Cardiovascular disease is the leading killer of men and women around the globe. Common heart health tests, including electrocardiograms, stress tests and echocardiograms, can help heart doctors (cardiologists) identify heart conditions earlier than ever before. Abimbola Shofu, MD, a cardiologist at OhioHealth, outlines the most common methods used to evaluate your heart health, when the tests are needed and what they can identify.
“Diagnostic cardiac tests are not something you should try to avoid, even if you don’t have any risk factors,” says Dr. Shofu. “Many people with heart disease are asymptomatic. These fast, simple and safe tests can provide important information about your overall heart health.”
Common heart health tests
Heart disease can be present without symptoms, which is why diagnostic testing is so important. If you are over the age of 50, Dr. Shofu says you should discuss which cardiac tests you might need with your provider. If you have a history of heart attack or stroke, high blood pressure or cholesterol levels, and previous or current tobacco use, you might begin these assessments earlier or have more frequent evaluations.
“As we age, our risk for developing heart disease goes up significantly,” says Dr. Shofu. “Cardiac assessments can help determine your risk of developing heart disease and help identify the underlying cause of any signs and symptoms you have.”
Electrocardiogram
An electrocardiogram, also known as an EKG or ECG, is one of the simplest and fastest cardiac tests available. The test works by monitoring the electrical activity of the heart. An EKG provides valuable information that can help your cardiologist diagnose heart conditions such as abnormal heart rhythms and coronary heart disease, which includes heart attack and angina.
During the test, you will have electrodes (small, plastic patches that stick to the skin) placed on your chest, arms and legs. The electrodes connect to the EKG machine by wires.
Cardiac stress test
A cardiac stress test is often recommended when there is a concern about blockages in the arteries of your heart or an exercise-induced abnormal heart rhythm. A stress test is essentially an EKG that is done while you walk on a treadmill or ride a stationary bike. It can help your cardiologist determine if you have heart disease and how severe your condition is.
During a cardiac stress test, electrodes placed on your skin will record your cardiac activity as your heart rate increases. Your blood pressure will also be monitored, and you might need to breathe into a tube that will measure your lung capacity. Patients who cannot exercise will take medications to raise their heart rate to levels common when exercising.
Dr. Shofu explains that before a stress test, some patients might need to stop taking specific medications depending on why the test has been ordered. It’s important to follow your doctor’s instructions and resume taking any medications as directed once the test is completed.
Echocardiogram
An echocardiogram, also called a cardiac echo, is an ultrasound of your heart. The test helps doctors get a good look at the structure and function of both the left and right side of the heart, as well as your heart valves. A cardiac echo can help determine whether your arteries are narrowing, if you have blockages in your heart and valves, how your blood is moving through your heart and how well your heart is pumping blood.
Cardiac computed tomography (CT) calcium score
Over the past decade, cardiac computed tomography (CT) scans have become an important diagnostic tool for cardiologists. Dr. Shofu says a cardiac CT with a calcium score can help identify areas of your heart with a build-up of calcium. Coronary artery disease can narrow your arteries and reduce blood flow to your heart, which makes cardiac CT a very useful tool for revealing it before you have symptoms. The test can also help determine your heart attack risk.
During the test, images of the arteries of your heart are collected in a CT scanner and analyzed for calcified plaque. The actual CT scan takes only a few minutes, but the entire procedure may take about 10 or 15 minutes from start to finish.
When to see your doctor
Many symptoms of heart disease and stroke can be difficult to identify. This is especially true for women, who often have symptoms such as nausea and fatigue that are dismissed as insignificant. Dr. Shofu says that no matter what your personal or family history of heart disease is, you should seek help right away if you experience any of the following symptoms:
- Chest discomfort
- Difficulty breathing or shortness of breath
- Palpitations (heart racing, abnormal heartbeats or skipped heartbeats)
- Fainting spells
- Leg swelling
Because of advances in treatment options and heart health awareness, people with cardiovascular disease have more treatment options than ever before. Early detection and diagnosis through routine tests such as EKGs, stress tests and CT scans lead to the best outcomes.
“Heart disease in 2024 looks a lot different than heart disease in 1988,” says Dr. Shofu. “Many patients have a very good prognosis thanks to new drugs and procedures. When in doubt, always check with your doctor.”
It’s always best to discuss testing with your physician. If you’re in need of a heart specialist, check out our find a doctor page.
