TERMINOLOGY

1) Acute coronary syndrome: Acute coronary syndrome is a condition seen due to decreased blood flow due to coronary artery disease which includes conditions like unstable angina, acute myocardial infarction.

2) Anemia: The hemoglobin level is less than normal. (decrease the level of red blood cell or hemoglobin)

3) Aneurysm: A localized bulging or sac-like structure at a weak point in the wall of a blood vessel.

4) Angina pectoris: Chest pain due to reduced blood flow in the heart muscles is known as Angina pectoris.

5) Angioplasty: Angioplasty is a surgical procedure used to open a narrowed or blocked coronary artery.

6) Arotic stenosis (Aortic stenosis): Aortic valve narrowing.

7) Arteriosclerosis (arteriosclerosis): Hardening and thickening of the artery.

8) Atherosclerosis: Atherosclerosis is a type of condition. In which the lumen becomes narrowing due to plaque buildup on the artery wall.

9) Athroma: Fatty deposits or plaque formation found on the walls of arteries is known as atheroma.

10) Buerger’s disease (Buerger’s disease): In Buerger’s disease, there is inflammation and thrombosis in the medium and small size arteries in the arm and leg due to which the blood flow is reduced.

11) Cardiac arrest: Sudden and unexpected loss of heart function

12) Cardiac catheterization: Cardiac catheterization is an invasive procedure used to diagnose and treat heart conditions.

13) Cardiac output: The amount of blood flow pumped by the heart in one minute is known as cardiac output.

14) Cardiomyopathy: Cardiomyopathy is a heart muscle disease. In which the heart becomes enlarged, stiff and thick due to which the heart cannot pump effectively.

15) Congestive heart failure (congestive heart failure): Congestive heart failure is a chronic condition in which the heart cannot pump blood effectively, causing fluid buildup in the lungs, liver.

16) Creatine kinase: Creatine kinase is a type of enzyme found in the heart, brain and skeletal muscles.

17) Defibrillation: Defibrillation is a medical procedure in which an electrical shock is delivered to the heart to restore normal heart rhythm.

18) Dyslipidemia: Abnormal lipid level in blood

19) Dysrhythmia: Abnormal heart rhythm

20) Endocarditis: Inflammation of inner layer of heart / inflammation of endocardium

21) Heart failure: In heart failure, the heart fails to pump enough blood.

22) High density lipoprotein (high density lipoprotein): High density lipoprotein is a type of cholesterol which is also known as good cholesterol as it helps in removing cholesterol from the blood.

23) Hemophilia: Hemophilia is a genetic disorder in which the blood does not clot properly, resulting in prolonged bleeding.

24) Hypertension: High level of blood pressure (below 140/90 mmHg)

25) Hypotension: Low level of blood pressure (about 90/60 mmHg)

26) Heterograft: Heterograft also known as xenograft is a type of tissue graft in which a tissue graft from one donor species is transferred to a recipient of another species.

27) Homograft: Homograft is also known as Allograft. Which is a type of tissue graft in which the donor and recipient of the tissue graft are the specific same.

28) Ischemia: Reduces blood flow to the particular part of the body.

29) Leukocytes: Leukocytes means white blood cells

30) Leukemia: Leukemia is a type of cancer that affects the blood and bone marrow.

31) Leukopenia: Low level of white blood cells / Decrease number in white blood cells

32) Low density lipoprotein (low density lipoprotein): Low density lipoprotein is a type of cholesterol which is also known as bad cholesterol. Plaque formation is seen in the arteries due to increase in its level.

33) Microcytosis: Red blood cells are smaller than their normal size.

34) Murmur : Abnormal heart sound

35) Myocardial infarction (myocardial infarction): This is a medical emergency in which the blood flow to the heart muscle is blocked.

36) Myocardial ischemia (myocardial ischemia): This is a type of condition in which the heart muscles are not supplied with enough oxygen due to insufficient blood flow to the heart muscles.

37) Myocarditis: Inflammation of myocardium.

38) Neutropenia: Decrease number in neutrophils

39) Pancytopenia: Decrease in the number of three types of blood cells (RBC, WBC, platelet)

40) Pericardiocentesis: Pericardiocentesis is a procedure in which a needle is inserted into the pericardial sac and the pericardial fluid is drained/removed.

