The short answer
We check your heart in up to four ways: a resting ECG in every Health Check; an ECG while you exercise and a heart and lung exercise test (CPET) in the Health Check, Ultimate and Ultimate+; and an echocardiogram, an ultrasound of the heart, in Ultimate+.
You can also have an echocardiogram on its own, with a specialist conversation about your results, for £699.
Why check the heart?
Cardiovascular disease is the world’s biggest killer, and heart and circulatory disease causes around one in four deaths in the UK. It can develop silently for decades before it leads to a heart attack, stroke or heart failure, and many heart problems don’t show while you are sitting still.
That is why we don’t rely on a single resting snapshot. We look at your heart’s electrical activity at rest, how it responds when your body works harder, how well your heart, lungs and muscles deliver and use oxygen, and, where it helps, the structure of the heart itself.
How we check it
Resting ECG
A 12-lead electrocardiogram records your heart’s electrical activity while you lie still. It shows your heart rate and rhythm and how electrical signals travel through the heart, and some patterns can point to a thickened heart muscle or a previous heart attack. It is our baseline before we ask your heart to work harder.
InsightHealth CheckUltimateUltimate+
ECG while you exercise (stress ECG)
We keep recording your ECG while you exercise on a bike and the workload gradually increases. It shows whether abnormal rhythms appear under exertion, whether there are changes that suggest the heart muscle is short of oxygen, whether your heart rate rises as it should, and how quickly it recovers afterwards.
Health CheckUltimateUltimate+
Heart and lung exercise test (CPET)
At the same time, a breathing mask measures the oxygen you use and the carbon dioxide you breathe out. This cardiopulmonary exercise test shows how well your heart, lungs, circulation and muscles work together, including your VO2 max, one of the strongest markers of long-term health. More about the exercise test.
Health CheckUltimateUltimate+
Echocardiogram (optional)
An ultrasound scan of the heart that shows its chambers, walls and valves in motion, and how well it pumps. It uses no radiation and needs no preparation. More about the echocardiogram.
Ultimate+Or on its own, £699
Which Health Checks include each test
| Test | Insight | Health Check | Ultimate | Ultimate+ |
|---|---|---|---|---|
| Resting ECG | Included | Included | Included | Included |
| Stress ECG | No | Included | Included | Included |
| CPET with VO2 max | No | Included | Included | Included |
| Echocardiogram | No | No | No | Included, with cardiology review |
| Price | £299 | £799 | £1,299 | £1,799 |
Why we combine them
- The resting ECG asks: is the heart’s rhythm and electrical activity normal at rest?
- The stress ECG asks: does that change when the heart has to work harder?
- CPET asks: how well do your heart, lungs and muscles work together, and how fit are you really?
- The echocardiogram asks: are the heart’s structure, valves and pumping strength normal?
Each answers a different question, and none of them answers all of them. A specialist reads them together, with your history and blood results, and explains what they mean for you on the day.
Your heart and your arteries
Heart tests show how your heart works. They don’t show whether plaque is building up in your arteries, which lies behind many heart attacks and strokes. Ultimate and Ultimate+ add real-time ultrasound imaging of your major arteries, to look for disease directly. What our artery scans look for.
When to see a doctor instead
Call 999 for chest pain or tightness, especially if it spreads to your arm, jaw or back, severe breathlessness, or fainting.
See your GP or call NHS 111 for new or worsening breathlessness, swollen ankles or palpitations. A private health check is not a substitute for urgent care.
Questions
What is the difference between an ECG and an echocardiogram?
An ECG records the heart’s electrical activity, which shows its rhythm. An echocardiogram uses ultrasound to show the heart’s structure: its chambers, walls and valves, and how well it pumps.
Can I have an echocardiogram on its own?
Yes. A standalone echocardiogram with a specialist conversation about your results costs £699. It is also part of Ultimate+, with specialist cardiology review.
Do I need a GP referral for a heart health check?
No. You can book any Tomorrow Health Check yourself. If a result needs follow-up, your specialist explains what it means and, with your permission, writes to your GP.
Is a heart health check worth it if I feel fine?
You can feel healthy and still have things worth knowing. Raised blood pressure, raised cholesterol and early changes in the arteries usually cause no symptoms. If you have symptoms now, speak to your GP or call NHS 111 first.