Testing for heart disease
Heart disease is any condition that affects your heart, such as coronary
artery disease and arrhythmia. According to the Centers for Disease Control
and Prevention (CDC), heart disease is responsible for one in every four
deaths in the United States each year. It’s a leading cause of death in both
men and women.
To diagnose heart disease, your doctor will perform a series of tests and
evaluations. They may also use some of these tests to screen you for heart
disease before you develop noticeable symptoms.
Symptoms of heart disease
Symptoms of a
heart problem can include:
- slow or fast
- chest tightness
- chest pain
- shortness of
- sudden swelling
in your legs, feet, ankles, or abdomen
you have any of these symptoms, you should schedule an appointment with your
doctor. Getting diagnosed and treated early can help lower your risk of
complications, like heart attack or stroke.
Physical exam and blood tests
During your appointment, your doctor will ask you about your symptoms and
your family medical history. They will also check your heart rate and blood
Your doctor may also order blood tests. For example, cholesterol tests
measure the levels of fat and cholesterol in your bloodstream. Your doctor can
use these tests to help determine your risk of heart disease and heart attack.
A complete cholesterol test checks four types of fats in your blood:
- Total cholesterol is the sum of all cholesterol in your blood.
lipoprotein (LDL) cholesterol is sometimes
called “bad” cholesterol. Too much of it causes fat to build up in your
arteries, which reduces blood flow. This can lead to a heart attack or
lipoprotein (HDL) cholesterol is sometimes
called “good” cholesterol. It helps carry away LDL cholesterol and clear
- Triglycerides are a type of fat in your blood. High levels of
triglyceride are often associated with diabetes, smoking, and excessive alcohol
doctor may also order C-reactive protein (CRP) tests to check your body for
signs of inflammation. They can use the results of your CRP and cholesterol
tests to assess your risk of heart disease.
Noninvasive tests for heart disease
After completing a physical examination and blood tests, your doctor may order
additional noninvasive tests. Noninvasive means the tests do not involve tools
that break the skin or physically enter the body. There are many noninvasive
tests available to help your doctor check for heart disease.
An electrocardiogram (EKG) is a short test that monitors the electrical
activity in your heart. It records this activity on a strip of paper. Your
doctor may use this test to check for an irregular heartbeat or heart damage.
An echocardiogram is an ultrasound of your heart. It uses sound waves to
create a picture of your heart. Your doctor may use it to evaluate your heart
valves and heart muscles.
To diagnose heart problems, your doctor may need to examine you while you’re
doing strenuous activity. During a stress test, they may ask you to ride a
stationary bicycle or walk or run on a treadmill for several minutes. They will
monitor your body’s reaction to stress as your heart rate increases.
A carotid ultrasound uses sound waves to create pictures of your carotid arteries
on both sides of your neck. It allows your doctor to check for a buildup of
plaque in your arteries and assess your risk of stroke.
If your doctor needs to monitor your heart over a period 24 to 48 hours, they
will ask you to wear a device called a Holter monitor. This small machine works
like a continuous EKG. Your doctor can use it to check for heart abnormalities
that can go undetected on a normal EKG, such as arrhythmias.
A chest X-ray creates images of the inside of your chest, including your
heart and blood vessels. It can help your doctor 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. They will ask
you to lie on a table that moves from a horizontal to a vertical position. As
the table moves, they will monitor your heart, blood pressure, and oxygen
level. The results can help them determine whether your fainting was caused by
heart disease or another condition.
A computed tomography (CT) scan uses multiple X-ray images to create a cross-sectional
image of your heart. Your doctor may use different types of CT scans to
diagnose heart disease. For example, they may use
a calcium score screening heart scan to check for calcium deposits in your coronary
arteries. Or they may use coronary CT angiography to check for fat or calcium
deposits in your arteries.
In magnetic resonance imaging (MRI), large magnets and radio waves create
images of the inside of your body. During a heart MRI, a technician creates
images of your blood vessels and heart while it’s beating. After the test, your
doctor can use the images to diagnose many conditions, such as heart muscle
diseases and coronary artery disease.
Invasive tests to diagnose heart disease
Sometimes noninvasive tests don’t provide enough answers. Your doctor may
need to use an invasive procedure to diagnose heart disease. Invasive
procedures involve tools that physically enter the body, such as a needle,
tube, or scope.
Coronary angiography and cardiac catheterization
During cardiac catheterization, your doctor inserts a long flexible tube
through a blood vessel in your groin or other part of your body. Then they move
this tube toward your heart. Your doctor can use it to conduct tests to check for
blood vessel problems and heart abnormalities.
For example, your doctor may complete a coronary angiography with
catheterization. They will inject a special dye into the blood vessels of your
heart. Then they will use an X-ray machine to look at your coronary arteries.
They can use this test to look for narrowed or blocked arteries.
If you have abnormal heart rhythms, your doctor may conduct an
electrophysiology study to determine the cause and best treatment plan. During
this test, your doctor feeds an electrode catheter through your blood vessel to
your heart. They use this electrode to send electric signals to your heart and
create a map of its electrical activity.
Your doctor may try to restore your natural heart rhythm by prescribing
medications or other treatments.
When to see your doctor
If you suspect you may have heart disease, make an appointment with your
doctor. Factors that put you at a higher risk for heart disease include:
- family history
of heart disease
- history of
- poor diet
Your doctor may perform a physical examination, order blood tests, or use
other tests to check for problems with your heart or blood vessels. These tests
can help them diagnose heart disease and develop a treatment plan.
Complications of heart disease include heart attack and stroke. You can
reduce the risk of complications with early diagnosis and treatment. Talk with
your doctor if you have any concerns. They will teach you how to identify
symptoms of heart disease and maintain a healthy heart.