41) Pericardiotomy: Opening in pericardium

42) Pericarditis: Inflammation of pericardium

43) Poikilocytosis: Abnormal shape of red blood cells

44) Polycythemia: Increase the number of red blood cells

45) Postural hypotension: Postural hypotension is also known as orthostatic hypotension. In which there is a sudden drop in blood pressure from a sitting or lying down position to a standing position.

46) Pulmonary edema (Pulmonary Edema): Fluid accumulates in the lungs.

47) Regurgitation (Regurgitation): Backward flow of fluid. / Due to the valves in the heart being properly closed, there is a backflow of blood which is known as regurgitation.

48) Rubor: Reddish blue discoloration of extremities indicating severe peripheral artery damage.

49) Stenosis: Stenosis is a narrowing of an opening or passage in the body.

50) Stent: A stent is a type of small mesh tube like structure that is placed in an artery or duct to keep it open.

51) Streptokinase: Streptokinase is a type of medicine used to dissolve blood clots.

52) Thalassemia: Thalassemia is a hereditary hemolytic disease characterized by abnormal hemoglobin production leading to an anemic condition.

53) Thrombin: Thrombin is an enzyme present in blood plasma which is required to convert blood fibrinogen into fibrin so that blood can clot.

54) Thrombocyte: Thrombocyte is the term used for platelet.

55) Thrombocytopenia (thrombocytopenia): Low platelet count means reduction in platelet count.

56) Thrombosis: Clot (thrombus) formation within the blood vessels.

57) Thrombocytosis (Thrombocytosis): High platelet count means increase in platelet count.

58) Thrombolytic: An agent that breaks down or dissolves a blood clot is known as thrombolytic.

59) Troponin : Troponin is a globular protein complex associated with muscle contraction.

60) Valvuloplasty : Repair of narrowing and stenosis valve

61) Vasoconstrictor : An agent used to constrict or narrow blood vessels.

62) Vasodilator : An agent used to dilate blood vessels

63) Ventricular tachycardia (Ventricular Tachycardia): This is a type of abnormal heart rhythm in which there is a fast and irregular heartbeat that originates from the lower chamber of the heart i.e. the ventricle.

64) Varicose vein: An enlarged, twisted and swollen vein. Which is mainly seen in the leg.

Physical examination / objective data

Inspection, palpation and auscultation methods are used in the examination of the cardiovascular system. Inspection

✓ General Appearance :

Assessing the patient’s general appearance. Such as assessing conscious level (alert, lethargic, comatose), mental status (oriented to time, place, person) and distress level.

✓ Inspection of Skin :

Checking the color of skin and mucus membrane.

To check whether central cyanosis as well as peripheral cyanosis is present in the skin.

Assess the skin for temperature, texture, ecchymosis, xanthalsema.

✓ Inspection of Extremities:

Assess hand, arm, leg and feet for skin and vascular changes.

Inspecting if swelling is present in the extremities.

Checking for presence of cyanosis and clubbing in fingers and toes.

✓ Inspection of Chest:

Checking whether any type of scar or surgical mark is present on the chest.

Inspecting Turkey’s position.

Assess the shape of the chest.

Checking for any dilated or engorged vein visible on the chest wall.

Assess for apex beat and other pulsations.

Also examine the jugular vein.

Palpation

Palpation uses the palmar surface of the fingers.

First check the body temperature.

To palpate the pulse points in the body.

Checking blood pressure.

Check whether swelling is present in the extremities with the help of palpation. Checking whether pitting edema is present or not.

Palpate rigidity of vessels.

Palpate the chest for an apical impulse or apex beat. The apical impulse is palpated in the mitral area.

Also palpate the chest for thrills.

To check whether parasternal heave is felt in the chest.

👉🏻For your knowledge Apical impulse
Apical impulse is also known as ‘Point of Maximum Impulse (PMI)’. The apical impulse is a palpable beat in the apical area of ​​the heart. which is felt on the left side of the 5th intercostal space and midcavalcular line. It is felt during the contraction of the left ventricle during systole. Thrill
A thrill is a palpable sensation due to tubulent blood flow. A thrill also known as a ‘palpable murmur’ is associated with heart valve abnormalities and ventricular septal defects. Parasternal heave

A parasternal heave is a noticeable outward movement of the chest wall. Which can be seen and felt on the left side of the sternum. which indicates increased activity of the enlarged right ventricle of the heart. (The hill of the hand is palpated with a parallel on the edge of the left sternal.

