Diagnosing Heart Disease

Before a treatment plan for heart disease can be developed, the specific type of heart problem must be accurately diagnosed. A doctor may use a number of tests to diagnose heart disease, depending on the specific symptoms and the results of previous tests. These tests may include one or more of the following.

Physical Exam

A physical exam is almost always the first step in diagnosing heart disease. The doctor will listen to the heart and lungs, check the pulse and blood pressure, and ask about both personal and family history.

Blood Tests

The doctor will usually order a series of blood tests that may include one or more of the following:

• Lipid profile (HDL, LDL, triglycerides, and total cholesterol), to determine if high cholesterol is a factor
• High-sensitivity C-reactive protein, to detect concentrations of CRP, a marker for inflammation associated with atherosclerosis and other conditions
• CBC (complete blood count), to measure the quantity of red blood cells, white blood cells, platelets, and hemoglobin in the blood
• Lipoprotein (a), which may indicate an increased risk of heart disease
• Plasma ceramides, to check for three specific ceramides linked to plaque buildup in the arteries that may indicate a risk of heart disease
• Brain natriuretic peptide, or BNP, a protein that is elevated when the heart is damaged

Chest X-Ray

A chest x-ray examines the heart, lungs, and bones to look for issues such as an enlarged heart, fluid in or around the lungs, blood vessel problems, congenital heart disease, or calcium build up. This test can be especially helpful in ruling out other possible causes of symptoms.

Electrocardiogram

An ECG records electrical signals to detect irregularities in the heart structure and/or heart rhythm.

Holter Monitor

Holter monitors are portable devices worn to record a continuous ECG for 24 to 72 hours, detecting heart rhythm irregularities that may not be found during a single ECG exam.

Echocardiogram

An echocardiogram uses ultrasound to create detailed images of the heart’s function and structure.

Stress Test

Stress tests raise the heart rate through exercise or medication while ECG testing and imaging are used to see if the heart responds properly.

Cardiac Catheterization

Cardiac catheterization involves having a flexible catheter inserted into a vein or artery in the leg, groin, or arm and guided using X-ray images to the heart, measuring pressure in the heart chambers and/or injecting dye to evaluate the blood flow in the heart, blood vessels, and valves.

Cardiac Computerized Tomography

A CT scan uses an X-ray tube that rotates around the body to collect images of the chest and heart, detecting problems or abnormalities.

Cardiac Magnetic Resonance Imaging

MRIs use a magnetic field to create pictures that help evaluate the condition of the heart.

After heart disease has been diagnosed, the doctor will discuss various treatment options depending on the specific type of condition and severity of the heart disease. In most cases, treatment will include lifestyle changes, medications, and/or medical procedures including surgery.