You are likely to have blood tests done before coming to clinic to check your cholesterol level and looking for evidence of diabetes. On occasion these blood tests are done "fasting" which means you have the blood taken in the morning on an empty stomach before breakfast.

An ECG is a recording of your heart's electrical activity. Electrode patches are attached to your skin to measure the electrical impulses given off by your heart. The result is a trace that can be read by a doctor. It can give information of current or previous heart attacks or problems with the heart rhythm. Depending on your history, examination and ECG, you may go on to have other tests.

This is an ultrasound scan of the heart called a Transthoracic Echocardiogram (TTE). It assesses the structure, function and size of your heart. A small handheld transducer, which sends out sound waves, is moved across your chest after gel has been applied. The transducer picks up the reflected sound waves and sends them to a computer which interprets the sound waves into an image of the heart walls and valves. In some circumstances an echocardiogram needs to be performed by inserting a tube into the swallowing tube (oesophagus). This technique is performed under sedation by a trained cardiologist; the procedure is called transoesophageal echocardiogram. An echocardiogram or transoesophageal echocardiogram test takes up to 45 mins and is performed by a cardiac sonographer. Echocardiograms are undertaken at the Te Whatu Ora, Taranaki New Plymouth Hospital only.

An exercise tolerance test can show abnormalities in the major blood vessels of the heart that do not happen when your heart is at rest or not under pressure. It involves walking on a treadmill whilst continuous monitoring of your heart function and blood pressure are undertaken. Every three minutes the slope and speed of the treadmill will increase. Changes in the ECG may indicate the presence of coronary artery disease. The test takes 30 minutes and is performed by a doctor or cardiac nurse practitioner with a cardiac physiologist or cardiac nurse. Appointments for exercise tolerance test procedures are available at both Te Whatu Ora, Taranaki New Plymouth and Hāwera hospital sites.

An ambulatory electrocardiogram (ECG). This can be performed with a Holter Monitor which is a portable device that monitors your heart for rhythm abnormalities during normal activity for an uninterrupted 24 to 48-hour period. During the test, electrodes attached to your chest are connected to a portable recorder - about the size of a matchbox - that's attached to your belt or hung from a shoulder strap. It takes 10 minutes to fit the monitor, the patient then removes the monitor and returns it the next day. The recording is then downloaded onto a computer and analysed by a cardiac physiologist and reported by a cardiologist. Another form of ambulatory ECG test is an Event Recorder (EVR) which covers 1-2 weeks. You wear a monitor the same as a Holter Monitor and if you have any symptoms, such as dizziness, you press a button on a recording device which saves the recording of your heart rhythm made in the minutes leading up to and during your symptoms. Because you can wear this for a longer period of time it has a higher rate of catching your abnormal rhythm. Holter and Event Recorder monitoring appointments are available at both Te Whatu Ora, Taranaki New Plymouth and Hāwera hospital sites.

An ambulatory blood pressure monitor is a portable device that records your blood pressure for 24 hours at 30 minute intervals during the day and every hour during the night. It takes 10 minutes to fit the device the patient then removes the device and returns it the next day. The information captured on the device is downloaded onto a computer and analysed by a cardiac physiologist and reported by a medical doctor. Ambulatory blood pressure monitor monitoring appointments are available at both Te Whatu Ora, Taranaki New Plymouth and Hāwera hospital sites.

This test examines blood flow to the heart and to determine whether there is a difference in flow under rest and stress. These scans are based on physical stress either on a treadmill (Stress Perfusion Scan) or, if the patient is unable to use the treadmill, a chemical known as a “tracer” which is a short-lived radioactive agent, is given through a line in your arm (Chemical Perfusion Scan). This scan is especially useful in determining whether heart artery disease is limiting blood flow, in assessing patients prior to major surgery, and in investigating patients with possible angina. Nuclear Medicine tests are undertaken at the Te Whatu Ora, Taranaki New Plymouth Hospital site only and are carried out by the Radiology Department.

