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Heart Tests: Getting a Diagnosis

Medically Reviewed by Brunilda Nazario, MD on March 08, 2021

The earlier the cardiologist (heart doctor) diagnoses you with a heart condition, the sooner they can treat it. You’ll take one or more tests. Which ones depend on your symptoms and medical history. Here are the different types.

Electrocardiogram (ECG)

This is a picture of your heart’s electrical activity. It tells your doctor if your heart is working too hard, too slow, or if there are other problems.

They’ll stick a set of wires to your arms, legs, and the front of your chest. The other end is connected to an ECG machine. It records electricity from your heartbeat.

Echocardiogram

Also called an ultrasound of the heart, an echocardiogram can show what is and isn’t working right. Your doctor will put the transducer, a device that turns sound waves into pictures, over your heart. This test can take up to an hour.

The results will show how strong your heart is and if there’s any damage. The pictures also show if your heart is pumping enough blood.

Chest X-Ray

A small amount of radiation is used to take a picture of your heart and lungs. It’ll show an outline of the size and shapes of the chambers of the heart. It also shows shadows of your major blood vessels. But it doesn’t show the inside.

Cardiac Catheterization

The doctor puts a long, thin tube -- or catheter -- into one of the arteries in your leg or wrist and sends it up to your heart. It may be used to take blood samples. The tube also shows how well blood moves through your heart and if there are any blockages in the arteries.

You may be able to go home the same day of the procedure. But you’ll rest in the hospital for a few hours after. Your doctor will talk to you about the results and next steps.

Angiogram

This procedure is often done during a cardiac catheterization. It uses a special dye that X-rays pick up to make a very detailed picture of your heart.

The results will show the reason for pain in your chest or shortness of breath. They’ll also show if blood flow to your heart is strong and where your arteries are blocked.

Magnetic Resonance Imaging (MRI)

An MRI uses magnetic radio waves instead of X-rays to make very clear pictures of the inside and outside of your heart. It shows blood flow and any scars within the muscle. A dye is injected into your arm. This helps to show your heart and arteries in more detail. The MRI machine is like a large tunnel that you slide into.

The results can show if you have heart disease and how bad it may be. Your doctor comes up with the best way to treat it.

Exercise Stress Test

This is done on a treadmill or an exercise bike. Your doctor will use an ECG and blood pressure monitor to measure how your heart works when you’re active. You may also get an echocardiogram during this test. Your doctor may order it if your heart rhythm skips a beat, slows down, or speeds up, or if you’re having atypical chest pain. You take this test if you have symptoms of damaged arteries. These might include pain in your chest, arms, or shoulders. You may be short of breath or feel weak or queasy.

If the test shows your heart functions well and your symptoms go away, there’s nothing to do. But if you still have symptoms, your doctor may want more tests that can tell them more about what’s going on. If the tests show cholesterol buildup in your arteries, you may need to start a treatment plan.

Holter Monitor

This tool records your heart’s activity as you go about your daily tasks. You’ll wear it for 24 hours or more. Small stickers are placed on your stomach and chest. They’re connected to an ECG machine with wires.

Your doctor tells you how long to wear it and how to take care of it. Use a notebook to keep track of your activities and symptoms while you have it on. After you return it, your doctor compares the results with your notes. More tests may be needed, or you may receive a diagnosis and treatment plan.

Event Monitor

You wear this like a Holter monitor. But it usually only records your heart’s activity when you tell it to. Start recording when you have a symptom.

Your doctor will tell you when to stop using it and if you need more tests or a treatment plan.

Blood Test

This can detect your risk for heart disease. Blood is drawn from a vein in your arm. It only takes a few minutes. The results show if have too much of a certain substance. This may include tests for LDL, or bad cholesterol.

Show Sources

Sources:

American Heart Association: “Common Tests for Congenital Heart Defects,” “Chest X-Ray.”

Johns Hopkins Medicine: “Electrocardiogram,” “Holter Monitor,” “Event Monitor.” 

Mayo Clinic: “Ultrasound,” “Cardiac catheterization,” “Stress test,” “Holter monitor,” “Electrocardiogram (ECG or EKG),” “Echocardiogram.”   

Radiological Society of North America: “X-ray (Radiography) – Chest.”

The Society for Cardiovascular Angiography and Interventions: “Your Angiogram: What to Expect.”

Highland Medical: “Early Detection of Heart Disease Can Keep You Healthy.”

National Heart, Lung and Blood Institute: “Blood Tests,” “Cardiac MRI.”

CDC: “Coronary Artery Disease.”

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