Diagnosis

Your health care provider will examine you and ask about your personal and family medical history.

Many different tests are used to diagnose heart disease. Besides blood tests and a chest X-ray, tests to diagnose heart disease can include:

  • Electrocardiogram (ECG or EKG). An ECG is a quick and painless test that records the electrical signals in the heart. It can tell if the heart is beating too fast or too slowly.
  • Holter monitoring. A Holter monitor is a portable ECG device that's worn for a day or more to record the heart's activity during daily activities. This test can detect irregular heartbeats that aren't found during a regular ECG exam.
  • Echocardiogram. This noninvasive exam uses sound waves to create detailed images of the heart in motion. It shows how blood moves through the heart and heart valves. An echocardiogram can help determine if a valve is narrowed or leaking.
  • Exercise tests or stress tests. These tests often involve walking on a treadmill or riding a stationary bike while the heart is monitored. Exercise tests help reveal how the heart responds to physical activity and whether heart disease symptoms occur during exercise. If you can't exercise, you might be given medications.
  • Cardiac catheterization. This test can show blockages in the heart arteries. A long, thin flexible tube (catheter) is inserted in a blood vessel, usually in the groin or wrist, and guided to the heart. Dye flows through the catheter to arteries in the heart. The dye helps the arteries show up more clearly on X-ray images taken during the test.
  • Heart (cardiac) CT scan. 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.
  • Heart (cardiac) magnetic resonance imaging (MRI) scan. A cardiac MRI uses a magnetic field and computer-generated radio waves to create detailed images of the heart.

Treatment

Heart disease treatment depends on the cause and type of heart damage. Healthy lifestyle habits — such as eating a low-fat, low-salt diet, getting regular exercise and good sleep, and not smoking — are an important part of treatment.

Medications

If lifestyle changes alone don't work, medications may be needed to control heart disease symptoms and to prevent complications. The type of medication used depends on the type of heart disease.

Surgery or other procedures

Some people with heart disease may need a procedure or surgery. The type of procedure or surgery will depend on the type of heart disease and the amount of damage to the heart.

Lifestyle and home remedies

Heart disease can be improved — or even prevented — by making certain lifestyle changes. The following changes are recommended to improve heart health:

  • Don't smoke. Smoking is a major risk factor for heart disease, especially atherosclerosis. Quitting is the best way to reduce the risk of heart disease and its complications. If you need help quitting, talk to your provider.
  • Eat healthy foods. Eat plenty of fruits, vegetables and whole grains. Limit sugar, salt and saturated fats.
  • Control blood pressure. Uncontrolled high blood pressure increases the risk of serious health problems. Get your blood pressure checked at least every two years if you're 18 and older. If you have risk factors for heart disease or are over age 40, you may need more-frequent checks. Ask your health care provider what blood pressure reading is best for you.
  • Get a cholesterol test. Ask your provider for a baseline cholesterol test when you're in your 20s and then at least every 4 to 6 years. You may need to start testing earlier if high cholesterol is in your family. You may need more-frequent checks if your test results aren't in a desirable range or you have risk factors for heart disease.
  • Manage diabetes. If you have diabetes, tight blood sugar control can help reduce the risk of heart disease.
  • Exercise. Physical activity helps you achieve and maintain a healthy weight. Regular exercise helps control diabetes, high cholesterol and high blood pressure — all risk factors for heart disease. With your provider's OK, aim for 30 to 60 minutes of physical activity most days of the week. Talk to your health care provider about the amount and type of exercise that's best for you.
  • Maintain a healthy weight. Being overweight increases the risk of heart disease. Talk with your care provider to set realistic goals for body mass index (BMI) and weight.
  • Manage stress. Find ways to help reduce emotional stress. Getting more exercise, practicing mindfulness and connecting with others in support groups are some ways to reduce and manage stress. If you have anxiety or depression, talk to your provider about strategies to help.
  • Practice good hygiene. Regularly wash your hands and brush and floss your teeth to keep yourself healthy.
  • Practice good sleep habits. Poor sleep may increase the risk of heart disease and other chronic conditions. Adults should aim to get 7 to 9 hours of sleep daily. Kids often need more. Go to bed and wake at the same time every day, including on weekends. If you have trouble sleeping, talk to your provider about strategies that might help.

Coping and support

You may feel frustrated, upset or overwhelmed upon learning that you or a loved one has heart disease. Here are some ways to help manage heart disease symptoms and improve quality of life:

  • Cardiac rehabilitation. This personalized exercise and education program teaches ways to improve heart health after heart surgery. Cardiac rehabilitation helps add healthy lifestyle changes — such as exercise, a heart-healthy diet and stress management — into your life.
  • Support groups. Connecting with friends and family or a support group is a good way to reduce stress. You may find that talking about your concerns with others in similar situations can help.
  • Continued medical checkups. Regular appointments with your health care provider can help make sure you're properly managing your heart disease.

Preparing for your appointment

Some types of heart disease will be discovered without an appointment — for example, if a child is born with a serious heart defect, the heart disease will be detected soon after birth. Other times, heart disease may be diagnosed in an emergency situation, such as a heart attack.

If you think you have heart disease or are at risk of heart disease because of family history, see your health care provider. You may be referred to a heart specialist (cardiologist).

Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet. You may need to avoid eating or drinking (fast) before a cholesterol test, for example.
  • Write down symptoms you're having, including any that seem unrelated to heart disease.
  • Write down key personal information — including a family history of heart disease, stroke, high blood pressure or diabetes — and major stresses or recent life changes.
  • Make a list of medications, vitamins or supplements you're taking.
  • Take someone along, if possible. Someone who goes with you can help you remember information you're given.
  • Be prepared to discuss your diet and your smoking and exercise habits. If you don't already follow a diet or exercise routine, talk to your care provider about getting started.
  • Write down questions to ask your provider.

For heart disease, some basic questions to ask your health care provider include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes for my symptoms or condition?
  • What tests will I need?
  • What's the best treatment?
  • Is there a generic alternative to the medicine you're prescribing?
  • What are alternatives to the primary approach you're suggesting?
  • What foods should I eat or avoid?
  • What's an appropriate level of physical activity?
  • How often should I be screened for heart disease? For example, how often do I need a cholesterol test?
  • I have other health conditions. How do I manage them together?
  • Are there restrictions that I need to follow?
  • Should I see a specialist?
  • Are there brochures or other materials that I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

  • When did your symptoms begin?
  • Do you always have symptoms or do they come and go?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, makes your symptoms worse?
  • Do you have a family history of heart disease, diabetes, high blood pressure or other serious illness?

What you can do in the meantime

It's never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and becoming more physically active. A healthy lifestyle is the main protection against heart disease and its complications.