Heart Disease Diagnosis

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• QWhat blood tests might my doctor order if I have a heart problem?

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  A Intermountain Healthcare answered

  Here are a few of the most common blood tests your healthcare provider may order to learn more about your heart problem:

  • Blood electrolytes. Checking levels of certain electrolytes can help show the cause of a heart problem or assist in treating it. Electrolytes are important for heart function.
  • Blood cell count. This blood test includes levels of white blood cells (WBCs) and red blood cells (RBCs). This test helps your healthcare provider check for an infection or measure your body's ability to fight infections. It also shows your body's ability to carry oxygen to vital organs such as the heart.
  • Cardiac marker analysis. Damaged heart cells release certain biochemicals. These telltale chemicals are called cardiac markers or cardiac enzymes. Two examples are troponin and CPK-MB. Along with other tests, checking for these markers in your blood can help determine whether or not you have recently suffered (or are suffering) a heart attack.
  • BNP. When the heart is under stress, it releases a biochemical called BNP (B-type natriuretic peptide). Measuring the BNP levels in your blood is one way to detect your risk for coronary artery disease or heart failure.
  • Blood coagulation tests. Anticoagulants (sometimes called "blood thinners") are drugs that cause your blood to take longer to clot. They help prevent dangerous clots from forming in your heart and blood vessels. Yet in doing so, they also bring a risk of excess bleeding throughout your body. That's why, if you're taking an anticoagulant (such as Coumadin), your healthcare provider will order regular blood tests to make sure your blood is clotting at the right level.
  • Glucose test. A glucose (blood sugar) test can help your provider check for diabetes and whether it's in good control. High blood glucose levels can lead to atherosclerosis and artery wall damage. A glucose test may also show if you've had a stressful event (such as a heart attack) that may raise your blood glucose.
  • Lipid tests. These tests check the levels of cholesterol, triglycerides, and other fatty substances in your blood. Test results help your provider evaluate your risk for coronary artery disease and your body's ability to process fats.
  • hs-CRP. Your healthcare provider may order a high-sensitivity CRP test (hs-CRP) to measure the level of C-reactive protein in your blood. High levels of this protein occur when blood vessels are inflamed—and signal increased risk for heart disease.

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• QHow is heart disease diagnosed?

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  A Dr. Tseday A. Sirak, MD , Cardiology (Cardiovascular Disease), answered on behalf of StoneSprings Hospital Center

  

  In this video Tseday Sirak, MD from StoneSprings Hospital Center, explains how heart disease is diagnosed, with the help of family history, physical exam and various tests.

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• QWhat can I expect when I go home after my electrophysiology (EP) study?

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  A Dr. Atul Bhatia, MD , Clinical Cardiac Electrophysiology, answered on behalf of Aurora Health Care

  Once home after your electrophysiology (EP) study, limit your activity for the first 24 hours. Move about, but don’t strain or try to lift heavy objects. Shower the day after your procedure, but wait for another day or two before taking a bath.

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• QHow will my doctor diagnose bradycardia (slow heart rate)?

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  A Columbia University Department of Surgery answered

  A history and physical examination by your doctor is likely the first step in the diagnosis of bradycardia. An EKG and review of your symptoms provides the doctor with important information. Additional tests, such as an electrophysiology study, may also be ordered. You may be the first person to know that something has changed because of how you feel. Or, you may not have felt any change, yet the tests and examination showed an arrhythmia.
• QWhat body fat measurements can help me assess my heart disease risk?

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  A Dr. Anthony L. Komaroff, MD , Internal Medicine, answered

  A recent report in The Lancet pooled findings from 58 studies involving more than 220,000 people to better understand how to use body fat measurements to help assess heart disease risk. The investigators concluded that body mass index (BMI), waist circumference, and waist-to-hip ratio (another way to gauge body size) were equal in terms of predicting heart disease risk.
  
  You can calculate your BMI like this: divide your weight in pounds by your height in inches. Divide the answer by your height in inches. Multiply that answer by 703. Or use the National Heart, Lung, and Blood Institute's easy online calculator.[http://www.nhlbisupport.com/bmi/] Given that it's simpler to look up your BMI than to correctly measure your waist or hip circumference, it makes sense to focus on BMI.
• QWhy are women more likely to be misdiagnosed when they have heart disease?

  8 Answers

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  A Dr. Tseday A. Sirak, MD , Cardiology (Cardiovascular Disease), answered on behalf of StoneSprings Hospital Center

  

  Women are often misdiagnosed earlier when it comes to heart disease because they have atypical symptoms. Tseday Sirak, MD from StoneSprings Hospital Center, explains this phenomenon.

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• QWhat heart tests are used for children?

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  A SecondsCount.org answered

  The common tests that are used in diagnosing heart disease in children are listed below. These same tests are used for adult patients who may have undiagnosed congenital heart disease and for adults who acquire heart disease later in life.

  • Echocardiogram
  • Electrocardiogram
  • Cardiac Catheterization/Angiogram
  • CT/MRI
  • Exercise/Stress Testing
  • Electrophysiology (EP) Study (Ablation Procedure)
  • Pulse Oximetry Screening

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• QWhat happens immediately after an electrophysiology (EP) study?

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  A Dr. Atul Bhatia, MD , Clinical Cardiac Electrophysiology, answered on behalf of Aurora Health Care

  After your electrophysiology (EP) procedure, you will be taken to your room or a recovery room. Your heart rate, blood pressure and dressings are checked while you lie in bed for about six hours, keeping your leg straight to prevent bleeding. You may have tenderness and bruising at the insertion sites. You may eat when you feel up to it. Your doctor will discuss results with you and your family.

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• QWhat should I ask my doctor about a recommended cardiovascular test?

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  A SecondsCount.org answered

  The question below can help you start a conversation with your physician/practitioner about recommended cardiovascular tests.

  • What information will this test give us about my cardiovascular disease?
  • What are the benefits of this test?
  • Does this test carry any risks? If so, what are the risks?
  • How accurate is this test?
  • What are some likely next steps if the test indicates a problem?

  Please print this list of questions. Take them with you to the doctor and share them with friends and loved ones when you are encouraging them to see their doctors.
• QHow do genetic tests for heart disease work?

  1 Answer

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  A SecondsCount.org answered

  Genetic testing is not recommended to try to assess risk for coronary artery disease, the acquired adult form of heart disease that leads to heart attack. Genetic tests are not available for all forms of congenital heart disease. Your cardiologist can help you determine if you are a good candidate.
  
  Another developing areas in genetic testing is that of identifying patients who may not respond well to certain medications, such as antiplatelet drugs. These patients are called poor metabolizers for that medication - that is, their bodies do not process the medication as would be expected due to genetic variations in the enzyme responsible for processing the medication. Poor metabolizers for certain drugs can be identified through a genetic test. The commonly prescribed antiplatelet medication clopidogrel (Plavix) is one example of a medication for which genetic testing can identify poor metabolizers. The value of genetic testing in a routine fashion to identify poor metabolizers is still unknown.
  
  For genetic tests for heart disease, a blood sample is sent to a lab where a scientist analyzes the DNA in the blood, which contains genetic information. The scientist looks for information patterns in and around the genes called “markers.” If someone has a particular marker that is known to be associated with a disease, that person should carry a specific gene. Presence of a gene that is associated with a disease only indicates that the person being tested may be predisposed to have that disease. It does not necessarily mean that the person will develop the disease.
  
  If you choose to pursue genetic testing, it is important to do so through a validated laboratory in the context of trained genetic counseling and experienced cardiovascular physicians, who can explain the results and place them in the context of your future cardiovascular care.