Auscultation

In auscultation, heart sound, rhythm, rate are heard with the help of stethoscope.

Abnormal heart sounds, murmurs and irregular heart rhythms can be detected with the help of auscultation.

Auscultate the valve area with the help of a stethoscope. The diaphragm of a stethoscope is used to auscultate.

It involves auscultating the mitral valve, tricuspid valve, aortic valve and pulmonary valve. Which is auscultated in the given area as shown in the picture below.

For your knowledge

Normal heart sound

S1 and S2 sounds are considered as normal heart sounds. S1 and S2 sounds are heard due to atrioventricular valve and semilunar valve closure. Hence S1 and S2 sounds are heard during a normal cardiac cycle.

S1 Sound :

Due to closure of atrioventricular valves i.e. tricuspid valve and mitral valve
S1 sound is heard. Lab sound is heard during S1 sound. S1 sound is heard during systole. The S1 sound can be heard well in the apical area.

S2 Sound :

S2 sound is heard due to closure of aortic and pulmonic valves. Dub sound is heard during S2 sound. The S2 sound is heard during diastole. The S2 sound can be better heard in the aortic and pulmonic areas.

Abnormal heart sound

An abnormal heart sound is heard when there is a structural or functional problem or abnormality in the heart. Abnormal heart sounds include S3 gallop, S4 gallop, murmur, opening snap, systolic click, friction rub. The S3 and S4 sounds are called gallop because they sound like a galloping horse.

S3 Sound :

The S3 sound is also known as ‘ventricular gallop’ and ‘protodiastolic gallop’. This is a type of extra heart sound heard immediately after the S2 heart sound i.e. lub-dub-dub. S3 heart sound is heard during early diastole. The S3 sound is due to rapid ventricular filling. S3 sound is normally heard in children, youth and athletic person whereas in old age it is considered abnormal which indicates left ventricular failure, mitral regurgitation. The S3 sound can best be heard at the apex side of the heart with the bell of the stethoscope.

S4 Sound :

The S4 sound is also known as ‘arterial gallop’ and ‘presystolic gallop’. This is a type of extra heart sound. Which is heard just before the S1 heart sound i.e. lub-lub-dub. The S4 sound is heard during late diastole. The S4 sound is due to the atria contracting during a non-ventricular murmur. An S4 sound is considered totally abnormal. S4 sound indicates hypertensive heart disease, aortic stenosis, myocardial infarction. The S4 sound can best be heard over the apex side of the heart with the bell part of the stethoscope.

Opening Snap:

Normally, no sound is heard when the valve opens, but when valvular disease is present, a sound is created by the leaflets during systolic and diastolic opening of the valve, known as the opening snap. An opening snap is an abnormal high pitched diastolic sound heard during opening of the AV valve and during early diastole i.e. the S2 sound bar is immediately heard. For example mitral stenosis

Systolic click:

Similar to the opening snap, when the semilunar valve has stenosis, a short high-pitched sound called a systolic click is heard as the valve opens. A systolic click is heard during early systole i.e. immediately after the S1 sound.

Friction Rub:

The hissing and grating sound heard during systole and diastole is known as friction rub. which is mainly heard during pericarditis due to abrasion of the inflamed pericardial surface. The friction rub can be heard well with the help of the diaphragm of the stethoscope.

Murmur:

A heart murmur is an abnormal heart sound that occurs due to turbulent blood flow in the heart and blood vessels. Intensity, timing, duration of murmur sound depends on its cause. Murmurs are of two types: systolic murmurs and diastolic murmurs

Systolic murmur: A systolic murmur is a type of heart murmur that is heard during contraction, or systole. A systolic murmur is heard in conditions such as aortic stenosis and mitral regurgitation.

Diastolic Murmur: A diastolic murmur is a type of heart murmur heard during relaxation or diastole. A diastolic murmur is heard in conditions such as aortic regurgitation and mitral stenosis.

Diagnostic test for heart and cardiovascular system

Laboratory test:

Laboratory tests include complete blood count, cardiac markers, blood chemistry test, lipid profile and coagulation study.

