How to Detect Heart Trouble

Reviewed by Robert Ehrman, MD

Heart disease is the number one killer in America today. This article will help you learn about the common tests used today to detect heart disease. It also helps you learn the signs and risk factors that mean you might get or already have heart disease.

The Tests

Before your health care providers order any of these tests, they will have found out about your medical and family history. They will have also done a physical exam. They might do a few of the heart tests in their office, send you to have them done in another location and/or refer you to a heart doctor (cardiologist). All of these tests help your health care providers learn how your heart is working.

These tests may include:

  • Electrocardiogram (EKG)
  • Echocardiogram
  • Stress Test
  • Cardiac Catheterization

What is an EKG?

An EKG is a recording of the electrical activity of your heart. Each heartbeat starts with this electrical activity. An EKG machine is a recording machine that can pick up these electrical signals and record them on paper. Several small wires that run to the recording machine are attached to your chest with a sticky gel. Each heartbeat makes wavy lines on the EKG. The EKG only takes a few seconds to do.

The pattern of the EKG helps your health care provider diagnose heart disease. They can determine the location and amount of damage done by a heart attack. An EKG can also give important information about the effects of high blood pressure on your heart, abnormal heart rhythms or heart defects you were born with. Either your health care provider or a cardiologist may perform an EKG. If your health care provider detects a problem, they may refer you to a cardiologist for further tests.

What is an Echocardiogram?

An echocardiogram is a quick, safe and painless test that uses sound waves to show how well your heart muscle and valves are working. A transducer (a tool that looks like a microphone) is used to bounce sound waves off your heart. A computer changes the sound waves into images. These images show how strongly your heart beats, whether or not anything is abnormal, and many other problems. An echocardiogram is usually done in a cardiologist’s office.

What is a Stress Test?

A stress test helps your health care provider find out whether or not you have heart disease. You are hooked up to an EKG machine and then observed as you walk on a treadmill. The treadmill gradually gets faster and steeper, increasing the workload on your heart. The professionals doing the test will coach you and closely monitor your EKG during the exercise.

There are several special types of stress tests that can be done depending on your situation. There are even stress tests for people who cannot walk at all on a treadmill. The stress test is done in a cardiologist’s office and takes about 45 minutes. An abnormal stress test may mean you have blockages in your heart.

If the cardiologist believes that these tests show signs of heart disease, you may be asked to have a cardiac catheterization.

What is a Cardiac Catheterization?

A cardiac catheterization (also called a coronary angiogram) is a test where a cardiologist takes pictures of the inside of the arteries of your heart. A cardiac catheterization is done in a hospital or an outpatient center in a special room with equipment designed just for this test. You don’t have to be admitted to the hospital for this test. With the special equipment, the cardiologist can see if you have any blockages and in which arteries they are located.

The results of a cardiac catheterization show exactly which treatment is best for you. Sometimes you may only need to take some new medicines after the test. Sometimes tiny balloons are used to remove blockages, and stents (small wire-mesh tubes) can be put in to help keep the arteries open.. Occasionally, a heart bypass surgery is necessary.

Reasons to detect heart disease

There are a variety of reasons why your health care provider would suggest that you have any of these tests. It may be because you have had one or more of the following warning signs of a heart attack:

  • Chest pain with physical activity
  • Shortness of breath
  • Tiredness
  • Pounding of the heart
  • Dizziness or fainting

Maybe you don’t have typical symptoms, but you have one or more risk factors for heart disease. The following risk factors increase your chances of developing heart disease or having a heart attack or stroke:

  • Diabetes (both type 1 and type 2)
  • Cigarette smoking
  • Family history of heart disease
  • Being overweight or obese
  • High blood pressure
  • High cholesterol
  • Stress

You can control many of these risk factors for heart disease by choosing to eat healthy, being physically active and quitting smoking (if you smoke). Other risk factors can’t be changed, such as your family history. Take steps, one at a time, to change the risk factors you can control.

If you have any of the warning signs and/or risk factors for heart disease, talk to your pharmacist and your health care provider about these and your concerns about heart disease.

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