Diagnostic Tests: ECG, 2D Echo with GLS & TMT

An ECG records the electrical activity of the heart using electrodes placed on the skin. It's quick, painless, and often the first test done during a consultation.

What it evaluates: heart rhythm and rate, and certain patterns that can point toward past or ongoing heart strain.

What to expect: the test takes only a few minutes, requires no special preparation, and involves no discomfort.

Limitations: an ECG captures a snapshot at a single point in time. It may not detect an intermittent rhythm problem unless one happens to occur during the recording. Results are interpreted by Dr. Kulin alongside your overall clinical picture.

What it evaluates:

A 2D echocardiogram (echo) uses ultrasound to create real-time images of the heart's structure and function: its chambers, valves, and pumping action.

• Ejection fraction - a measure of how effectively the heart pumps blood with each beat
• Valve function - whether valves are opening and closing properly
• Global longitudinal strain (GLS) - a more sensitive measure of heart muscle function, used where clinically useful alongside standard echo findings, to help detect subtler changes that ejection fraction alone might not show

When it's useful: evaluating breathlessness, suspected heart failure, valve disease, or as part of a broader cardiac risk assessment.

What to expect / preparation: no special preparation is needed. The test typically takes 20–40 minutes and involves no discomfort.

Limitations: image quality can vary depending on individual factors.

A treadmill stress test evaluates how your heart responds to physical exertion, using a supervised, gradually increasing workload on a treadmill while your ECG and blood pressure are monitored.

Why it's performed: to assess for signs of reduced blood flow to the heart during exertion, and to evaluate exercise tolerance.

Preparation: wear comfortable clothing and footwear suitable for walking; specific instructions about food or medication timing will be given when the test is scheduled.

What happens: you walk on a treadmill at an increasing pace and incline while being monitored, until a target heart rate is reached or the test is stopped for clinical reasons.

Duration: typically 15–30 minutes including preparation and monitoring.

What a result can and cannot tell you: a TMT provides useful information about exercise-related heart function, but it isn't a standalone diagnosis. In some cases, TMT may not be appropriate, and an alternative test is used instead.