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:
- a slow or fast heartbeat
- chest discomfort
- shortness of breath
- sudden swelling in the legs, feet, ankles, or
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
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:
cholesterol is a sum of the cholesterol in your blood.
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.
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
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.
This is a short test that monitors the electrical activity
in your heart. Doctors use this test to check for an irregular heartbeat and
The echocardiogram (EKG) test uses ultrasound waves to
create a picture of your heart. An echo monitors the heart valves and heart
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.
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.
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.
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.
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.
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.
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
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
- poor diet
Talk with your doctor if you have any concerns. They will
help you learn how to maintain a healthy heart.