We then usually carry out a transthoracic echocardiography. This is an ultrasound examination that can detect heart muscle, heart valves and pericardial diseases. The pumping function of the heart can also be assessed. An ergometric test is used to measure physical performance using an ECG. The resistance of the bicycle ergometer is increased every two minutes in order to induce a controlled increase in exertion. The examination is carried out up to the stress limit. With these two examinations, many illnesses can already be detected or the need for further examinations can be assessed.