Heart Disease Tests and Diagnosis

Written by Valencia Higuera | Published on September 2, 2014
Medically Reviewed by Brenda B. Spriggs, MD, MPH, MBA on September 2, 2014

Heart Disease: Tests and Diagnosis

Heart disease is any condition that affects the heart, such as coronary artery disease and arrhythmia. According to the Centers for Disease Control and Prevention (CDC), this disease is responsible for about one in every four deaths in the United States each year. Heart disease is also a leading cause of death in both men and women.

Doctors may recommend lifestyle changes or prescribe medications to reduce your risk of stroke or heart attack. However, before a doctor decides the best treatment for a person with heart disease, they must perform a series of tests, which, along with clinical signs and your symptoms, will help in diagnosing the condition.

Physical Exam and Blood Tests

Signs of a possible heart problem can include:

  • fainting
  • a slow or fast heartbeat
  • chest discomfort
  • angina
  • shortness of breath
  • sudden swelling in the legs, feet, ankles, or abdomen

Schedule an appointment with your doctor if you have any of the above symptoms. During the appointment, your doctor may ask about your family history and check your heart rate and blood pressure. They may also run blood tests that help detect heart disease. Your doctor will order a number of tests.

Cholesterol tests measure fat and cholesterol in the bloodstream. They help determine the risk for heart disease or heart attack. According to Mayo Clinic, a complete cholesterol test includes testing four types of fats in your blood:

  • Total cholesterol is a sum of the cholesterol in your blood.
  • Low-density lipoprotein (LDL) cholesterol is sometimes called the “bad” cholesterol. Too much of it causes a buildup of fat deposits in your arteries and reduces blood flow. The buildup can sometimes result in heart attack or stroke.
  • High-density lipoprotein (HDL) cholesterol is sometimes called “good” cholesterol. It helps carry away LDL cholesterol, clearing your arteries.
  • Triglycerides are a type of fat in the blood. High levels of triglyceride are often associated with diabetes, smoking, and excessive consumption of alcohol.
  • C-reactive protein (CRP) tests check your body for signs of inflammation. Doctors use results from a CRP and cholesterol test to determine the risk for heart disease.

Non-Invasive Tests for Heart Disease

After completing a physical examination and blood tests, your doctor may run one or more additional tests. There are many non-invasive tests for diagnosing heart disease.

Electrocardiograms

This is a short test that monitors the electrical activity in your heart. Doctors use this test to check for an irregular heartbeat and heart damage.

Echocardiogram

The echocardiogram (EKG) test uses ultrasound waves to create a picture of your heart. An echo monitors the heart valves and heart muscles.

Stress Test

Diagnosing heart problems can sometimes require examining the heart during strenuous activity. During a stress test, you may ride an exercise bike, or walk or run on a treadmill for several minutes. Your doctor monitors your reaction to stress as your heart rate increases.

Carotid Ultrasound

This test checks your risk for stroke. A sonogram takes pictures from both sides of your neck to see whether there’s a buildup of plaque in your arteries.

Holter Monitor

If your doctor needs to monitor your heart over 24 or 48 hours, you’ll wear a device called a Holter monitor. It works like a continuous EKG. This small machine checks for heart abnormalities that can go undetected on a normal EKG, like arrhythmias.

Chest X-Ray

A chest X-ray creates images of the chest, including your heart and blood vessels. This test can help doctors determine the cause of shortness of breath or chest pains.

Tilt Table Test

Your doctor may perform a tilt table test if you’ve fainted. You’ll lie on a table that moves from a horizontal to a vertical position. Your doctor monitors your heart, blood pressure, and oxygen level. He examines the results to determine whether fainting was caused by heart disease or another condition.

CT Scan

A computed tomography (CT) scan uses multiple X-ray images to create a cross sectional view of your heart. Your doctor may use different types of CT scans to diagnose heart disease. These include a calcium score screening heart scan that checks for calcium deposits in the coronary arteries, or a coronary CT angiography to see if there’s fat or calcium deposits in your arteries.

Heart MRI

In magnetic resonance imaging (MRI), large magnets and radio waves create images of your heart. A technician monitors your heart while it’s beating. After the test, your doctor can use images of your heart and blood vessels to diagnose many conditions, such as heart muscle diseases and coronary artery disease.

Invasive Tests to Diagnose Heart Disease

Sometimes non-invasive tests do not provide answers. Your doctor may need to complete an invasive procedure to diagnose heart disease.

Coronary Angiography and Cardiac Catheterization

A cardiac catheterization is when a long, flexible tube is inserted through a blood vessel in your groin or other part of the body. Your doctor moves this tube toward your heart. With an X-ray machine and dye, he looks at your coronary arteries.

This test checks for blood vessel problems and heart abnormalities. A coronary angiography is sometimes completed with catheterization. This test looks for narrowing or blocked arteries.

Electrophysiology Study

Your doctor may use this test to determine the cause and the best treatment of abnormal heart rhythms. Your doctor feeds an electrode catheter through your blood vessel to your heart. The electrode creates an abnormal heart rhythm that’s similar to your irregular rhythm. Your doctor will try to restore your natural rhythm by giving you different medications.

Conclusion

Complications of heart disease include heart attack and stroke. But you can reduce the risk of complications with early diagnosis and treatment. Factors that may put you at a higher risk for heart disease include:

  • family history
  • smoker
  • obese
  • poor diet
  • age    

Talk with your doctor if you have any concerns. They will help you learn how to maintain a healthy heart. 

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