Screening Packages

Screening package offered at the Novena Heart Centre

At the Novena Heart Centre, we offer screening to detect possible abnormalities of the heart that may lead to problems during exercise. This includes:

1. An interview and physical examination by a Cardiologist
2. Electrocardiogram
3. Exercise stress echocardiogram. This is a combination of an exercise stress test on a treadmill combined with ultrasound technology to evaluate heart function and structure
4. Coronary calcium scoring using ultra-fast CT scanner. This allows us to pick up early cholesterol deposits in the heart arteries. Only severe narrowing of the heart arteries lead to restriction of oxygen to the heart and these are picked up by stress tests. Early narrowing that can still lead to heart problems is undetected by routine stress testing
5. A review of all the results and its implications

Price breakdown for screening package

Frequently Asked Questions

• How common is sudden death or collapse amongst seemingly fit people during exercise?

  It remains a rare event with a rate of about 1 per 100000 amongst young people (<35 years of age) and about 6 per 100000 amongst older people (particularly middle aged men).

• A list of the most common causes of heart related conditions that lead to collapse:

  Structural Abnormalities

  • Hypertrophic Cardiomyopathy (HOCM)
  • Aortic Valve Stenosis
  • Mitral valve Regurgitation/Prolapse
  • Right ventricular dysplasia
  • Anomalous origin of the coronary arteries
  • Coronary artery disease ( This condition is rare among pre-menopausal women and those aged <35 years. It is the most common problem of sudden death during exercise in people >35 years of age).

  Electrical Abnormalities

  • Wolff Parkinson White syndrome (WPW)
  • Brugada syndrome
  • Prolonged QT syndromes
• Should I go for screening before participating in vigorous training/exercise?

  If you have experienced abnormal symptoms during exercise as listed below, screening could help ensure that there is no underlying disease or condition that would put you at high risk.

  • fainting of unknown cause, especially during exercise
  • chest pain during exercise
  • excessive or unexplained breathlessness associated with exercise
  • a history of heart murmur
  • a history of abnormal heart beat
  • a family history of sudden death in close relatives

  As mentioned above, for those who have no symptoms, the risk is low and the chance of finding abnormalities would be unlikely. There is therefore no official recommendations by any health authorities for screening such persons.

• What are the tests that would be useful in detecting problems?

  • Resting ECG

    This is a test where electrical detectors are placed over the chest to read the electrical activity of the heart. This allows us to detect abnormal conduction patterns that may be life threatening during exercise. (eg Wolff Parkinson White syndrome, Brugada syndrome, Prolonged QT syndrome).

  • Exercise testing

    The combination of doing an echocardiogram and exercise testing allows us to look at the structure of the heart at rest and the response of the heart to exercise. An ECG done during the exercise also allows us to look for abnormal heart rhythms during the exercise. Structural heart problems that can be detected by this test include Hypertrophic Cardiomyopathy (HOCM), aortic valve stenosis, right ventricular dysplasia, mitral valve stenosis or regurgitation and significant heart artery narrowings.

  • CT coronary calcium score

    Another cause of sudden collapse is an abnormal origin of the arteries that supply blood to the heart. In the past only an invasive coronary angiogram can detect this abnormality. Now with the advent of ultra fast CT scanning, such conditions can be detected. The absence of calcium in the arteries of the heart would suggest that there is unlikely to be cholesterol deposits narrowing the heart arteries.

• Can these tests detect all dangerous abnormalities during exercise?

  Not all collapses that occur during strenuous activity is due to the heart. Other conditions include heat stroke, pulmonary embolism, rupture of the aorta and bleeding in the brain.

  There are also conditions that can affect a healthy heart such as infections (viral myocarditis) and certain medications including antibiotics that can predispose some susceptible individuals to heart rhythm disturbances.

  Some underlying conditions particularly related to the electrical system of the heart may be hidden even with these screening tests.

  However, these tests excludes the most common causes of heart related collapses during exercise.

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More About NHC

• Our NHC Values
• Ongoing Research
• Screening Packages