✓ Complete Blood Count:

Red blood cell count

White blood cell count

Platelet

Differentiate count

✓ Cardiac Biomarkers :

Creatine kinase

Cardiac Troponin

Myoglobin

Lactic dehydrogenase

✓ Blood chemistry test:

Electrolyte level

Lipid profile

Blood glucose level

✓ Coagulation study:

Prothrombin time

Activated partial thromboplastin time

Partial thromboplastin time

Cardiac enzymes

When heart cells or muscles are damaged (such as a heart attack) they release proteins and enzymes known as cardiac enzymes. These enzymes dissolve in the blood and their levels are high in the blood. Hence blood tests measure cardiac enzyme levels and identify cardiac conditions. Cardiac enzymes include creatine kinase, lactate dehydrogenase, cardiac troponin, myoglobin.

Creatine kinase

Creatine kinase is a type of enzyme found in heart, brain and skeletal muscle tissue. The enzyme in the heart is known as CK-MB, the enzyme in the brain is known as CK-BB, and the tissue in skeletal muscles is known as CK-MM. Hence, when cardiac cell damage occurs, creatine kinase is released into the blood and the level of CK-MB in the blood increases. CK-MB levels increase within four to six hours of cardiac cell damage, peak at 12 to 24 hours, and return to normal levels within 48 to 72 hours. Hence an increase in CK-MB level indicates the condition of heart attack.

Cardiac troponin

Troponin is a type of protein found only in cardiac muscle. which plays an important role in the contraction of the cardiac muscles. Troponin exists in two forms, troponin T and troponin I. of which troponin T is a highly sensitive indicator of myocardial damage. When the heart muscle is damaged, troponin is released from the muscle and gets mixed into the blood. of which troponin T is a highly sensitive indicator of myocardial damage. Levels of this troponin are elevated within 4 to 6 hours of heart muscle damage, peak levels are seen at 10 to 24 hours, and remain elevated for up to 7 days after muscle damage. Cardiac troponin is a crucial marker for diagnosing heart attack and is useful for assessing the severity of heart muscle damage.

Myoglobin

Myoglobin is a monomeric protein. Also known as oxygen storage protein because it can bind with oxygen and release oxygen when needed. It stores oxygen. Myoglobin is a protein found in cardiac muscles as well as skeletal muscles. Hence, when cardiac muscles or skeletal muscles are damaged, myoglobin is released into the blood and its level in the blood increases. Myoglobin levels increase within 1 hour of acute myocardial infarction with peak levels at 4 to 12 hours and normal levels at 18 hours.

Lactic dehydrogenase (LDH)

Lactic dehydrogenase is a type of enzyme that is present in many tissues in the body such as heart, liver, kidney, lung, red blood cells. Lactic dehydrogenase plays an important role in converting lactate to pyruvate during anaerobic metabolism. There are five types of lactic dehydrogenase: LDH1, LDH2, LDH3, LDH4, LDH5. Of which LDH1 and LDH2 are present in heart, kidney and red blood cells while LDH3 is present in lung and LDH4 and LDH5 are present in skeletal muscle. Normally LDH2 is higher than LDH1. But when cardiac muscle is damaged, the level of LDH1 increases more than LDH2. LDH levels rise within 8 to 12 hours after MI and peak levels occur at 24 to 48 hours and return to normal levels within 5 to 7 days.

Lipid profile

A lipid profile is a blood test that measures different types of lipids in the blood such as cholesterol, high density lipoprotein, low density lipoprotein, triglycerides, phospholipid. Cardio vascular disease risk or not can be assessed through this test.

X-ray

In a chest x-ray, a small amount of x-rays are used to create a 2D image of the area. In which mainly anterior posterior and lateral side view is taken. The size, shape and position of the heart can be known with the help of X-ray. Chest X-ray is used to diagnose conditions like pericardial calcification, pericardial effusion.

Computed tomography scan (CT scan)

Computed tomography scan (CT scan) is also known as computerized axial tomography (CAT). This is an imaging technique in which a detailed cross-sectional image of the body is created using X-rays and computer processes. Which provides valuable information about the body’s internal organs, bones, soft tissue and blood vessels. During a CT scan of the chest, it provides images of the heart and great vessels that can be used to evaluate cardiac masses as well as disease of the aorta and pericardium.

Magnetic resonance imaging (MRI)

Magnetic resonance imaging is a non-invasive medical imaging technique that provides a 3D image of the heart. This test uses powerful magnets and radio waves to create a cross-section image of a given area and provides detailed information about the heart, lungs and blood vessels. MRI is used to detect abnormalities of heart chambers, valves, and to identify tumors and coronary artery disease.

