How is a heart problem diagnosed?

History of the type of pain and the risk factors you have help a lot with diagnosing a heart problem. Your doctor may also perform tests that include exercise testing, isotope imaging, cardiac ultrasound (echocardiography) and cardiac catheterization.

When diagnosing a heart problem, one of the most important things that doctors want to know is whether your discomfort has just occurred or whether it has been there for a while. They want to know these kinds of characteristics, because so many pains are not due to the heart and others are in the gray zone.

Some signs are pretty obvious, such as chest discomfort every time you walk upstairs (but when you're sitting down you don't feel anything), or if you get short of breath, sweaty and uncomfortable during physical activity.

But more subtle chest discomfort that comes and goes requires testing via an electrocardiogram (EKG), a physical exam, oftentimes a stress test and sometimes more sophisticated stress tests. A doctor's evaluation starts with a history and physical exam, followed by an EKG for initial clues to what’s happening, and then some more sophisticated testing if those clues are either inconclusive or point toward the heart.