For remitters
Hjärt & Kärlcentrum is an accredited and environmentally certified facility located outside of a hospital.
For practical reasons, we are unable to lift patients, e.g. from a wheelchair to an examination table. We are also unable to accept patients who arrive by lying down transport. Do not hesitate to contact us in advance if you, as the referring physician, suspect a problem during the examination.
We do not examine children under the age of 5.
Do not forget to indicate any need for an interpreter.
Echocardiography at HKC is only performed transthoracically. The examination normally provides answers to questions about right and left ventricular function (heart failure), pressure in the pulmonary circulation and any defects.
It is good if any known heart attacks, lung diseases, pacemakers, murmurs or signs of failure are stated in the referral.
In obesity, transmission conditions can be severely impaired and the findings difficult to interpret.
A biomedical analyst performs the examination, which is then interpreted by a specialist physician.
Time required: approximately 30-45 minutes.
Preparations: None.
Please indicate if an interpreter is needed!
Stress echocardiography examines how the heart functions in connection with stress. The most common question is the presence of inducible ischemia, which manifests itself in the form of additional regional movement disorder/hypokinesia during stress. Other questions that may be relevant are assessment of viability and in the case of so-called low-flow, low-gradient aortic stenosis, in which case low-dose dobutamine provocation is performed.
Stress with work provocation (as in a bicycle work test) is, according to American guidelines, the recommended first choice and then assumes that the patient can cycle and reach at least 85% of the calculated maximum heart rate. Ultrasound images of the heart are obtained before and immediately after the work. The work provocation also provides additional information as in a regular work test.
Stress with pharmacological provocation simulates physical work by giving the patient a continuous infusion of dobutamine in increasing doses, which increases the heart’s contractility and ventricular rate. The examination is always performed with contrast media and sometimes with atropine. Ultrasound images of the heart are obtained continuously throughout the provocation. Stress echocardiography with pharmacological provocation is well suited for patients who are unable or expected to be unable to perform a satisfactory exercise test and who have reduced echocardiographic image quality.
Contraindications for stress echocardiography are the presence of left bundle branch block (LBBB), unstable angina pectoris, significant tachy- or bradyarrhythmia, and pronounced valvular disease.
Time required: approximately 60 minutes.
Patients are asked to refrain from nicotine, caffeine, nitroglycerin, and beta-blockers 24 hours before the examination.
Please notify us if an interpreter is needed!
The purpose of the examination is to assess the function of the heart during physical exertion.
According to international guidelines, the examination is no longer a first-line method when it comes to assessing inducible ischemia – for this, for example, stress echocardiography is better. However, the examination still has a place when it comes to assessing, for example, work capacity and the occurrence of arrhythmias during work.
Time required: approximately 45 minutes.
The patient can take their medications as usual before the examination.
Please inform us if an interpreter is needed, or if the patient cannot cycle!
We record standard 12-lead resting ECGs.
No preparation is required.
Indications are primarily checks where a quick response is desired – for more detailed analysis, multi-day recordings are made.
Time required: approximately 15 minutes.
Let us know if an interpreter is needed!
We perform short orthostatic tests where the patient’s pulse and blood pressure are recorded while lying down and then continued for ten minutes while standing.
Time required: about 30 minutes.
Preparations: None. The patient can take their medications as usual before the examination.
Let us know if an interpreter is needed!
Long-term ECG recording is done for 1-4 days with an ambulatory device that the patient wears around the neck connected to four adhesive electrodes on the chest.
The examination includes two visits, connection and submission – please remind the patient to read the invitation carefully so that he/she is available for both times, or that someone else can submit the equipment at the designated time.
The examination provides answers to the average heart rate day and night, the proportion of supraventricular and ventricular extra beats, any tachy- or bradyarrhythmias, pauses, atrial fibrillation and other possible arrhythmias.
Indications are suspicion of atrial fibrillation, fainting where cardiac genesis is suspected, palpitations, pacemaker check, etc.
The patient can take their medications as usual before the examination.
Let us know if an interpreter is needed!
During the examination, blood pressure is automatically recorded twice an hour during the day and once an hour at night, after which a daily average value can be calculated.
The examination includes two visits: connection and return (can be done by someone other than the patient). Please remind the patient to read the invitation carefully so that both visits are possible.
The patient will be given a blood pressure cuff around their arm and a small blood pressure monitor around their neck or belt.
The patient can take their medications as usual before the examination.
Let us know if an interpreter is needed!
