Heart Arrhythmias Diagnosis

A diagnosis of a heart arrhythmia is based on a person's risk factor assessment, physical examination, and medical tests.

Risk factor assessment

A heart arrhythmia risk factor assessment is based on person's medical history and the medical history of their family members. A doctor or other healthcare provider gathers information by asking specific questions. A questionnaire is often used to help organize the information.

• The medical history contains information about a person's:
  • Health (high blood pressure, diabetes, previously diagnosed heart disease condition, thyroid condition)
  • Lifestyle (physical activity, smoking, alcohol use)
  • Drug use (prescription and over-the-counter medications, supplements, herbs, illegal drugs)
• The family medical history contains information about health problems of family members.
  

Physical examination

The physical examination helps identify heart arrhythmia symptoms. In addition to measuring a person's blood pressure and pulse, the doctor:

• Listens to the chest for abnormal heart and lung sounds.
• Examines the person's eyes, arms and legs, and skin.

Medical tests

A person's risk factor assessment and physical exam determine which medical tests the doctor will order. The medical tests also help determine a person's treatment options. Tests for heart arrhythmias may include:

• Echocardiogram
  An echocardiogram uses sound waves (ultrasound) to create moving images of the heart. The test identifies blood flow, heart contractions, and muscle damage.
• Electrocardiogram (ECG, EKG)
  An ECG measures the heartbeat's rate and regularity.
• Electrophysiology study (EPS)
  An EPS is a recording of the heart's electrical activity. Cardiac catheterization is used to insert electrodes into the heart.
  
• Event monitor
  People wear an event monitor for several weeks or longer. They press a button on the device whenever they feel symptoms and the monitor records the person's heart rhythm.
  
• Holter monitor
  A holter monitor continuously records the heart’s electrical activity over a 24-hour period.
• Stress test
  A stress test measures ECG and blood pressure while people exercise or after they take medication to make their hearts beat faster.
• Tilt table studies
  A tilt table study is ordered for some people with recurrent fainting spells (syncope). The test shows how a person's heart rate and blood pressure respond to changes in position as a table is tilted (from lying down to standing up).