Doppler ultrasound

Doppler ultrasound is a non-invasive imaging technique. In which blood flow is evaluated using sound waves. In this test, changes in the frequency of sound waves are reflected on blood cells and blood flow is measured. Doppler ultrasound is used to identify blood clots, narrowing arteries, and problems with heart valves.

Duplex ultrasound

This is a non-invasive imaging method that involves a combination of Doppler ultrasound and traditional ultrasound imaging. In this test, blood flow speed, moving capacity is measured with the help of a transducer. It is useful for detecting blockages in the blood flow, conditions like arterial stenosis.

Gated blood pool scan

A gated blood pool scan is also known as ‘radionuclide ventriculography’ and ‘multigated acquisition scan (MUGA)’. This is a nuclear medicine imaging technique used to assess the function of the heart chambers, especially the ventricles. In this test, a small amount of radio tracer is injected into the blood stream. This tracer circulates in the heart and at this time an image of that area is captured with the help of a special camera. This image provides information about ventricular function, ejection-fraction, ventricular volume, and cardiac output. Gated blood pool scans are used to diagnose and monitor heart failure, cardiomyopathy, coronary artery disease.

Positron emission tomography\

Positron emission tomography is a nuclear medicine imaging technique that provides 3D images of the body’s organs and tissues. In this test, the radioactive tracer nitrogen-13 ammonia is injected into the blood stream. Positrons are emitted by this radioactive tracer. This positron colloid combines with the electrons of the body and releases gamma rays. The area is then scanned to show the distribution of the radio tracer in the body. Hence PET scan is used in medical fields like oncology, neurology cardiology. PET scan provides information about blood flow, metabolic function, cardiac function. PET scans are therefore used to evaluate myocardial ischemia, myocardial metabolic function.

Angiography

Angiography is a type of imaging test used to visualize blood vessels in various parts of the body. Angiography includes arteriography and venography. In which a contrast agent is injected into the blood stream and an X-ray image is taken of the given area and blockages, obstructions, blood clot formation and other conditions in the blood vessels are identified. For example an aneurysm. Coronary angiography is done for the heart.

Phlebograohy (phlebography)

Phlebography is also known as venography. This is a diagnostic imaging technique used to visualize veins in the body, especially veins in the extremities. In this test, a contrast dye is injected into a vein in the foot or hand and an X-ray image of the given area is taken and the vein is visualized. Phlebography is used to identify conditions such as deep vein thrombosis, varicose veins, venous insufficiency, and venous malformations.

: Radioisotope imaging

Radioisotope imaging is also known as ‘nuclear medicine imaging’. This is a medical imaging technique in which a radioactive subtone—a radioisotope—is injected intravesically and the subtone emits a gamma ray. Hence, images of organs, tissues and physiological processes are taken with the help of special cameras. Cancer, heart disease and bone disorders are detected with the help of this image.

Technetium pyrophosphate scan (Tc PYP)

A technetium pyrophosphate scan is a nuclear imaging test used to diagnose cardiac amyloidosis. This is a condition in which abnormal proteins accumulate in the heart tissue. During this test, the radioactive tracer technetium pyrophosphate is injected into the blood stream. This radioactive tracer binds to the amyloid protein deposited in the heart so that area is imaged with the help of a special camera and can be identified through this image.

Fluroscopy

This is an imaging technique in which the heart can be visualized on an x-ray screen, in which a real-time moving image of the body’s internal structures is created using continuous x-ray beams. With its help, cardiac and vascular pulsation can be seen and the shape and size of the heart can be seen. Hence it is used to provide guidance while inserting the catheter during cardiac catheterization as well as positioning the intravenous electrode.

: Echocardiograohy (Echocardiography)

Echocardiography is a non-invasive test that uses sound waves to create an image of the heart. which provides detailed information about the structure and function of the heart. Like providing information about heart chamber shape and size, pumping function, heart valve movement, blood flow. Echocardiography is used to diagnose and monitor conditions like heart valve disorders, congenital heart defects, heart failure.

