First-line cardiovascular examinations

Cardiology consultation

This is the first step. It provides time to listen to the patient, review symptoms, medical history, treatments and risk factors, perform a clinical examination and choose useful investigations.

Electrocardiogram (ECG)

An ECG records the heart's electrical activity for a few seconds. It assesses rhythm, rate and conduction and may show signs of hypertrophy or ischaemia. A normal ECG does not rule out an intermittent arrhythmia.

Transthoracic echocardiography (TTE)

TTE uses ultrasound to examine the heart chambers, ventricular function, valves, aortic root and certain measures of blood flow and pressure. It may be indicated for a heart murmur, breathlessness, an abnormal ECG or known heart disease.

Holter ECG: 24 to 72 hours

A Holter records the heart rhythm during everyday life. It is useful for palpitations, faintness, selected episodes of fainting, suspected arrhythmia or monitoring a known rhythm disorder. Recording the time of symptoms is important.

24-hour ambulatory blood pressure monitoring (ABPM)

ABPM automatically measures blood pressure during the day and night. It helps confirm hypertension, identify white-coat or masked hypertension, assess night-time readings and evaluate treatment effectiveness.

When are further tests needed?

Depending on the results, cardiac CT, cardiac MRI, coronary angiography or an electrophysiology opinion may be proposed. These second-line investigations answer different questions and require an individual assessment of their indication.

Emergency

For persistent chest pain, respiratory distress, prolonged loss of consciousness or sudden neurological symptoms, call 15, the medical emergency number in France.

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