Getting Tested for Heart Disease

You may be reading this book because you think you might have heart disease but aren’t yet sure. Keep in mind that heart disease doesn’t always announce itself with symptoms. That means you could have heart disease and still feel perfectly fine. The best course is to talk with your doctor about your personal degree of heart disease risk and about whether getting tested is a good idea.

Most screening tests for heart disease are done outside of the body and are painless. After taking a careful medical history and doing a physical examination, your doctor may give you one or more of the following tests:

Electrocardiogram (ECG or EKG) makes a graph of the heart’s electrical activity as it beats. This test can show abnormal heartbeats, heart muscle damage, blood flow problems in the coronary arteries, and heart enlargement.

Stress test (or treadmill test or exercise ECG) re c o rds the heart ’s electrical activity during exercise, usually on a treadmill or exercise bike. If you are unable to exercise due to arthritis or another health condition, a stress test can be done without exercise . Instead, you can take a medicine that increases blood flow to the h e a rt muscle and shows whether there are any problems in that flow.

Nuclear scan (or thallium stress test) shows the working of the heart muscle as blood flows through the heart . A small amount of radioactive material is injected into a vein, usually in the arm, and a camera records how much is taken up by the heart muscle.

Echocardiographic changes sound waves into pictures that show the heart’s size, shape, and movement. The sound waves also can be u s e d to see how much blood is pumped out by the heart when it contracts.

Coronary angiography (or angiogram or arteriography) shows an x ray of blood flow problems and blockages in the coronary arteries. A thin, flexible tube called a catheter is threaded through an artery of an arm or leg up into the heart. A dye is then injected into the tube, allowing the heart and blood vessels to be filmed as the heart pumps. The picture is called an angiogram or arteriogram.

Ventriculogram is frequently a part of the x-ray dye test described before. It is used to get a picture of the heart’s main pumping chamber, typically the left ventricle.

Intracoronary ultrasound uses a catheter that measures blood flow. It creates a picture of the coronary arteries that shows the thickness and other features of the artery wall. This lets the doctor see blood flow and any blockages.

In addition, several new, highly sensitive screening tests have been developed. Ask your doctor about these tests:

Carotid doppler ultrasound uses sound waves to detect blockages and narrowing of the carotid artery in the neck, both of which can signal an increased risk for heart attack or stroke.

Electron-beam computed tomography is a superfast scan that provides a snapshot of the calcium buildup in your coronary arteries.