Examinations for athletes

Appointment with a specialist in cardiology

When you come for your first appointment, we will go through your symptoms and discuss artery disease risk factors and existing diseases. We will also listen to the heart and lungs, conduct an echocardiographic examination and interpret the electrocardiogram, or ECG.

If the tests reveal any anomalies in heart functions, we will refer you to the necessary further examinations.

Echocardiographic examination

The echocardiographic examination is one of our basic examinations and is carried out during the first appointment unless it has been done previously. The purpose of the examination is to inspect the structure and functions of the various parts of the heart.

The examination is easy and quick: it only takes approximately 15 minutes. The patient lies on their back and, occasionally, turns on their side while the cardiologist keeps an ultrasonic transducer on the patient’s chest.

Long-term ECG monitoring (Holter)

The aim of the examination is to analyse the functions of the heart in normal conditions over a period of 24 hours. The nurse attaches some ECG electrodes to the patient’s chest, and their cords are connected to a small portable recording device.

When the electrodes are in place, the person being examined should live as normally as possible, including exerting themselves physically. Keeping a diary is an integral part of the examination: the patient writes down their activities throughout the day and any symptoms they notice.

The examination is concluded by transmitting the data into an analysis programme at our clinic. Then, the doctor draws their conclusions from the findings and also refers to the diary entries.

24-hour blood pressure monitoring

In 24-hour blood pressure monitoring, the patient puts on a shoulder orthosis, like in ordinary blood pressure measurement. The orthosis is taped in place for 24 hours, and the tubes connect it to the measuring device. The device measures the patient’s blood pressure every half hour, for example, and once per hour at night.

It is important that the patient lives with the device as normally as possible during the examination. They can, for example, go to work or do exercise and move freely in their house. In the meantime, they write down all their activities in the diary. The data collected by the device is transmitted to a computer analysis programme at the clinic, and the physician draws their conclusions from the findings while referring to the diary entries.

Clinical stress test

After ECG electrodes are attached to the patient’s body, they start pedalling a stationary bicycle. The doctor checks the ECG values once a minute, measures the blood pressure and asks about the symptoms the patient is experiencing and the intensity of the strain.

The test is focused on symptoms: the patient pedals the bicycle until their legs start running out of strength or they are forced to quit by shortness of breath or another symptom. A successful examination requires the patient to reach a sub-maximal heart rate. This refers to 85% of the age-appropriate maximum heart rate, calculated using a table.

Once the stress test is completed, the physician monitors the patient’s general well-being, blood pressure and ECG for a few minutes. The physician interprets the ECG findings relative to the heart rate, blood pressure rates and symptoms.

Stress ultrasound examination

There are two types of stress ultrasound examinations. The examination can be conducted by pedalling a special pedal exerciser, intended for research purposes, in a half-standing position, or the heart rate can be increased through medicine.

In a stress ultrasound examination, the rising heart rate helps clarify whether the patient experiences, for example, cardiac muscle contractions as the heart rate increases. This could indicate oxygen deficiency in the heart muscle during exertion. The examination can also help analyse cases of cardiac valve leakage, helping us see if, for example, the state of the valve could turn from moderate (in rest) to worse during exertion as the heart rate increases. With athletes, the stress ultrasound examination can be used to analyse cardiac muscle contraction in more detail, particularly if there is suspicion of cardiomyopathy.