“Prevention is better than Cure”.

At Bethesda Medical Centre our focus is on Primary Prevention.  Early medical interventions improve your chance against common heart diseases.  However if you do experience chest pain or shortness of breath, please consult your physician or get medical attention immediately.

High Cholesterol

Elevated cholesterol levels are known to contribute to plaque build-up or atherosclerosis. Our basic Lipid Screening involves measurement of Low Density Lipoprotein (bad cholesterol), High Density Lipoprotein (good cholesterol), Triglycerides, Total Cholesterol and TC/HDL ratio.

Diabetes/High Blood Glucose

Fasting glucose level, HBA1C measurement, and OGTT (Oral glucose tolerance test) are some of the tests we conduct for basic diabetes screening.  Early detection and management can prevent progressing to Type 2 diabetes mellitus.  Early management with diet, lifestyle measures +/- medication can retard or prevent progression to insulin dependency.

Hypertension

Blood pressure is the force on the blood vessels and heart by the blood flow. The two components commonly measured are: systolic pressure (the higher reading), which is the maximum pressure in the arteries when the heart is pumping; and diastolic pressure (the lower reading) which is the pressure when the heart is relaxing in between contractions.  Hypertension is defined as a blood pressure consistently exceeding 140/90mmHg.  Hypertension is commonly acknowledged as the ‘silent killer’ because it does not always produce symptoms.  It is also one of the common condition that causes damages to different organs. High blood pressure if left uncontrolled can lead to potentially serious complications like heart attack, stroke, blindness and chronic kidney failure.

Stroke

Stroke is a major cause of death or disability in Singapore.  Stroke occurs when blood supply to part of the brain is reduced or interrupted, causing the brain tissue to be deprived of oxygen and nutrients.

Obesity

Being overweight will increase your risk of cardiovascular diseases.  Please discuss with your staff regarding measurement of your body mass index (BMI). Body mass index (BMI) is a measure of body fat based on height and weight.

High-Sensitivity C-Reactive Protein (hsCRP)

C-reactive protein is a protein substance present in the blood in response to injury or infection.  High-sensitivity C-reactive protein (hs-CRP) is more sensitive compared to a standard test and can be used to evaluate the risk of developing coronary artery disease.  High levels may be associated with increased risk for heart attacks and/or stroke.

Resting 12-lead Electrocardiography (ECG)

Resting ECG is a non-invasive test that is useful in detecting cardiac abnormalities such as arrhythmias, heart blockages (bundle branch blocks), coronary artery disease, left and right heart enlargement (hypertrophy).  It is also useful in pre-exercise assessment.

Exercise Stress Test

Exercise Stress ECG (Treadmill Stress Test)

Exercise Stress Test looks at how well the heart works while under stress.  When exercising, the body works harder and requires more oxygen to flow to the heart. The test can evaluate if the blood supply to the heart is adequate during stress.  It also helps us discuss with you regarding the appropriate type and level of exercise programme.  During the test, the patient will have leads placed on the chest/body that is attached to the ECG monitoring equipment.  The patient starts by walking slowly on a treadmill. The speed and tilt of the treadmill will increase as the exercise test progresses, producing the effect of going up a slope at a progressively increased work-rate.  The heart rate and blood pressure will be monitored during the test.  The patient may stop anytime he feels tired, unwell or for any reason. An exercise stress test can be used to evaluate for the following;

  • adequacy of blood flow to the heart and diagnose for coronary artery diseases,
  • symptoms such as chest pain, palpitation or shortness of breath,
  • suitability to start or continue with exercise program,
  • risk of dangerous heart-related conditions such as a heart attacks or other cardiac diseases.
  • assess effectiveness of cardiac procedures done.

Purpose:

  • Detect ischaemic heart disease
  • Investigate symptoms of chest pain, shortness of breath or light-headedness
  • Assess the response of the heart to increased workload and demand for blood during exercise.
  • Monitor how much the heart can handle before abnormal rhythm begins or blood flow to the heart muscle drops
  • Identify abnormal heart rhythms
  • Develop a safe exercise program

Who should go for TMX:

  • Positive family history of ischaemic heart diseases
  • Unhealthy lifestyle

Preparation before procedure:

  • Ensure you are not on beta-blockers. Check with your doctor if you are required to stop your hypertension medication before the test.
  • No caffeine for 12hrs before test
  • Not pregnant
  • Bring along a set of running attire and shoes
  • For patients with chest hair, it is advisable to shave before exam. Do not apply lotion, oil or powder to the chest
  • Bring your inhaler in case you require it to help in breathing

Risk of Procedure:

  • The test is generally safe with very low risk of complications
  • Life-threatening heart rhythm (<0.2%)
  • Acute myocardial infarction (0.1%)
  • Death (0.1%)
  • Fall

Before Procedure:
The patient is hooked up to ECG leads and blood pressure cuff.
During Procedure:
Start off at a slow walking pace, then speed and gradient of the treadmill will increase regularly at 3 minutes interval.
End of Procedure:
Monitor for at least 5 mins at recovery stage to monitor on ECG / blood pressure changes.

To stop procedure when:

  • Develop chest pain or shortness of breath
  • Abnormally high or low blood pressure/ heart rhythm
  • Dizziness /fatigue / unable to continue exercise
  • Abnormal changes in your electrocardiogram