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Untersuchungen | Praxis Dr. Nikolaus Höllen: Internist, Sportmedizin, Allgemeinmedizin - 10781 Berlin-Schöneberg Fotomotiv: Hafen, Wasservögel

Sonography Stress ECG  |  Ergometry Long-Term ECG  |  Vascular examination


is the use of ultrasound in medicine as an imaging technique for the examination of organic tissue.

The wide use of sonography has contributed considerably to progress in medicine. Its principle is based on the reflection of ultrasonic waves. Using computer aided evaluation, two-dimensional images (sonograms) of numerous organs and regions of the body can be produced on a monitor from the captured data.

Here you can see Dr Höllen at work.

Stress ECG

While increasing the physical load, a monitor ECG is continually recorded, and the blood pressure and oxygen partial pressure (O2 saturation) measured. This enables an assessment to be made of a patient's physical fitness, for example before and after therapy.

In addition, it is possible to diagnose blood circulation problems (ischaemia) as a prelude to coronary heart disease (heart attack).


… in everyday language also called stress ECG testing, is a method of accurately dosing physical work, and reproducing it at any time under the same conditions.

On an ergometer (exercise machine) set up for the patient, the individual physical fitness is examined during performance diagnosis either in a staged test or in an endurance test. This enables the internist to diagnose possible heart damage.

Long-Term ECG

A normal ECG and an ergometry ECG capture the actions of the heart for just a few minutes.

By contrast, a long-term ECG usually records heart activity over a 24-hour period. We attach electrodes to the patient's chest that transmit electrical signals to a small portable recording device.

During the recording the patient continues to lead life as normal (exception: swimming and water!)

A long-term ECG primarily serves to identify heart rhythm disorders. Also rhythm disorders that only occur occasionally, for example brief attacks of heart racing, or an irregular heartbeat, can be diagnosed in this way. Spells of dizziness triggered by heart irregularities can also be detected.

A long-term ECG functions like a conventional electrocardiogram. However, it is usually recorded over a period of 24 hours, but not less than 18 hours.

It is used to find sporadically occurring heart rhythm disorders that often cannot be detected in a normal ECG because they appear so seldom. Especially in people with blood circulation problems, the long-term ECG often shows up heart rhythm disorders that must be treated with urgency, although the person affected may not have noticed anything wrong at all.

In addition, the long-term ECG finds application in the diagnosis of syncopes (brief loss of consciousness, e.g. due to a defective heart valve), and for monitoring therapy that uses heart pacemakers.

Vascular examination

An assessment of the arteries consists of the palpable arterial pulse, the detection of any abnormal flow noises, and the inspection of the affected limbs in the case of blood circulation problems.

On the legs note must be made of the development of varicose veins, any pain or swelling. Other important changes may affect the skin (deepening pigmentation) and the underlying soft tissue with possible ulceration.

In addition, with the aid of the Doppler method (a particular form of ultrasound scan of the blood vessels), a statement can be made about any circulation disorders: venous insufficiency, arterial blood circulation problems (intermittent claudication) etc.