YOUR CONSULTATION - A personal view:
Medical practice differs substantially from surgical practice. In surgery, your General Practitioner may well have already identified the problem – perhaps a hernia, or even something as obvious as a bunion. Your consultation with a surgeon may therefore be brief, and limited to a discussion of the surgical options. In medical practice, and particularly cardiological practice, the diagnosis may not be straightforward. Adequate time must be allowed to explore symptoms, and to perform a detailed general medical and cardiac examination. An ECG (electrocardiogram) will be performed and analysed, and consideration given to other diagnostic tests such as scans or blood tests which may give a precise diagnosis. This will then be explained and treatment options discussed.
If you have been referred as a new patient, then I allow three-quarters of an hour for a full assessment, which involves taking a detailed medical history, talking about your symptoms, and then a general medical and cardiac clinical examination including an ECG (see Chaperone Policy).
I generally allow about 20 minutes to discuss progress with you, to make an examination and further ECG, and to plan any future treatment and assessment.
I allow 30 minutes to obtain multiple views and recordings from the heart and to discuss the findings.
24 HOUR ELECTROCARDIOGRAM, ALSO KNOWN AS HOLTER RECORDING (FITTING)
Allow 20 minutes for electrode placement and checking of recording signal before recorder is activated.
24 HOUR ELECTROCARDIOGRAM (REMOVAL)
Allow 10 minutes for removal of device and electrodes (24 hours after fitting)
CARDIOCALL (LONG TERM CARDIAC EVENT MONITOR) DEVICE (FITTING)
May take up to 30 minutes to attach electrodes, make test recordings, and explain device function
CARDIOCALL (LONG TERM CARDIAC EVENT MONITOR) DEVICE (REMOVAL)
Allow 20 minutes for device downloading of ECG recordings, quality assessment, and decision as to whether further recording necessary.
24 HOUR AMBULATORY BLOOD PRESSURE MEASUREMENT (FITTING)
May take up to 30 minutes to get optimum blood pressure cuff location, test recordings for quality control, etc.
24 HOUR AMBULATORY BLOOD PRESSURE MEASUREMENT (REMOVAL)
Allow 20 minutes for downloading Blood Pressure Recording, removal of device.
EXERCISE ELECTROCARDIOGRAPHY (SOMETIMES CALLED A STRESS, OR TREADMILL, TEST)
Performed in the Cardiac Department, Poole Hospital NHS Trust, using a Marquette motor driven treadmill and full ECG recording with signal averaged ECG analysis. Allow 30 minutes (slightly more if a pilot and undertaking exercise testing to CAA protocols). Loose fitting comfortable clothes and trainers recommended. Full details of this test will be provided if you need this investigation.
CARDIAC CATHETERISATION (also known as 'CORONARY ANGIOGRAPHY')
A small operative procedure performed as an in-patient daycase procedure. The operation is technically straightforward, and generally not as uncomfortable as having a filling done at the dentist's. The only complexity in the procedure is radiological - acquiring the optimal images and information about the heart and blood vessels. This test is generally only performed if coronary artery disease ("furring up" or "atherosclerosis") is suspected. Websites such as the British Heart Foundation can give you further information about this procedure (though the current BHF description of this procedure is a little outdated).
OTHER HEART TESTS
Occasionally other types of investigation may be necessary. I can discuss these further if I think they may be required.
Some of these investigations use complex and expensive equipment, so they may cost more than the consultation fee itself. Please ask my secretary for exact up to date costings of procedures. Please note that your private medical insurance will have a limit to outpatient test expenditure in any one year, and of course, you may have chosen to pay a lower premium which excludes outpatient test reimbursement. Some insurances are the other way round - the consultations are excluded, but tests are reimbursed. Almost all insurances cover inpatient investigation, and the hospitals where I undertake procedures such as Cardiac Catheterisation, or implantation of Cardiac Pacemakers, are fully approved.
We are an approved BUPA centre for testing. The title of the centre is ‘Deepdene Non-Invasive Cardiology Clinic’ and the provider number is 60010968.