be considered when symptoms such as fainting or palpitations are intermittent and have not been explained by shorter monitoring. The device can help capture rhythm information around an episode, but it does not prevent an abnormal rhythm or treat it.
Insertion involves placing the recorder beneath the skin, usually through a small incision. The team can explain how the device records information, how data is reviewed and what to do if symptoms occur. An ILR is removed, or explanted, when it is no longer needed or when its recording period has ended. The timing and arrangements depend on the individual plan.
How test results can shape the next step
Investigations are most useful when their findings are interpreted alongside symptoms and examination. A result may support a diagnosis, make one explanation less likely, or show that another test is needed. Sometimes the appropriate plan is treatment; sometimes it is monitoring, lifestyle advice, review of medicines or follow-up to see how symptoms change.
Before a test, it can help to ask:
- What question is this investigation intended to answer?
- How should I prepare, including whether to take my usual medicines?
- When and how will the results be explained?
- What are the possible next steps for different results?
These questions can make the process clearer and help you take part in decisions. Do not stop or change prescribed medicines unless your clinician advises you to.
When to seek urgent help
Do not wait for a routine appointment if you think you may be having a medical emergency. Call 999 for severe or persistent chest pain, particularly if it spreads to your arm, back, neck or jaw, or occurs with breathlessness, sweating, nausea or collapse. Seek urgent help for sudden severe symptoms or loss of consciousness. If symptoms are concerning but not immediately life-threatening, contact NHS 111 or an appropriate healthcare professional for advice.
Frequently Asked Questions
What happens at a cardiology consultation?
Your cardiologist will ask about your symptoms and medical history, review relevant medicines and test results, and may examine you. They will discuss possible explanations and whether tests or treatment are appropriate.
Can an ECG detect every heart rhythm problem?
No. A resting ECG records a short period, so an intermittent problem may not occur during the test. Longer monitoring may be considered if symptoms are occasional.
What is the difference between angiography and angioplasty?
Angiography is an imaging test that shows the coronary arteries. Angioplasty is a procedure to widen a suitable narrowed artery, sometimes using a stent.
Does everyone with palpitations need an implantable loop recorder?
No. An ILR is considered in selected situations, for example when symptoms are intermittent and other monitoring has not provided an explanation. The choice depends on your history and clinical assessment.
Is right heart catheterisation the same as coronary angiography?
No. Right heart catheterisation measures pressures in the right heart and circulation to the lungs. Coronary angiography images the arteries supplying the heart muscle.
Where can I arrange a cardiology consultation with Dr Chabok?
Dr Chabok lists clinics in London and Harefield. Contact the practice for current appointment and referral information.
Frequently Asked Questions
What happens at a cardiology consultation?
Your cardiologist will ask about symptoms and medical history, review relevant medicines and test results, and may examine you. They will discuss possible explanations and whether tests or treatment are appropriate.
Can an ECG detect every heart rhythm problem?
No. A resting ECG records a short period, so an intermittent problem may not occur during the test. Longer monitoring may be considered if symptoms are occasional.
What is the difference between angiography and angioplasty?
Angiography is an imaging test that shows the coronary arteries. Angioplasty is a procedure to widen a suitable narrowed artery, sometimes using a stent.
Does everyone with palpitations need an implantable loop recorder?
No. An ILR is considered in selected situations, such as when symptoms are intermittent and other monitoring has not provided an explanation. The choice depends on your history and clinical assessment.
Is right heart catheterisation the same as coronary angiography?
No. Right heart catheterisation measures pressures in the right heart and circulation to the lungs. Coronary angiography images the arteries supplying the heart muscle.
Where can I arrange a cardiology consultation with Dr Chabok?
Dr Chabok lists clinics in London and Harefield. Contact the practice for current appointment and referral information.