Electrocardiogram (ECG / EKG)

An electrocardiogram is a non-invasive test used to record the electrical activity of the heart. In which the electrodes are placed in different areas as shown in the picture below and the electrical activity of the heart is recorded on the page for a given time period and then this electrical activity is evaluated. This electrical activity depends on conduction, rate and rhythm. An electrocardiogram is used to detect arrhythmias, heart attacks, electrolyte imbalances, and other cardiac conditions.

Cardiac catheterization

Cardiac catheterization is an invasive diagnostic test used to diagnose and treat heart conditions. In this test, a thin flexible tube known as a catheter is inserted into the blood vessels of the groin or arm through the heart. It measures the blood pressure of the heart chambers, great blood vessels, coronary arteries and provides information about the output. Cardiac catheterization is used to evaluate coronary artery disease, heart valve problems, and other heart-related problems. Also cardiac catheterization is used in procedures like angioplasty, stent replacement. Cardiac catheterization includes right side catheterization and left side catheterization.

: Electrophysiology study

An electrophysiology study is used to evaluate the electrical activity of the heart and to diagnose arrhythmias. During this test, a thin flexible wire (catheter) and electrodes are inserted into the blood vessels through the heart and electrical signals are recorded and evaluated to select the best treatment options such as medication, cardiac ablation, implantation. of pacemaker etc.

Holter monitoring

This is a type of diagnostic test. In which the electrical activity of the heart is monitored for 24 to 48 hours with the help of a Holter monitor. A Holter monitor is a battery operated portable electrocardiogram device. It can be easily worn and the electrodes in it are applied as shown in the picture and the electrical activity of the heart is monitored. During this test the patient is asked to wear loose clothes and the patient is given an empty sponge bath so the patient is prohibited from bathing during this test. A Holter monitoring test is used to detect arrhythmias

Hemodynamic monitoring

Hemodynamic monitoring is a type of invasive test that continuously monitors blood flow and blood pressure. So that cardiac function and tissue perfusion can be evaluated. Hemodynamic monitoring uses invasive methods such as catheterization and non-invasive methods such as echocardiography. This method is used in conditions like shock, heart failure and sepsis.

Central venous pressure monitoring

In central venous pressure monitoring, blood is measured directly from the right atrium or vena cava. In this method, a central venous catheter is placed in a central vein such as the jugular vein or the subclavian vein. which performs pressure measurement. Which provides information about volume status, cardiac function. It provides information about hemodynamic stability in conditions such as shock, heart failure, and sepsis. Normal CVP is 2-6 mm hg.

Pulse volume recording – PVR (Pulse volume recording)

Pulse volume recording is a non-invasive diagnostic method. It is used to measure blood flow and pressure in arteries in the limbus. In which a pressure cuff is placed on the patient’s leg and inflated, followed by rapid and then rapid deflation of the cuff and changes in venous volume are recorded. A decrease in venous volume indicates a thrombus.
Pulse volume recordings are used to diagnose deep vein thrombosis, pulmonary embolism, and peripheral vascular disease.

Cardiac stress test

Cardiac stress test is also known as ‘exercise stress test’ and ‘treadmill test’. In this test, the patient is asked to walk on a treadmill or ride on a stationary bike while the patient’s heart rate, blood pressure and electrical activity are noted and the heart’s response to stress is checked. This test is used to detect coronary artery disease and to assess the condition of the heart after a heart attack or heart surgery.

Tilt table test

The tilt table test is a type of diagnostic test used to evaluate the cause of fainting or syncope. In this test, the patient is placed on a table and the table is tilted at different angles as shown in the picture while heart rate, blood pressure and other symptoms are noted.

Peripheral vascular stress test

Peripheral vascular stress test is also known as ‘ankle-brachial index (ABI) test’. Arm and leg circulation and blood flow can be assessed during physical activity with the help of this test. In this test, the patient is asked to walk on a treadmill or pedal a stationary bicycle. Heart rate, blood pressure are measured before the exercise, during the exercise and after the exercise. A peripheral vascular stress test is used to identify peripheral vascular disease.

Exercise tolerance test

Exercise tolerance test is also known as ‘stress test’ or ‘exercise electrocardiogram’. This is a diagnostic test used to assess how well the heart works during physical activity. During this test the patient is asked to run or walk on a treadmill while the patient’s heart rate, blood pressure and ECG are monitored. This test is used to detect reduced blood flow in the heart muscle, irregular heart rhythm and symptoms of heart failure.