Cardiac MRI provides excellent images of the heart using standard MRI scanning equipment, which relies on powerful magnetic fields. The test allows cardiologists to see aspects of heart structure and function not easily visible with other techniques, including the detection of scarring in the heart muscle, and visualisation of the major blood vessels. Patients will commonly receive the contrast agent “Gadolinium” via an injection during the scan. Cardiac MRI does not involve the use of radiation, but some patients, such as those with pacemakers, may be unsuitable for scanning. MRI scans are undertaken at the Te Whatu Ora, Taranaki New Plymouth Hospital site or via Absolute Radiology. On occasion patients with complex heart conditions may also have their referral sent to a tertiary facility for completion.

CTCA is a CT scan of the arteries of the heart. By injecting contrast dye into a line in your arm, the scan can provide high definition, 3 dimensional images of your arteries. It is one of the best ways to detect signs of coronary atherosclerosis (narrowing of the arteries) from plaques developing in the walls of the artery. Coronary atherosclerosis may cause angina or a heart attack. For this test you will require an IV line in a vein of your arm. Your heart rate will need to be less than 60 beats per minute so good images can be obtained. You may require a medication to reduce your heart rate if necessary or a medication that makes the arteries expand so the arteries are more easily seen. Outpatient CTCA appointments can take up to 4 hours. The actual scanning time is only 5 minutes, but the preparation and recovery period can take time. CTCA scans are undertaken at the Te Whatu Ora, Taranaki New Plymouth Hospital site only and are carried out by the Radiology Department.

A cardioversion is a procedure that can restore an abnormal heart rhythm and is a frequently recommended procedure for patients with atrial fibrillation. It is carried out under a brief general anaesthetic or sedation. A small electric shock is delivered via adhesive pads on the chest. In most patients, this normalises the heart rhythm. Cardioversions are only undertaken at the Te Whatu Ora, Taranaki New Plymouth Hospital site.

This test is performed by a cardiologist in a sterile catheter laboratory. The procedure will be explained to you before being requested to sign the legal consent form which will be co-signed by your cardiologist. You are not given a general anaesthetic but will have some medication to relax you. Local anaesthetic is put into an area of skin on your wrist (or the side of your groin if access from the wrist is unsuccessful). A needle and then tube are fed into an artery and advanced through the blood vessels to the heart. Passing a catheter through the blood vessels is a painless procedure. Dye is then injected so that the heart and its blood vessels can be seen on X-ray. X-rays and measurements are then taken, giving the doctors information about the state of your heart and the exact nature of any narrowed blood vessels. This allows them to plan the best form of treatment to prevent heart attacks and control any symptoms you may have. Diagnostic Coronary Angiography is only undertaken at the Te Whatu Ora, Taranaki New Plymouth Hospital site. Any intervention that may be required will be referred to Waikato Hospital as our tertiary facility.

This test is performed for some patients with episodes of fainting. It is performed by tilting the patient at an angle on a special table while the heart rhythm and blood pressure are monitored. This diagnostic procedure can take up to two hours plus some recovery time. This is performed in the Cardiology Outpatients Department. Tilt tables are only undertaken at the Te Whatu Ora, Taranaki New Plymouth Hospital site.

The Cardiac CNS specialise in working with cardiac patients and their families providing education and health promotion. This includes addressing risk factors for heart disease, promoting healthy lifestyle changes and supporting people through cardiac events, interventions and surgery. Patients can be seen in hospital, their own homes, clinic settings and contacted by telephone. They liaise with the Te Whatu Ora, Taranaki cardiac multidisciplinary teams and Waikato Cardiac Services. The CNS co-ordinate the cardiac rehabilitation group sessions and work in liaison with the Te Whatu Ora, Taranaki cardiac physiotherapist, general practitioners, local cardiac support groups and the National Heart Foundation. The service is Taranaki wide with clinics in New Plymouth, Stratford, Hāwera and Waitara. You can access this service by self-referral.

The Cardiac Heart Function CNS specialises in working with cardiac patients and their families living with heart failure. Patients are seen as inpatients or in outpatient clinic appointments. Referral to this service is by general practitioner or hospital specialist.