Several tests are used to detect heart conditions. These determine if the patient has angina or whether a heart attack has occurred.

Initially a risk assessment is carried out.  If necessary, you will be referred by your doctor for the most appropriate tests.  This depends on the warning signs experienced and physical wellbeing.

These investigations look at the image of the heart and its activity, or investigate the linings of the arteries, to determine the extent of damage by atherosclerosis.

Some tests are non-invasive (no puncturing of the skin, or no insertion of instrument into body), whereas others are invasive.  More than one type may be required to diagnose a condition.

Risk assessment tests

The highest predictors of heart disease risk are family history and smoking status.  These details are recorded as part of a full medical history.

Your blood pressure and the results of any blood tests measuring protein, lipids and cholesterol will also be used to assess your risk of disease.

Non-invasive tests

• Electrocardiogram (ECG) and exercise stress test -
  The ECG is carried out whilst lying still, with 12 electrodes attached to the chest, arms, and legs.  It is a dynamic instrument, capable of showing changes in the heart muscle over the weeks, and when and where damage has occurred.

An ECG records the electrical activity of the heart and the heartbeat.  It enables the consultant to see whether the heart is enlarged or damaged.

It is used to confirm whether a heart attack has occurred, recently or in the past.  The results highlight tissue that is not functioning and areas of heart muscle deprived of oxygen.  A characteristic trace is produced when an attack has occurred.

If the ECG results appear normal or the changes are mild, blood tests can determine whether there has been any damage to the heart muscle.  These analyse for proteins that are released into the blood from non-functioning heart muscle.

The exercise stress test is an ECG procedure carried out whilst the patient exercises, usually on a treadmill.  This will enable the consultant to determine whether the patient has stable angina, the symptoms of which occur when under exertion.  The test forecasts the risk of a possible heart attack, and is used as a preventive tool.

• Imaging tests
  An echocardiography is an ultrasound test that displays an image of the heart from a transducer placed on the chest.  The pulses of the ultrasound reflect from the heart structure to produce the image.

Magnetic Resonance Imaging (MRI) is another means of producing an image of the heart and blood vessels through the use of radio waves.  It produces a two or three-dimensional picture and can eliminate the need for a collection of tests.   It involves lying on a table, which then passes through the MRI machine that produces the scan.  During the procedure, small atoms in the body tissues are magnetised and respond to a pulse of radio waves.

Invasive tests

Complications can occur during invasive tests due to the nature of the procedure.  These tests should be thoroughly discussed with your doctor.

A coronary angiogram involves passing a catheter into an artery in the leg, arm or groin.  A radiopaque dye is then injected into the blood vessels or heart chambers, and a map of the heart and blood vessels is displayed on X-ray.

Cardiac catheterization, at the time of the coronary angiography, measures cardiac output and blood flow as well as an image of the heart.

If a heart condition is diagnosed, there are numerous treatments available, depending on the type and severity of the disease.  Your doctor will discuss these with you, but to find out background information on the different types click on Treatments.

20/05/2009