Physical Tests for Diagnosing Heart Disease

After your initial physical exam, your doctor may recommend additional tests to better understand your heart health. These may include cardiac stress tests, blood tests or other diagnostic studies. The type of test recommended depends on your symptoms, medical history and overall risk for heart disease. 

These tests help your care team evaluate how your heart responds to activity, identify possible risk factors and guide next steps in care. 

What is a cardiac stress test? 

A cardiac stress test shows how well your heart works during physical activity or controlled stress. It’s one of the most common tests used to evaluate chest pain, shortness of breath or suspected coronary artery disease. 

Stress tests can reveal problems with blood flow, heart rhythm or how the heart muscle responds when it has to work harder. 

Types of stress tests your doctor may recommend 

Your provider may recommend one of the following stress tests based on your health and ability to exercise: 

• Exercise stress test
  You walk or jog on a treadmill or ride a stationary bike while your heart rhythm, heart rate and blood pressure are monitored. 
• Nuclear stress test
  Combines exercise or medication with nuclear imaging to show blood flow to the heart muscle. This is sometimes called a chemical stress test. 
• Pharmacologic stress test
  Uses medication to simulate exercise if you are unable to safely walk or run on a treadmill. This test is often combined with nuclear imaging. 
• Stress echocardiogram
  Uses ultrasound imaging before and during exercise to evaluate heart structure and function. 
• Dobutamine stress test
  A type of medication stress test that uses dobutamine to increase heart rate while ultrasound images are taken. 

What to expect during your stress test 

Preparation 

Most people don’t need special preparation. Your provider may give instructions about medications or eating before the test. Wear comfortable clothing and supportive shoes. 

During the test 

Small electrodes will be placed on your chest to record your heart’s electrical activity using an electrocardiogram (ECG). Your blood pressure and oxygen levels will also be monitored. 

Exercise or medication 

You may walk on a treadmill, ride a stationary bike or receive medication through an IV to mimic exercise. 

Monitoring 

Your heart rhythm, blood flow and symptoms are closely watched throughout the test to ensure safety and accuracy. 

Blood tests used to evaluate heart health 

Blood tests provide important information about your risk for heart attack, heart disease or vascular disease. They are often used alongside stress tests or imaging to give a more complete picture of cardiovascular health. 

Common blood tests include: 

• Cholesterol panel
  Measures LDL (“bad” cholesterol), HDL (“good” cholesterol) and triglycerides. 
• Blood glucose testing 
  Helps identify diabetes or prediabetes, which increases heart disease risk. 
• C-reactive protein (CRP) 
  A marker of inflammation that may indicate higher cardiovascular risk when combined with other findings. 
• Cardiac enzymes (troponin, CK-MB) 
  Used when a heart attack is suspected to detect heart muscle damage. 
• Additional laboratory tests 
  Thyroid, kidney or other blood tests may be ordered to identify conditions that affect heart health. 

Why these tests matter 

Together, stress tests and blood tests help your provider: 

• Detect early signs of heart disease 
• Evaluate symptoms such as chest pain, fatigue or shortness of breath 
• Determine the most appropriate treatment plan 
• Monitor heart health over time if you already have a heart condition 

Next steps 

If your provider has recommended a stress test or blood work, follow their instructions and ask questions if anything is unclear. At Banner Health, our heart care teams are here to guide you through testing, explain your results and help you plan next steps for your heart health. 

You may also be referred for: 

• Heart imaging tests to look at structure and blood flow 
• Electrophysiology testing to evaluate heart rhythm concerns 

Your care team will help determine which tests are right for you.