Preliminary Testing
Heart disease is the leading killer of adults in the United States. According to the American Heart Association, more than 1 million people are diagnosed with heart disease every year. For 445,000 of them, a heart attack will be their first symptom. The good news is 90 percent of heart disease patients can be treated if they receive immediate medical care. The most accurate diagnostic tools are physical examinations, blood tests, electrocardiograms, exercise tests and, ultimately, invasive laboratory procedures.
Physical Examinations and Blood Tests
If you're older than 40 or have a family history of heart disease, schedule an annual physical with your doctor. During the examination, he will ask you about your health, diet and activity that could represent risk factors for heart disease. He will also order a comprehensive blood lipid panel. A lipid panel tests your blood for total cholesterol, low density lipoproteins, high-density lipoproteins and triglycerides. Abnormal results can represent a risk for heart disease.
Looking at the Heart
Another important part of your physical examination is performing a resting electrocardiogram, or EKG. An EKG looks at the electrical activity of your heart from 12 different angles. Based on your EKG results, your doctor can draw conclusions about the health of your heart and how they relate to heart disease. If he can't make an accurate diagnosis from a resting EKG, he might order an exercise cardiac stress test (ECST) or a radionuclide stress test. During an ECST, your doctor will watch your responses as you walk on a treadmill at increasing speeds and inclines. He'll watch for your responses to exercise--your heart rate, EKG forms and blood pressure reading. While an ECST is highly predictive for heart disease, it can't accurately diagnose heart disease in everyone.
The next level of testing is the radionuclide stress test. Before the test, your doctor will inject a small amount of radioactive isotope into your bloodstream. After a few minutes, you'll exercise in the same manner as an ECST. After the test, your doctor will take pictures of your heart using a special instrument that is designed to show cold spots or areas of the heart that are not getting adequate blood circulation.
Invasive Heart Tests
If none of these tests demonstrates symptoms for heart disease but your doctor still thinks you are at risk, he may suggest coronary angiography. During coronary angiography, a small tube is fed through your arm or groin until it reaches the opening of your coronary arteries. After introducing a small amount of dye, your doctor will advance the tube into your arteries, looking for areas where the blood supply has become occluded through a special camera. The test is quick, relatively painless and highly diagnostic of heart disease.
