How is heart disease diagnosed?

Classically the stress test is used to diagnose heart disease. The stress test shows severe plaque buildup typically vessels of the heart, but stress tests aren’t given to the whole population. The decision to order a stress test is based on symptoms, such as chest pain or pressure, shortness of breath, very bad sweating, sometimes bad fatigue. These can lead a doctor to order a stress test to assess for heart disease.

In order to diagnose and determine treatment for your particular heart disease, your doctor will obtain a complete medical history, perform a thorough physical exam and order any or all of the following special diagnostic tests:

  • Chest X-rays—provide information about the size of your heart and its four chambers
  • Electrocardiogram (ECG)—records the changes in electrical activity that occurs during your heartbeat
  • Echocardiogram (Echo)—uses ultrasound to examine and measure the structure of your heart. An echo demonstrates performance of the heart valves and provides information on heart muscle function.
  • Stress Test—records your heart's electrical patterns while you exercise or are stressed by drugs
  • Nuclear Scan—helps determine heart function. A small amount of radioactive material is injected into a vein, and is temporarily absorbed by the parts of your heart that are not receiving enough blood flow.
  • Cardiac Magnetic Resonance Imaging (MRI)—looks at the size, shape, and thickness of the heart muscle
  • Computed Tomography (CT) Scan—provides assessment of abnormalities of the ascending and descending aorta after administration of a contrast dye
  • Cardiac Catheterization (Coronary Angiogram)—allows visualization of your blood vessels and measurement of pressures inside your heart chambers following injection of a contrast dye.

In addition to regular checkups, your health care team may do one or more special tests to check the condition of your heart and blood vessels. The tests to diagnose heart disease are:

  • An electrocardiogram, also called an ECG or EKG, provides information on heart rate and rhythm and shows if there has been damage or injury to the heart muscle.
  • An echocardiogram uses sound waves (ultrasound) to produce images of the heart and blood vessels on a screen. It tells your doctor if your heart is pumping blood correctly.
  • An exercise stress test, or a treadmill test, uses an ECG to measure how your heart works while you walk on a moving treadmill.
  • An exercise perfusion test, or a stress nuclear perfusion test, uses small amounts of radioactive material to produce images of blood flow to the heart as you exercise.
  • A medication stress test uses medicine instead of exercise to increase your heart rate.
  • A stress echocardiogram uses ultrasound and either exercise or medication to provide images of the heart and blood vessels.
  • Cardiac catheterization is used with other tests. A small tube, the catheter, is inserted into an artery and guided into the blood vessels of the heart.
  • A coronary angiogram, orarteriogram, is a test in which dye is injected into the blood vessels using a catheter and X-rays are taken. It shows if arteries are narrowed or blocked.
  • A chest X-ray shows the size and shape of the heart and can also show congestion in the lungs.
Dr. Samin K. Sharma, MD
Cardiologist (Heart Specialist)

Although heart disease can show up as a heart attack, there are usually other symptoms before heart attack. In this video, Dr. Samin Sharma, MD, a leading cardiologist at The Mount Sinai Medical Center, discusses tests used to diagnose heart disease.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.