Your doctor will perform a physical exam and ask about your personal and family medical history. The tests you'll need to diagnose your heart disease depend on what condition your doctor thinks you might have. 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 your heart. It can spot abnormal heart rhythms. You may have an ECG while you're at rest or while exercising (stress electrocardiogram).
- Holter monitoring. A Holter monitor is a portable ECG device you wear to continuously record your heart rhythm, usually for 24 to 72 hours. Holter monitoring is used to detect heart rhythm problems that aren't found during a regular ECG exam.
- Echocardiogram. This noninvasive exam uses sound waves to produce detailed images of your heart's structure. It shows how your heart beats and pumps blood.
- Stress test. This type of test involves raising your heart rate with exercise or medicine while performing heart tests and imaging to check how your heart responds.
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. Using X-ray images on a monitor as a guide, your doctor carefully threads the catheter through the artery until it reaches your heart.
During cardiac catheterization, 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 problems.
- Cardiac computerized tomography (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.
- Cardiac magnetic resonance imaging (MRI). A cardiac MRI uses a magnetic field and computer-generated radio waves to create detailed images of your heart.
The type of treatment you receive depends on the type of heart disease you have. In general, treatment for heart disease usually includes:
- Lifestyle changes. You can lower your risk of heart disease by eating a low-fat and low-sodium diet, getting at least 30 minutes of moderate exercise on most days of the week, quitting smoking, and limiting alcohol intake.
- Medications. If lifestyle changes alone aren't enough, your doctor may prescribe medications to control your heart disease. The type of medication you receive will depend on the type of heart disease.
- Medical procedures or surgery. If medications aren't enough, it's possible your doctor will recommend specific procedures or surgery. The type of procedure or surgery will depend on the type of heart disease and the extent of the damage to your heart.
Lifestyle and home remedies
Heart disease can be improved — or even prevented — by making certain lifestyle changes. The following changes can help anyone who wants to improve heart health:
- Stop smoking. Smoking is a major risk factor for heart disease, especially atherosclerosis. Quitting is the best way to reduce your risk of heart disease and its complications.
- Control your blood pressure. Ask your doctor for a blood pressure measurement at least every two years. He or she may recommend more frequent measurements if your blood pressure is higher than normal or you have a history of heart disease. Optimal blood pressure is less than 120 systolic and 80 diastolic, as measured in millimeters of mercury (mm Hg).
Check your cholesterol. Ask your doctor for a baseline cholesterol test when you're in your 20s and then at least every five years. You may need to start testing earlier if high cholesterol is in your family. If your test results aren't within desirable ranges, your doctor may recommend more-frequent measurements.
Most people should aim for a low-density lipoprotein (LDL) level below 130 milligrams per deciliter (mg/dL), or 3.4 millimoles per liter (mmol/L). If you have other risk factors for heart disease, you should aim for an LDL level below 100 mg/dL (2.6 mmol/L). If you're at very high risk of heart disease — if you've already had a heart attack or have diabetes, for example — aim for an LDL level below 70 mg/dL (1.8 mmol/L).
- Keep diabetes under control. 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 and control diabetes, high cholesterol and high blood pressure — all risk factors for heart disease. If you have a heart arrhythmia or heart defect, there may be some restrictions on the activities you can do, so talk to your doctor. With your doctor's OK, aim for 30 to 60 minutes of physical activity most days of the week.
- Eat healthy foods. A heart-healthy diet based on fruits, vegetables and whole grains — and low in saturated fat, cholesterol, sodium and added sugar — can help you control your weight, blood pressure and cholesterol.
- Maintain a healthy weight. Being overweight increases your risk of heart disease. A body mass index (BMI) of less than 25 and a waist circumference of 35 inches (88.9 centimeters) or less is the goal for preventing and treating heart disease.
- Manage stress. Reduce stress as much as possible. Practice techniques for managing stress, such as muscle relaxation and deep breathing.
- Get treatment for depression. Being depressed can increase your risk of heart disease significantly. Talk to your doctor if you feel hopeless or uninterested in your life.
- Practice good hygiene. Regularly wash your hands and brush and floss your teeth to keep yourself well.
Also, get regular medical checkups. Early detection and treatment can set the stage for a lifetime of better heart health.
Coping and support
You may feel frustrated, upset or overwhelmed upon learning that you or your loved one has heart disease. Here are some ways to help cope with heart disease or improve your condition:
- Cardiac rehabilitation. For people who have cardiovascular disease that's caused a heart attack or has required surgery to correct, cardiac rehabilitation is often recommended as a way to improve treatment and speed recovery. Cardiac rehabilitation involves levels of monitored exercise, nutritional counseling, emotional support, and support and education about lifestyle changes to reduce your risk of heart problems.
- Support groups. Turning to friends and family for support is essential, but if you need more help, talk to your doctor about joining a support group. You may find that talking about your concerns with others in similar situations can help.
- Continued medical checkups. If you have a recurring or long-term (chronic) heart condition, regularly check in with your doctor to make sure you're properly managing your heart condition.
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, it will be detected soon after birth. In other cases, your heart disease may be diagnosed in an emergency situation, such as a heart attack.
If you think you have heart disease or are worried about your heart disease risk because of your family history, see your family doctor. 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 experiencing, 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 doctor about getting started.
- Write down questions to ask your doctor.
For heart disease, some basic questions to ask your doctor 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 doctor is likely to ask you questions, such as:
- When did your symptoms begin?
- Are your symptoms continuous or do they come and go?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- 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.