Cardiac Tests | ECG, Echocardiogram, Holter | Naas

Cardiology · Naas, Co. Kildare

Cardiac Investigations & Tests

A comprehensive range of cardiac investigations in one clinic, interpreted in the context of your individual clinical history by Dr Imtiaz Ali Kalyar, Consultant Cardiologist.

Dr Imtiaz Ali Kalyar — Consultant Cardiologist IMC: 102093 Sunday Clinics Available

Overview

The Right Test at the Right Time

Cardiac investigations are only as valuable as the clinical context in which they are ordered and interpreted. At Naas Cardiology and Endocrinology Clinic, Dr Kalyar takes a personalised approach — selecting investigations based on a thorough clinical assessment rather than a one-size-fits-all protocol. Results are reviewed by the consultant and explained in plain terms at each stage of your care.

No investigation is performed without clinical justification. Below is an overview of the investigations available at or coordinated through our clinic.

This page is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999 or 112.

Available Investigations

Cardiac Tests Explained

ECG

Resting 12-Lead ECG

Duration: 5–10 minutes

The electrocardiogram (ECG) is a simple, completely painless recording of the electrical activity of the heart at rest. Twelve electrodes are placed on the chest, arms and legs and a trace is recorded over approximately 10 seconds. No needles or electricity are involved.

What it can detect

  • Cardiac arrhythmias (abnormal heart rhythms)
  • Ischaemic changes suggesting angina or previous heart attack
  • Left ventricular hypertrophy (thickened heart muscle from hypertension)
  • Conduction abnormalities (bundle branch block, AV block)
  • Prolonged QT interval and pre-excitation patterns (e.g. Wolff-Parkinson-White)
  • Pericarditis

When it is appropriate

A resting ECG is the first investigation for virtually all cardiac presentations, including chest pain, palpitations, breathlessness, syncope and pre-operative assessment.

Echo

Echocardiography

Duration: 30–45 minutes

Echocardiography — a cardiac ultrasound — produces real-time moving images of the heart using sound waves. It is completely painless, does not involve radiation, and requires no preparation beyond removing your upper clothing. Gel is applied to the chest and a handheld probe is moved over the skin surface.

What it can detect

  • Left ventricular ejection fraction (heart pumping strength)
  • Valve abnormalities — regurgitation, stenosis, prolapse
  • Wall motion abnormalities consistent with coronary artery disease
  • Left ventricular hypertrophy and diastolic dysfunction
  • Pericardial effusion
  • Cardiomyopathies (dilated, hypertrophic)
  • Congenital heart abnormalities

When it is appropriate

Echocardiography is indicated for suspected heart failure, murmurs, cardiomyopathy, valvular disease, shortness of breath, post-ACS assessment and monitoring of known cardiac conditions.

Holter

24–72 Hour Holter Monitor

Duration: 24–72 hours wear

A Holter monitor is a portable ECG device worn continuously for 24 to 72 hours while you go about your normal daily routine. A small recorder is attached to your clothing or belt, connected to adhesive electrode patches on your chest. You are asked to keep a symptom diary so that any rhythm abnormalities can be correlated with how you felt at the time.

What it can detect

  • Paroxysmal (intermittent) arrhythmias not captured on resting ECG
  • Frequency and type of ectopic beats (PACs, PVCs)
  • Paroxysmal atrial fibrillation or atrial flutter
  • Episodes of SVT or AV block
  • Nocturnal rhythm disturbances

When it is appropriate

The Holter monitor is the investigation of choice for patients with frequent (daily or near-daily) palpitations, dizziness, or pre-syncope when the resting ECG is normal.

ABPM

Ambulatory Blood Pressure Monitoring

Duration: 24 hours wear

Ambulatory blood pressure monitoring (ABPM) involves wearing a standard blood pressure cuff on the upper arm for 24 hours. The cuff inflates automatically at regular intervals (typically every 15–30 minutes during the day and every 30–60 minutes at night), recording readings throughout your normal daily activities and during sleep. The device is compact and can be worn under clothing.

