Tests for Heart Health

Heart disease is the leading cause of death in the United States and a major cause of disability. Finding it early, when it is easier to treat, matters, and blood tests and heart tests can reveal heart disease or problems that lead to it. Your health care provider will choose tests based on your symptoms, risk factors and medical history.

Electrocardiogram (EKG or ECG)

A painless test that records the heart's electrical activity, showing how fast it beats and whether the rhythm is steady. It may be part of a routine exam, or used to look for heart attacks, arrhythmia and heart failure. Electrodes — sensor patches — are placed on the chest, arms and legs and wired to a recording machine while you lie still.

Echocardiography (echo)

A painless test using sound waves to make moving pictures of the heart, showing its size and shape and how well its chambers and valves work. In the most common kind, transthoracic echo, a technician spreads gel on your chest and moves a wand-like transducer over it; the ultrasound echoes are turned into images by a computer.

Stress testing

Shows how the heart works under physical stress, to diagnose coronary artery disease and judge its severity, and to check for valve disease and heart failure. You exercise — or get medicine if you cannot — to make the heart work hard while an EKG and blood pressure are monitored. You may also have an echo or a nuclear scan, in which an injected radioactive tracer lets special cameras picture the heart after exercise and at rest.

Chest x-ray

Pictures of the heart, lungs, blood vessels and other structures in the chest. It can show signs of heart failure, as well as lung disorders and other causes of symptoms unrelated to the heart.

Cardiac CT scan

A painless test using x-rays, combined by computer into a 3D model of the heart and its blood vessels, after an injection of contrast dye. It helps detect coronary artery disease, calcium in the coronary arteries, congenital heart defects, problems with the aorta (the main artery leaving the heart), problems with heart function and valves, and diseases of the pericardium. You lie still on a table that slides into a large, tunnel-like scanner.

Cardiac MRI

A painless test using radio waves, magnets and a computer to make detailed pictures of the heart. It shows whether you have heart disease and how severe it is, and helps guide treatment of congenital defects, coronary artery disease, valve problems, pericarditis, cardiac tumors and damage from a heart attack. The tunnel-like machine is loud, and contrast dye is sometimes injected first.

Cardiac catheterization and coronary angiography

In cardiac catheterization, a long, thin, flexible tube is threaded from a blood vessel in the arm, groin or neck to the heart. Through it, a provider can take blood and heart-muscle samples, examine the valves, and perform procedures such as angioplasty or minor surgery to repair congenital defects or replace valves.

It is also used for coronary angiography: dye injected through the catheter makes the coronary arteries visible on x-rays, showing whether plaque is blocking them and how badly. Coronary artery disease is caused by plaque buildup in these arteries. Angiography is used after chest pain, sudden cardiac arrest, or abnormal results from other tests such as an EKG or stress test.

Sources

• MedlinePlus, National Library of Medicine: "Heart Health Tests," drawing on the National Heart, Lung, and Blood Institute.