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Most heart disease in the U.S. is related to blockages in the coronary arteries. In order to make the diagnosis, if the history is suggestive (exertional chest pain), the best test is a stress test. If the stress test is abnormal, then cardiac catheterization may be indicated. This procedure takes pictures of the arteries to outline the blockages. Other types of heart diseases are related to valvular dysfunction, which are best diagnosed with an echocardiogram which is a sonographic picture of the structure of the heart. Abnormal rhythms of the heart are diagnosed with an electrocardiograph, or with a 24 hour monitor.