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Heart and Cardiac Diagnostic Testing

If you have symptoms of heart disease or you’re at risk for developing heart disease, there are several diagnostic tests, or heart screenings, your doctor may recommend. Below are descriptions of some of the most common tests and why doctors recommend them.

EKG/ECG – An EKG, also called an ECG, is an electrocardiogram. It records the electrical activity of the heart and can show any arrhythmias that occur during the test. It may also be able to detect certain types of damage to the heart muscle.

Echocardiogram – An echocardiogram, sometimes called an echo, is a test that uses sound waves to create images that allow your doctor to evaluate the structure of your heart and how it’s functioning. 

Holter monitor – A holter monitor is a portable ECG. It can be worn for a day or up to two weeks at a time . It is a small recording device that records the electrical activity of your heart for your doctor to review later. 

Mobile Cardiac Monitor - A mobile cardiac monitor is worn for up to 30 days to record your heart rhythm.  The results are automatically sent to your physician. Your physician uses this information to evaluate your symptoms and determine what is causing the arrhythmia. 

Event monitor – An event monitor is a portable rhythm monitor that is used for patients who have an irregular heart rhythm less frequently. You may wear the monitor always, and activate it when you feel symptoms. These devices lets your doctor check your heart rhythm at the time of your symptoms.

Cardiac CT – Cardiac computed tomography, or cardiac CT uses an x-ray machine technology and a computer to take clear, detailed pictures of the heart to create 3D images of the heart. Your cardiologist or heart surgeon may order this test to look for certain heart abnormalities.

Cardiac MRI – A cardiac MRI uses radiofrequencies, magnets, and a computer to create images of your heart. The images are quite detailed, which makes it possible for your doctor to evaluate your heart valves, arteries, and heart muscle. It can check for coronary artery disease, congenital heart defects, tumors, valve disease and other abnormalities. Cardiac MRIs are sometimes done before heart and vascular surgery.

Stress test – Stress tests can identify abnormal heart rates or blood pressures, heart rhythm irregularities and classify an individual's aerobic capacity. Stress tests are often used to determine a safe level of exercise for those who are recovering from a cardiac event, such as a heart attack or heart surgery. They can also help differentiate whether a patient’s symptoms of palpitations, heart racing, shortness of breath or new onset of fatigue are stemming from blockages in the heart arteries rather than a simple manifestation of stress or anxiety. Stress tests are typically done walking on a treadmill, and can be done in conjunction with an ultrasound or nuclear scan to increase the accuracy of the results.

Angiography – Angiography is a test that looks at your coronary arteries and heart. During an angiography, a tiny tube is inserted into an artery into your heart. Dye is injected into your veins that helps highlight areas of the heart, then x-ray images are taken. This can help detect coronary artery disease.

Electrophysiology studies (EPS) – These tests help doctors measure the electrical activity in the heart. They are used to help diagnose the underlying cause of arrhythmias. During the test, tiny catheters are put into a vein or artery. These catheters are electrodes that can stimulate the heart and record the electrical activity. If the doctor finds an accessory pathway that is causing the arrhythmias, he or she can also perform a cardiac ablation at the same time.

In addition to these tests, your doctor may recommend blood pressure monitoring and blood tests to help evaluate or diagnose heart disease.

When you should consider getting your heart screenings

Certain screenings are right for every adult, beginning at age 20. For example, it’s a good idea to have blood pressure screenings at every annual checkup starting in your early adult years. Cholesterol screenings should also start young, and you should begin monitoring your body weight as a young adult too. It’s important to screen for some risks early so you will know your baseline and can track changes as you age.

How frequently heart screenings should be done

There is no definitive answer regarding the appropriate time for all screenings. Your doctor will recommend screening tests for you based upon your own individual circumstances and risks. For example, if you have high blood pressure, you may need to monitor your blood pressure daily at home and regularly at your doctor’s office. If you’re experiencing palpitations or lightheadedness, your doctor may recommend that you have an EKG or a Holter monitor, while someone with no symptoms may never have a Holter monitor regardless of age.

Here are some basic guidelines for five common screening tests:

Blood pressure – Blood pressure should be screened every year to two years beginning at age 20. If you have high blood pressure, your doctor may want to screen you more often.

Fasting cholesterol test – Starting at about age 20, your doctor will likely recommend that you have a fasting cholesterol test done every four to six years to look for the levels of cholesterol and triglycerides in your blood. If you’re at high risk for heart disease or stroke, your doctor may test you more frequently.

Blood glucose – Your doctor will likely recommend blood glucose testing every three years beginning at age 45 for those with normal risk. For those at high risk, screenings may occur earlier and more frequently. Having high blood glucose levels (also known as blood sugar levels) puts you at risk for developing diabetes, pre-diabetes, and insulin resistance.

Body weight, waist circumference, and body mass index (BMI) – Your doctor may start recording your body weight and BMI when you’re a young adult. Your weight will be recorded at every annual exam, and depending on your weight and body composition, you may need more frequent screenings. This is because being overweight increases your risk for heart disease, stroke, and many other health problems.

Lifestyle screenings – Every year at your annual checkup, your doctor may ask you whether you smoke and drink alcohol, how much you exercise, what kind of exercise you do, and what your diet is like. These screenings, while not tests, help the doctor understand your risks for heart disease and they can lead to conversations about the importance of a healthy lifestyle.

When doctors find something on a test, what happens next?

If you have diagnostic heart tests and your doctor finds something, the next step will be to talk about treatment options. Your doctor will recommend treatments based on factors like your age, risk factors, condition, the severity of your condition, your symptoms, and your lifestyle. Treatments will range from lifestyle changes to medication to surgery.

The Beaumont difference

Beaumont is a world leader in innovative heart care. Our heart and vascular teams provide the most advanced treatment options. We have specialized heart care centers throughout Metro Detroit.

Start your search at Beaumont. Find a Beaumont cardiologist or heart surgeon near you.