What it measures

  • Daytime average, night-time average and 24-hour mean blood pressure
  • Blood pressure variability and dipping pattern during sleep
  • White-coat effect (elevated clinic readings but normal ambulatory readings)
  • Masked hypertension (normal clinic but elevated ambulatory readings)

When it is appropriate

ABPM is the gold standard for confirming a new diagnosis of hypertension, assessing treatment adequacy, investigating resistant hypertension and characterising blood pressure behaviour over the full 24-hour period.

ETT

Exercise Tolerance Test

Duration: 45–60 minutes

The exercise tolerance test (ETT) — also known as a treadmill stress test — records a continuous 12-lead ECG while you walk on a treadmill at progressively increasing speeds and gradients, following the standard Bruce protocol. Blood pressure and symptoms are monitored throughout. The test is stopped when target heart rate is achieved, symptoms develop, or ECG changes indicate ischaemia.

What it assesses

  • ECG changes (ST depression/elevation) consistent with myocardial ischaemia
  • Exercise-induced arrhythmias
  • Chronotropic response (heart rate response to exercise)
  • Blood pressure response to exercise
  • Exercise capacity and functional limitation

When it is appropriate

The ETT is valuable for patients with exertional chest pain or breathlessness and an intermediate pre-test probability of coronary artery disease. It is not indicated for all chest pain — Dr Kalyar will advise whether it is the right test for your specific situation.

Common Questions

Frequently Asked Questions

An echocardiogram is an ultrasound scan of the heart — the same technology used in obstetric scans. It is completely painless and involves no radiation. A gel is applied to your chest and a small handheld probe is moved over the skin to capture images of your heart. You may feel slight pressure from the probe, but most people find it very comfortable. The scan takes approximately 30 to 45 minutes, and you can return to normal activities immediately afterwards.
A Holter monitor is a small portable device that records your heart's electrical activity continuously for 24 to 72 hours while you go about your daily life. Adhesive electrode patches are attached to your chest and connected to a small recorder worn on a belt or strap. You carry on with normal activities but are asked to avoid swimming or showering with the device attached, and to keep a diary of any symptoms such as palpitations or dizziness. The data is downloaded and analysed to identify any rhythm disturbances and correlate them with your symptoms.
A resting 12-lead ECG records the electrical signals produced by your heart at rest over approximately 10 seconds. It can identify the heart rhythm, detect signs of previous heart attack or current ischaemia, show evidence of left ventricular hypertrophy (thickened heart muscle), identify conduction abnormalities such as bundle branch block, and detect pre-excitation patterns. However, a normal ECG does not exclude all cardiac conditions — many patients with significant cardiac disease have a normal resting ECG, which is why further investigation is often needed.
A single clinic blood pressure reading can be misleading. Some people have consistently elevated readings only when in a healthcare setting ("white-coat hypertension"), while others have normal clinic readings but elevated pressures throughout the rest of their day ("masked hypertension"). ABPM captures blood pressure at regular intervals over 24 hours in your normal environment, providing a much more accurate picture of your true blood pressure burden, including during sleep — an important period that a clinic visit cannot capture.
A resting ECG takes approximately 5 to 10 minutes in total. An echocardiogram typically takes 30 to 45 minutes. A Holter monitor is fitted in around 15 minutes and then worn for 24 to 72 hours before being returned to the clinic for analysis. ABPM is fitted in around 15 minutes and worn for 24 hours. An exercise tolerance test, including preparation, monitoring and recovery time, usually takes 45 to 60 minutes. All tests are arranged through the clinic at a time convenient to you.

Book a Cardiology Appointment

Consultant-led cardiac investigations and results review with Dr Imtiaz Ali Kalyar. Sunday clinics available. Naas, Co. Kildare.

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