Medical tests for heart disease

The medical tests needed to diagnose your heart disease depend on what condition your doctor thinks you might have based on your symptoms (if any), risk factors and medical history.

Some of the most common medical tests performed for diagnosis of a heart condition are: 

Angiogram

Coronary angiogram

A coronary angiogram may be done during or after a heart attack or angina. It's sometimes called ‘cardiac catheterisation’.

A catheter (a small tube) is put into an artery in your groin, arm or wrist under local anaesthetic. The catheter is moved up inside the artery until it reaches your heart. You will not feel this.

A special dye is injected into your coronary arteries and an X-ray is taken. It may make you feel hot and flushed for a few seconds. The X-ray shows your doctor where and how much your coronary arteries are narrowed. It also shows how well your heart is pumping.

Coronary angiograms help your doctor decide the best treatment for you. Sometimes it is best to go straight on to coronary angioplasty while you are in the laboratory having a coronary angiogram and the tubes are in place. The cardiologist will discuss this option with you before the procedure and it is your choice whether to proceed.

MORE ON CORONARY ANGIOGRAMS

Coronary computed tomography angiogram (CCTA)

This is a type of computed tomography (CT) scan that can help diagnose coronary artery disease. It gives a 3-dimensional image of the heart chambers and coronary arteries supplying blood to the heart.

A CCTA is a non-invasive test for people who may be experiencing unusual cardiac symptoms

Blood tests

When your heart muscle has been damaged, as in a heart attack, your body releases substances in your blood. Blood tests can measure the levels of these substances and show if, and how much of, your heart has been damaged. 

The most common test after a heart attack checks levels of troponin in your blood. Blood tests are also done to measure the level of other substances in your blood, such as blood fats (e.g. cholesterol and triglycerides) and minerals.

MORE ON BLOOD TESTS

Blood pressure monitoring

Your doctor may arrange for you to wear a blood pressure monitor for 24 hours (during day-to-day activity and sleep). This light-weight, easy to wear monitor will help your doctor get accurate information about your blood pressure. Your doctor may ask you to measure and record your own blood pressure at home.

MORE ON MONITORING BLOOD PRESSURE

Chest X-ray

Using an X-ray, pictures are taken of the structure and organs inside your chest, like your heart, lungs and blood vessels.

They can show if there are signs of heart failure.

MORE ON CHEST X-RAYS

Echocardiogram (heart ultrasound)

An echocardiogram is a common test. It gives a picture of your heart using ultrasound. It uses a probe either on your chest or sometimes can be done down your oesophagus (throat).

It helps your doctor check if there are any problems with your heart’s valves and chambers, and see how strongly your heart pumps blood.

An echocardiogram performed before and after exercise is also used to detect areas of the heart where the blood supply through the coronary arteries to the heart muscle is reduced (see stress tests below).

Electrocardiogram (ECG)

An ECG reads your heart's electrical impulses. Small sticky dots and wire leads are put on your chest, arms and legs. The leads are attached to an ECG machine which records the electrical impulses and prints them out on paper.

Your doctor may use an ECG to diagnose a heart attack or abnormal heart rhythms (called 'arrhythmias').

Electrophysiology studies

Electrophysiology studies use a computer to help find out about an abnormal heartbeat (arrhythmia).

Special tubes (catheters) are inserted, via a vein in your leg, into your heart. The catheters record your heart's electrical activity and test its response to various stimuli. Your heart's electrical response to these stimuli helps doctors to determine the type and cause of your arrhythmia.

MRI

An MRI uses very strong magnets and radio waves to create detailed images of your heart on a computer. It can take still or moving pictures of your heart. It does not involve radiation and the main thing you will notice is a drumming noise while the scanning is being done.  

Sometimes a special dye is used to make parts of the heart and coronary arteries easier to see.

This test shows your doctor the structure of your heart and how well it is working, so they can decide the best treatment for you.

Stress tests

Stress tests help your doctor find out how well your heart works when you're physically active, using exercise machines (e.g. a treadmill).

Exercise stress test

This is an electrocardiogram (ECG) done while you exercise. The doctor checks your heart rate, heart rhythm and blood pressure.

The test will show how your heart works during exercise. Sometimes it’s called a treadmill test or exercise test.

Stress echocardiogram (stress echo)

A radioactive substance (a tracer) is injected into your bloodstream. The stress echo uses an ultrasound to detect differences in your heart’s chambers and valves and how strongly your heart beats when exercised, or when stressed using a medicine (e.g. dobutamine).

Nuclear cardiac stress test

This test is sometimes called an 'exercise thallium scan', a 'dual isotope treadmill' or an 'exercise nuclear scan'.

A tiny dose of a radioactive substance called a 'tracer' is injected into your bloodstream. It goes to your heart and releases energy. Special cameras take a picture of this energy from outside your body.

Your doctor uses this picture to see how much blood flows to your heart muscle and how well your heart pumps blood when you are resting and doing physical activity. This test also helps your doctor to see if your heart muscle is damaged.

Tilt tests

Doctors use tilt tests to see whether different body positions will trigger an abnormal heart beat (arrhythmia). They’re especially useful for investigating the hearts of people who faint without explanation.

Tip: Ask your doctor for information about any test you’re having, so you understand why you’re having it, and what's involved during and after the test.