History and Physical Exam
Understanding your symptoms and knowing your health history will help your doctor diagnose and treat your disease. Your doctor will give you a physical exam and ask you questions about your health history, your family's health history, and your daily habits. This information will help your doctor decide what further tests you will need. Your doctor uses the information provided by your examination and tests to develop a treatment plan. This treatment plan is designed to relieve some of your symptoms and help make you more comfortable. Your treatment plan may include:
- Medications to help your heart work better
- Changes in your diet to reduce the amount of salt and sodium you eat
- Rest to give your heart a break
- Activity as recommended by your doctor
- Lifestyle changes, such as stopping smoking.
Laboratory Tests
Your doctor will order a series of blood tests to help diagnose your heart disease:
- A cardiac enzyme count, troponin count and other blood chemistry tests can show if the heart muscle has been damaged.
- A lipid profile, cholesterol levels, triglyceride levels and glucose (blood sugar) levels can help identify your risk factors for heart disease.
- A B-type natriuretic peptide (BNP) test can demonstrate whether the heart is stressed and stretched.
Computerized Tomography Scan (CT or CAT)
CT, sometimes called CAT scan, is a safe, non-invasive, well tolerated procedure, which uses specialized x-ray equipment to obtain detailed images from various angles around the body. Computers process the information and create cross-sectional images, or slices, of body tissues and organs like the heart. CT imaging can show several types of tissue such as lung, bone, soft tissue, and blood vessels. CT is very useful in the diagnosis and evaluation of heart disease.
Electrocardiogram (EKG OR ECG)
The EKG records the heart's electrical activity and shows abnormal heart rhythms. It can even show a heart attack in progress.
Tilt-Table Test
If you have sudden or frequent fainting spells (syncope), your doctor may order a Tilt-Table Test. During this test, we will monitor your heart rate and blood pressure as you lie flat on a table. Then we will tilt the table upward, so that you are almost in a standing position. The changes in your heart rate and blood pressure as you change position can show whether it is a heart rhythm problem that is causing you to faint.
Stress Tests
A cardiac stress test is an EKG done when you are at rest and when your heart is "stressed" or working hard. The test can show how your heart responds to increased workload, including how much work your heart can safely do after you have had a heart attack or heart surgery. The test may involve walking on a treadmill or medications (pharmacological stress test) to increase your heart rate. If your doctor wants pictures of your heart as well as an EKG, he or she may order a nuclear stress test.
Treadmill Stress Test
We will monitor your blood pressure and EKG while you walk on a treadmill. As the treadmill speed increases, you will have to walk faster, and your heart will have to work harder. Try to go as long as possible on the treadmill. Your best effort will give your doctor the most accurate information.
Pharmacological (Drug-Induced) Stress Tests
This test is for patients who are not able to walk on a treadmill. Like a treadmill test, it evaluates your heart's response to stress, but in this case, medication rather than physical exercise stresses the heart.
Nuclear Stress Test
In addition to measuring your heart's electrical activity during stress, a nuclear study provides pictures of your heart. This nuclear study has 2 parts: a scan of your heart at rest and a scan of your heart under stress. This information will help us determine if any of the coronary arteries are blocked. To take the scan, we will give you a small amount of weak radioactive isotope through your IV. On a scan, it will show which areas of your heart muscle are receiving blood. The isotope leaves the body through the kidneys and should be completely gone within 24 to 48 hours. If you are not on a fluid restriction, drinking water and other fluids can help your body clean out the isotope.
Echocardiogram (ECHO)
The echocardiogram uses ultrasound to create video pictures of the heart's chambers, valves, wall motion and blood flow patterns. This test can be done while you are at rest or during a stress test (stress echocardiogram).
Transesophageal Echocardiogram (TEE)
Like a routine echocardiogram, TEE uses ultrasound to create images. TEE images, however, are clearer because they are taken with a scope from inside your body. Your doctor may order a TEE if the routine echocardiogram cannot answer all of the questions about your heart's structure and function. TEE involves passing a special ultrasound scope through your mouth into your food pipe (esophagus) to take pictures. We will give you medication to help you relax and keep you comfortable during your TEE.
Muga Scan/Viability Scan
A Multigated Wall Motion Study (MUGA or viability scan) shows how well the walls of your heart are moving. It can also show if and where a wall is damaged. We will give you a small amount of weak radioactive isotope through your IV. As the isotope flows through your heart, a scanner will take pictures. The isotope leaves the body through the kidneys and should be completely gone within 24 to 48 hours. If you are not on a fluid restriction, drinking water and other fluids can help your body clean out the isotope.
Positron Emission Tomography (PET)
PET scans show the difference between the living and damaged cells in your heart. These scans can help your doctor determine whether medication or surgery would be the most effective treatment for you. The test uses a weak radioactive isotope to take images of your heart. We will give you a small amount of weak radioactive isotope through your IV. As the isotope flows through your heart, the scan can show which cells are damaged. The isotope leaves the body through the kidneys and should be completely gone within 24 to 48 hours. If you are not on a fluid restriction, drinking water and other fluids can help your body clean out the isotope.
Cardiac Catheterization
Cardiac catheterization (also called cardiac cath, coronary angiography or heart catheterization) gives your doctor a view of the valves, the heart muscle and coronary arteries at work. If your doctor finds a problem during a catheterization, he or she may treat it right away.
Cardiac Catheterization Preparation Guide 
Electrophisiology Study (EPS)
An EPS can show if you have or are at risk of having a life-threatening heart rhythm disturbance. The EPS offers clear and accurate information about your heart's electrical system. In some cases, the cardiologist can treat the problem during the test.
EPS Preparation Guide