Doctors have a variety of medical tests available to them to determine if patients have heart disease, to assess their risk of disease and to determine a cause for a heart attack. Some of these tests are simple to administer and are noninvasive, while others might require anesthesia, intravenous fluids and all day at the hospital.
Cardiovascular disease is the top killer of both men and women in America. While living a healthy lifestyle can go a long way toward fighting off heart disease, sometimes genetics deal a hand that diet and exercise alone can't defeat. By receiving appropriate screening procedures or necessary tests in the face of certain symptoms, doctors can learn vital clues about how best to treat or prevent future cardiac problems in your life, or to alleviate or lessen heart disease already present.
A standard and fairly simple test is the ECG or EKG, or electrocardiogram. This noninvasive test uses electrodes stuck to the surface of the skin on the chest, arms and legs. The electrodes transmit the electrical impulses of the heart to a machine that prints it all out. Another simple, noninvasive test is the echocardiogram. This machine uses ultrasound waves to look at the heart; shows the doctor the heart in action, how it looks and is working; and reveals the blood flow to the heart as well. In a stress test, doctors use the technology of the EKG while a patient is physically active, typically while running a treadmill or riding a stationary bike. This measures how the heart performs under harder conditions.
More invasive tests are cardiac catherization, which are needed if a doctor is planning an angioplasty. This is a more involved test and not appropriate for all patients. It gives a more detailed look at where and how blocked arteries are. Heart MRIs are useful for giving a good deal of detail about the anatomy and functioning of the heart, without having to do an invasive procedure. Unless the patient is claustrophobic, there is no real discomfort involved. Newer anatomic computed tomography, or CT, is safer, faster and cheaper than cardiac catherization, but it may not give the precise information needed about the level of arterial plaque present. Finally, a simple chest X-ray can help provide some clues about a patient's condition. It gives a pretty good picture of the structures of the chest, and may indicate whether the problem might be stemming from the lungs, heart or ribs.
There are many reasons a physician might order heart tests for a patient. One reason is if a person is suspected of recently suffering a heart attack. There are a number of tests that confirm or rule out the diagnosis of heart attack. Sometimes patients complain of symptoms that appear to be irregular heart rhythms. In this situation, a doctor will order tests to determine if the patient is indeed having irregular heartbeats and pinpoint a cause. Other times, a patient might be having a cluster of problems that point to heart disease, and the doctor will want to get a good look at the physical appearance and function of the heart to determine if that is indeed the problem. Another reason for various heart tests is a strong family history of heart disease, or strong risk factors in the patient.
Each type of test has different amounts of prepping involved and therefore can vary greatly in how long they take to administer. For instance, in the case of an EKG, it takes approximately 10 minutes to place all the electrodes on the skin, and only seconds to record the necessary information. A chest X-ray is also fairly simple and takes no more than 10 or 15 minutes. Expect to spend an hour or so in the physician's office for a stress test, but don't worry; you won't be exercising for more than 10 minutes or so of that hour. A typical echocardiogram takes about 40 minutes altogether; however, if you are having a stress echo or other combination tests done with the echo, test times can vary. For a cardiac catherization, the procedure itself takes only about a half-hour, but with all the preparation and safeguards, expect to spend a full day at the hospital since this is an invasive procedure. A CT scan of the heart takes only several minutes, since it is fairly straightforward and simple to administer.
Certain invasive procedures carry some risks of serious problems, and the risks must not outweigh the potential benefit. Additionally, newer technologies and tests are being developed all the time, and it is in your best interest to learn more about these. Make certain you are getting the best test to give your doctor the most helpful information with as little risk involved as possible.