Heart Disease Diagnosis

A heart disease diagnosis is based on a person's risk factor assessment, physical examination, laboratory tests, and other medical tests. In life-threatening situations, emergency treatment is started before the diagnosis is finalized.

Risk factor assessment

A heart disease risk factor assessment is based on person's medical history and the medical history of their family members. A doctor or another 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 disease 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.

Laboratory tests

Laboratory tests check a person's blood and urine samples to identify test results that fall outside of the normal ranges. Laboratory tests for heart disease include:

• Blood chemistry test
• Blood enzymes test (checks creatine phosphokinase, myoglobin, and troponin)
• Complete blood count
• C-reactive protein test (blood protein that is a sign of inflammation)
• Drug screening
• Fasting glucose test (checks blood sugar level)
• Lipoprotein profile (checks cholesterol and triglyceride levels)
• Liver function test
• Thyroid hormone test
• Urinalysis

Medical tests

Additional medical tests help:

• Identify the presence of a person's heart disease risk factors.
• Rule out other diseases.
• Identify the type and severity of a person's heart disease.
• Determine a person's treatment options.

The medical tests chosen depend on a person's risk factor assessment and symptoms:

• Medical tests for the common types of heart disease
• Explanations of medical tests

Medical tests for the common types of heart disease

Coronary artery disease

• Coronary angiography with cardiac catherization
• Echocardiogram
• Electrocardiogram
• Electron-beam computed tomography
• Magnetic resonance angiography (MRA)
• Nuclear heart scan
• Stress test

Angina

• Chest X-ray
• Coronary angiography with cardiac catherization
• Echocardiogram or stress echocardiogram
• Electrocardiogram
• Nuclear stress test
• Stress test

Heart attack

• Chest CT scan
• Coronary angiography with cardiac catherization
• Echocardiogram
• Electrocardiogram
• Magnetic resonance imaging (MRI)
• Nuclear heart scan

Heart failure

• Chest CT scan
• Chest X-ray
• Coronary angiography with cardiac catherization
• Echocardiogram
• Electrocardiogram
• Magnetic resonance imaging (MRI)
• Nuclear heart scan
• Stress test

Arrhythmias

• Coronary angiography with cardiac catherization
• Echocardiogram
• Electrocardiogram
• Electrophysiology study (EPS)
• Holter monitor
• Event monitor
  
• Stress test

Explanations of medical tests

• Chest CT scan
  A chest CT scan (computed tomography scan) uses X-rays to produce cross-sectional computerized images of the heart and lungs. The CT scan identifies an enlarged heart, fluid in the lungs, and lung disease.
• Chest X-ray
  A chest X-ray uses electromagnetic radiation to produce images of the heart, lungs, and blood vessels in the chest.
• Coronary angiography with cardiac catheterization
  Coronary angiography uses X-rays to examine the coronary arteries after a radiopaque substance is injected into a coronary artery using cardiac catheterization. Cardiac catheterization passes a thin, flexible tube through a coronary artery or into the heart's chambers.
• Echocardiogram
  An echocardiogram uses sound waves 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.
• Magnetic resonance angiography (MRA)
  MRA uses magnetic fields and radio waves to produce images of the blood vessels in the heart. This test doesn't require cardiac catheterization.
• Magnetic resonance imaging (MRI)
  MRI uses strong magnetic fields, radio waves, and a computer to create images of the structure of the heart without radiation or surgery.
  
• Nuclear heart scan
  A radioactive tracer is injected into a person's bloodstream, and then pictures are taken of the heart's blood flow.
• Nuclear stress test
  s radioactive tracer is injected into a person's bloodstream, and then a special camera shows the flow of blood through your heart and arteries.
• Stress test
  A stress test measures ECG and blood pressure while people exercise or after they take medication to make their hearts beat faster.