During a heart health checkup, your doctor will talk to you about how you’re feeling and offer you screening tests to assess your cardiovascular health and risk factors. Your cardiovascular system includes your heart and blood vessels.

As part of the checkup, they’ll look for any signs of heart disease and consider your risk for developing heart disease in the future. For example, risk factors include:

  • high blood pressure
  • high blood cholesterol
  • high blood sugar
  • overweight and obesity
  • certain lifestyle habits, like smoking and alcohol use

Some heart health screening tests should begin as early as age 20, recommends the American Heart Association (AHA). Other heart health screenings may begin later in life.

Your doctor can help you learn which screenings you should get and how often you should get them.

Also let your doctor know right away if you develop signs or symptoms of heart disease. These symptoms may include:

  • chest pain or discomfort
  • fluttering in your chest
  • slow or racing heartbeat
  • shortness of breath
  • dizziness
  • fatigue
  • swelling in your feet or abdomen

Read on to learn about the steps you can take to monitor your heart health.

Routine heart health screenings are an important part of preventive healthcare for adults.

Starting around age 20, or in some cases earlier, your doctor will likely advise you to get several screening tests on a regular basis.

If the results of your screening tests show signs of heart disease or a high risk of developing heart disease, your doctor may order additional tests.

Family history can determine when the testing should start and how frequently it should be done.

Routine screening tests

Even if you have no history of heart disease, the AHA recommends getting the following heart health screenings:

  • blood pressure and cholesterol tests, starting by age 20 for most people
  • blood glucose tests, starting by age 40 to 45 for most people
  • body mass index (BMI) measurement, based on body weight or waist circumference

If you have certain risk factors for heart disease or a strong family history, your doctor might encourage you to start these screenings at a younger age than usual.

They may also order high-sensitivity C-reactive protein (hs-CRP) testing. This test measures C-reactive protein (CRP), a marker of inflammation or infection that’s associated with increased risk of heart attack.

Additional heart tests

If your doctor thinks you might have heart disease, they may order one of more of the following tests to assess your heart health:

  • Electrocardiography (ECG, EKG). Small, sticky electrodes are applied to your chest and attached to a special machine, known an ECG machine. This machine records your heart’s electrical activity and provides information about your heart rate and rhythm.
  • Exercise cardiac stress test. Electrodes are applied to your chest and attached to an ECG machine. Then you’re asked to walk or run on a treadmill, or pedal on a stationary bike, while a healthcare professional assesses your heart’s response to physical stress.
  • Echocardiography. A healthcare professional uses an ultrasound machine to create moving images of your heart to see if you have problems with the pumping function of your heart, and to assess your heart valves. Sometimes, they may do this before and after you’ve exercised or taken certain medications to learn how your heart responds to stress.
  • Nuclear stress test. A small amount of radioactive dye is injected into your bloodstream, where it travels to your heart. A healthcare professional uses an imaging machine to take pictures while you’re at rest and after exercise to learn how blood is flowing through your heart.
  • Cardiac CT scan for calcium scoring. You’re positioned under a CT scanner with electrodes attached to your chest to record your heart’s electrical activity. A healthcare professional uses the CT scanner to create images of your heart and check for plaque buildup in your coronary arteries.
  • Coronary CT angiography (CTA). Similar to the test above, you lie under a CT scanner with electrodes attached to your chest so a healthcare professional can record your heart’s activity and create pictures of your heart based on the CT scan’s images. A contrast dye is injected into your bloodstream to make it easier for them to see plaque buildup in your coronary arteries.
  • Coronary catheter angiography. A small tube, or catheter, is inserted into your groin or arm and threaded through an artery to your heart. Contrast dye is injected through the catheter while a healthcare professional takes X-ray pictures of your heart, allowing them to see if your coronary arteries are narrowed or blocked.

If you receive a diagnosis of heart disease, your doctor may recommend a combination of lifestyle changes, medications, or other treatments to manage it.