The purpose of the examination is to see any changes or narrowing in the neck vessels.
The patient is examined lying on a couch. With ultrasound, the carotid arteries can be imaged and flow rates measured, to provide answers to any narrowing/embolic sources.
Time required: approximately 30-45 minutes.
Preparations: None.
Please indicate if an interpreter is needed!
The purpose of the examination is to see any changes or narrowing in the arteries of the arms.
The patient is examined lying on a couch. With ultrasound, the arteries can be imaged and flow rates measured, to provide answers to any narrowing/stenosis.
Time required: approximately 30-45 minutes.
Preparations: None.
Please indicate if an interpreter is needed!
The purpose of the examination is to see any changes or narrowing in the arteries of the legs.
The patient is examined lying on a couch. With ultrasound, the arteries can be imaged and flow rates measured, to provide answers to any narrowing/embolism sources.
Preparations: Fast 4 hours before the examination (however, this does not apply to type 1 diabetes). Medications are taken as usual and water is fine to drink.
Time required: approximately 45-60 minutes.
Please indicate if an interpreter is needed!
The purpose of the examination is to examine the abdominal aorta to detect hernias/aneurysms.
The patient is examined lying on a couch. Ultrasound can be used to image the abdominal arteries, measure diameters and flow rates, and provide answers to any aneurysms and/or thrombosis.
Time required: approximately 20-60 minutes, depending on how many vessels are examined.
Preparations: Fast for 4 hours before the examination (In the case of type 1 diabetes, the patient should eat and drink as usual). Medications are taken as usual and water is fine to drink.
Please indicate if an interpreter is needed!
This examination aims to assess blood circulation in the legs.
The patient is examined lying on a table with blood pressure cuffs on the big toe and in the arm. Blood pressure will be measured in the arms, toes and ankles.
Time required: approximately 45-60 minutes.
Preparations: Smoking and coffee should be avoided approximately 1 hour before the examination as it can make the measurement more difficult. Medications are taken as usual.
Please indicate if an interpreter is needed!
A lung function test at our clinic consists of three parts (as in most hospital clinics):
- Dynamic spirometry, i.e. how fast you can exhale air, which is a measure of obstruction and thus an indirect measure of the dimensions of the airways
- Static lung volumes, i.e. a measurement of how large the lung volumes are to assess possible restrictiveness
- Diffusion capacity, i.e. an assessment of how gas exchange in the alveoli works, which is impaired in e.g. emphysema and pulmonary fibrosis (but not in asthma).
In the case of clear obstruction, we sometimes add administration of a ß2-agonist, the so-called reversibility test, but if there is a real suspicion/question of asthma, we instead perform a bronchial provocation, since the sensitivity of the reversibility test is low (see below).
Please state any inhaled medications and smoking habits on the referral.
The patient can take their medications as usual before the examination.
Please let us know if an interpreter is needed!
Asthma cannot be ruled out with spirometry + reversibility test. As asthma involves an underlying hyperreactivity, it is better to test the reactivity of the airways and therefore we regularly perform a bronchial provocation if the question on the referral is ”Asthma?”
Our bronchial provocations are performed by inhaling methacholine chloride in increasing doses.
The test has a relatively high sensitivity, which means that if no hyperreactivity is seen, the diagnosis of asthma (in ICS-untreated people) can in practice be ruled out.
In a patient with established asthma who is treated with inhaled steroids, the test instead provides an answer to whether the treatment appears to be sufficient.
Examination with the question ”Asthma?” in a patient with ongoing or recently completed treatment with inhaled steroids has very low sensitivity. If you are planning a bronchial provocation with that question, it is therefore good if the patient is started on a ß2-agonist only.
The entire examination takes just under an hour.
Please state any inhaled medications and smoking habits on the referral.
The patient can take their medications as usual before the examination.
Let us know if an interpreter is needed!
Remit to us electronically or via paper remittance.
Now you can easily and quickly refer to us via TakeCare. In addition to electronic referral, you can also refer to us with the usual paper referral via letter.
Postal address Södertälje
Hjärt & Kärlcentrum Fysiologlab
Nygatan 16 (floor 8)
151 72 Södertälje
Postadress Skärholmen
Hjärt & Kärlcentrum Fysiologlab
More info shortly…
Get direct contact with our clinical physiologists
As a referrer, you also have the opportunity to get in direct contact with our clinical physiologists by telephone. Send a request via email to info@hkcentrum.se