Tests and diagnosis

By Mayo Clinic Staff

The tests you'll need to diagnose your heart disease depend on what condition your doctor thinks you might have. No matter what type of heart disease you have, your doctor will likely perform a physical exam and ask about your personal and family medical history before doing any tests. Tests to diagnose heart disease can include:

  • Blood tests. You may need to have your blood drawn and tested for substances that could indicate you have heart disease. Your doctor may check the levels of your cholesterol and triglycerides, blood cell counts, or other blood tests that might show damage to your heart.
  • Chest X-ray. An image is created by directing X-rays at your chest and positioning a large piece of photographic film or a digital recording plate against your back. The X-ray machine produces a small burst of radiation that passes through your body and produces an image on the film or digital plate. A chest X-ray shows an image of your heart, lungs and blood vessels. It can reveal if your heart is enlarged, a sign of some forms of heart disease.
  • Electrocardiogram (ECG). In this noninvasive test, a technician will place probes on your chest that record the electrical impulses that make your heart beat. An ECG records these electrical signals and can help your doctor detect irregularities in your heart's rhythm and structure. You may have an ECG while you're at rest or while exercising (stress electrocardiogram).
  • Holter monitoring. A Holter monitor is a portable device that you wear to record a continuous ECG, usually for 24 to 72 hours. Holter monitoring is used to detect heart rhythm irregularities that aren't found during a regular ECG exam.
  • Echocardiogram. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart's structure and function. Sound waves are transmitted, and their echoes are recorded with a device called a transducer that's held outside your body. A computer uses the information from the transducer to create moving images on a video monitor.

    If the images from a regular echocardiogram are unclear, your doctor may recommend a transesophageal ultrasound. During this exam, you swallow a flexible tube containing a small transducer, about the size of your index finger, that is guided down your throat. The transducer will transmit images of your heart to a computer monitor.

  • Cardiac catheterization. In this test, a short tube (sheath) is inserted into a vein or artery in your leg (groin) or arm. A hollow, flexible and longer tube (guide catheter) is then inserted into the sheath. Aided by X-ray images on a monitor, your doctor threads the guide catheter through that artery until it reaches your heart. The pressures in your heart chambers can be measured, and dye can be injected. The dye can be seen on an X-ray, which helps your doctor see the blood flow through your heart, blood vessels and valves to check for abnormalities.
  • Heart biopsy. Sometimes a heart biopsy will be done as part of cardiac catheterization, especially if your doctor suspects you have heart inflammation and hasn't been able to confirm that with other tests. In a heart biopsy, a tiny sample of your heart tissue is removed through the catheter and is sent to a lab for testing.
  • Cardiac computerized tomography (CT) scan. This test is often used to check for heart failure or heart arrhythmias. In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest. Some walk-in clinics may advertise heart scans that look for calcium buildup in your arteries, which may show you're at risk of having a heart attack. However, these scans are not recommended for most people, as the information they provide isn't often useful.
  • Cardiac magnetic resonance imaging (MRI). In a cardiac MRI, you lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. Images of your heart are created from these signals, which your doctor will look at to help determine the cause of your heart condition.
Jan. 16, 2013