How do I make an appointment?
You can call our office on 09 520 9540. We are open from 8am to 6pm Monday to Friday. It is important to have a referral letter from your GP. This allows us to make sure the right amount of time is allocated and the right type of testing done. We try and do everything you need in just one visit. For first time appointments you will usually be with us for around an hour.
Where are you and what about parking?
We are at Ascot hospital, 90 Green Lane Rd, adjacent to the Ellerslie race course. From the motorway take the Green lane Exit and head east. Turn right at the second set of traffic lights. There are 110 car parks at the front of the hospital. The maximum parking time is 90 minutes. This time can be extended by our office staff if necessary. There is more parking at the rear of the hospital for the rare occasions that the front car park is full.
What about the charges?
Our staff will discuss this with you when you book in. Our services are covered by most health insurance policies. If you are not sure if you are covered you should check with your health insurer. We are an affiliated provider to Southern Cross Healthcare. This means that for full care policies we bill the insurer directly for all charges. For shared care policies you just pay us your part of the fee. It is useful to have your Southern Cross number when you call to make an appointment. Many other insurers will give you a “prior approval to see us”. Our staff will tell you how to arrange this.
What else do I need to know before coming?
If you are taking tablets it’s very useful to bring a list of your current medications. If you have been in hospital recently, please bring the discharge note you were given. Walking shoes and clothes suitable to exercise in should be worn by those patients who need a treadmill test or stress echo. No other special preparation is necessary for our other tests.
Who needs to see a cardiologist?
In most cases your GP will tell you if you would benefit from a cardiac check. Generally patients who have noticed something wrong are seen. The main cardiac symptoms are chest pains, shortness of breath, palpitations, dizziness, blackouts and ankle swelling. Occasionally there is fatigue and inability to exercise. Sometimes your GP may notice something even if you feel completely well – for example a heart murmur (noise heard with a stethoscope), an irregular pulse or an abnormal Chest X-ray or ECG. Blood pressure and cholesterol problems also sometimes need assessment by a specialist. Patients who are high risk for a heart attack sometimes come as they get older.
What tests might be done during my visit?
Testing is tailored to your individual needs. Your general practitioner will often tell you what you need. We may also make suggestions based on the problems you present with:
Exercise ECG or Treadmill Test – you walk on an treadmill connected to an ECG machine. Is most often used to investigate chest pains.
Stress Echo – you walk on a treadmill connected to an ECG machine and have an echocardiogram (ultrasound picture of the heart) before and after exercise. This is a more accurate way of investigating chest pains.
Echocardiogram – we image your heart with ultrasound to diagnose heart muscle and valve problems.
Holter Monitor – your heart beat is monitored with a small portable device you wear at home for 24 hours.
Blood Pressure Monitor – a machine measures your blood pressure automatically twice an hour for 24 hours while you are at home or work.
Tests we may order for you
CT calcium score – measure the amount of calcium in your coronary arteries and helps to decide who needs treatment to prevent blocked arteries.
CT Coronary Angiogram – for patients with chest pains and possible blockages an image of the arteries can be obtained with a CT scanner.
MRI Heart Scan – another method of checking valve and heart muscle function.
Nuclear Heart Scan – sometimes used to determine if blood flow to the heart is reduced in patients with chest pain of uncertain cause.
Coronary Angiogram – imaging of the coronary arteries using direct contrast (dye) injection. This may lead to coronary angioplasty with stent insertion.
Can you tell me more about some common cardiac symptoms?
Chest pain
Common causes of chest pain are disorders of the heart (cardiac, angina), indigestion (gastro-intestinal), chest wall or spine (musculoskeletal), lungs (pleuritic) or stress. Cardiac pain most commonly occurs when the heart is stressed (exercise or emotional upset), and is relieved by rest or relaxation and also by nitrolongual spray. Cardiac pain may be felt anywhere in the chest – it is a popular myth that heart pains are just felt over the left chest. Sometimes heart pain is noticed only in the throat, jaw or arms. It is often described as a discomfort rather than a pain – often with a tight, constricting or aching sensation. Cardiac pain seldom lasts for a prolonged time in a low grade form. Gastrointestinal pain may sometimes be very difficult to distinguish from cardiac pain – it is usually not associated with exertion and may be related to food. Pain that is sharp is most commonly musculoskeletal, especially if changing position brings it on. If the pain is sharp and it hurts to breathe in, the lung is most often the cause. These are general rules only, and in a particular individual it can be very difficult to diagnose the exact cause without further testing.
Shortness of Breath (SOB)
SOB is seen in heart conditions, lung conditions, blood disorders and very commonly in overweight and unfit people. Most patients require additional tests to determine the cause. In severe heart disease the patient may wake at night acutely SOB or is unable to lie flat.
Palpitations
The patient is aware of their heart beat. They may take the form of thumps or misses of the heart, a brief fluttering feeling, or more prolonged pounding of the heart. Palpitations due an abnormal heart rhythm (arrhythmia) need to be distinguished from those where the heart is beating in the normal order, but just faster (sinus rhythm). It is usually necessary to perform additional tests to make this distinction.
Dizziness and Syncope
Feeling dizzy or blacking out has many causes. Causes include ear problems, brain disorders, cardiac disease and vasovagal (fainting).
Swelling of the ankles (leg oedema)
This is a late sign of cardiac disease. Breathlessness and fatigue are usually present if ankle swelling is due to the heart. Leaky capillaries or venous disease of the lower legs accounts for the majority of cases of leg swelling.
Can you suggest some other websites with helpful information?
For excellent information on a wide variety of heart diseases we suggest either the Mayo Clinic or the Cleveland Clinic.
For more general information about heart disease in NZ please go the the National Heart Foundation site
For more detailed information on coronary angiography and angioplasty please go to the Ascot Angiography site
What about insurance?
If you have Southern Cross Insurance you do not need to get prior approval as we are an affiliated provider – it is helpful if you have your membership number available when you book. For other insurance companies you can get a prior approval. Our staff will tell you how to do this.