A routine heart health checkup doesn’t typically involve complicated tests. To monitor the health of your heart, your doctor should routinely:

  • assess your weight and BMI
  • measure your blood pressure
  • order blood tests to check your cholesterol and blood sugar levels
  • ask about your diet, physical activity, and smoking history
  • ask about your personal and family medical history
  • ask whether you’ve noticed any changes in your health

If you’ve received a heart disease diagnosis or your healthcare provider thinks you might have developed it, they may order other heart tests.

The AHA recommends the following schedule for heart health screenings:

  • Weight and BMI: during regular annual checkups
  • Blood pressure tests: at least once every 2 years, starting by age 20
  • Blood cholesterol tests: at least once every 4 to 6 years, starting by age 20
  • Blood glucose tests: at least once every 3 years, typically starting at age 40 to 45

Some people should get heart health screenings at a younger age or more often than others.

For example, your doctor may recommend earlier or more frequent screening if you have:

  • high blood pressure, blood cholesterol, or blood sugar
  • a heart condition, such as atrial fibrillation
  • a family history of heart disease
  • overweight or obesity
  • prediabetes or diabetes
  • certain lifestyle factors, like smoking tobacco
  • had complications during pregnancy, such as high blood pressure, preeclampsia, or gestational diabetes

Ask your doctor how often you should undergo heart health screenings, based on your medical history and health needs.

You may be able to access heart health screening tests at low or no cost, depending on where you live and your insurance coverage.

If you don’t have health insurance, federal health centers offer many essential health services regardless of ability to pay. You can see if there’s a qualified health center near you using their search tool.

Some pharmacies also offer free heart health screenings in February, National Heart Health Month.

If you have health insurance, you may have no cost for basic heart checkup tests. Under the Affordable Care Act, many health insurance plans are required to cover the cost of certain preventive health screenings with no copayment, coinsurance, or deductible fee.

Depending on your health insurance coverage, age, and health history, you may be able to get blood pressure, blood cholesterol, and blood sugar screenings for free.

If your doctor orders additional tests to evaluate your heart health, you may have charges for those tests. Some or all of the cost of the tests may be covered by your health insurance.

If you have health insurance, contact your insurance provider to learn if you’re eligible for free heart health screenings. Ask them how much specific tests will cost.

Depending on your health history, your doctor might encourage you to monitor your own heart health and risk factors between checkups.

For example, they might advise you to monitor one or more of the following:

  • your body weight or BMI, using a scale
  • your blood pressure, using a home blood pressure monitor
  • your blood sugar levels, using a glucose monitor
  • your heart rate and rhythm, using a wearable fitness tracker, smartwatch, or other device

If your doctor wants to assess your heart’s electrical activity over the course of multiple hours or days, they might ask you to wear a Holter monitor.

A Holter monitor is a small battery-operated device that functions as a portable ECG machine. Your doctor may ask you to wear it for 24 to 48 hours before returning the monitor to them.

Your doctor may also ask you keep track of your fitness activities, diet, or other lifestyle factors that might affect your heart health. Similarly, they may ask you to log any symptoms of heart disease that you develop.

To help lower your risk for heart disease, it’s important to practice a healthy lifestyle. For example:

  • Avoid smoking tobacco.
  • Get at least 150 minutes of moderate-intensity exercise per week.
  • Eat a wide variety of nutrient-rich foods, including fruits, vegetables, and whole grains.
  • Limit your consumption of trans fat, saturated fat, and sugar-sweetened foods and drinks.
  • Take steps to manage your weight.
  • Follow your doctor’s recommended treatment plan if you’ve received a diagnosis of high blood pressure, high cholesterol, prediabetes, diabetes, or other health conditions.

Getting routine heart health screenings is also important for maintaining your heart health. These screenings can help your doctor identify potential problems early so you can get the treatment you need.

To monitor your heart health, your doctor may check your weight, blood pressure, blood cholesterol, and blood sugar levels on a regular basis.

They will also ask you about your medical history and lifestyle habits, which affect your chances of developing heart disease.

Many other tests are also available to evaluate your heart’s function and health, if your doctor thinks you might have developed heart disease.

Talk to your doctor to learn which screenings and tests you should get.