Diagnostic Tests and Procedures

Diagnostic tests and procedures are used to determine whether you have heart disease, as well as to determine the type and severity of the problem and the most effective treatment plan. In recent years, the diagnostic procedures available have become more precise and sophisticated, enabling physicians and other health care professionals to tailor treatment to an individual's particular condition.

Common Tests

Event Recorders are small, portable electrocardiography machines that record the heart's beats and rhythm. Each monitor has unique features related to length of recording time and ability to send the recordings over the phone. Your doctor may order an ambulatory monitor to diagnose, evaluate and treat abnormal heart rhythms. An event recorder is worn during normal daily activities for a lengthy period of time and is removed for bathing or showering. Small electrodes are attached to your chest. When you feel symptoms, you press a button to activate the recorder, which will record the event for one minute before the time you pushed the button and up to 40 seconds after the arrhythmia is over. The rhythm can be sent immediately or saved and transmitted later over a telephone line.

A Holter Monitor can be worn up to 48 hours. Electrodes are placed on the skin of your chest. Electrical impulses are continuously recorded and stored in the Holter monitor. You will keep a diary of your activities and symptoms while you're wearing the device (palpitations, rapid heartbeats and any episodes of dizziness or faintness). When the test is finished, you will return the monitor, and a technician will play the tape on a special computer that analyzes the recording and looks for abnormalities of the rhythm.

Electrocardiography (EKG) tests detect cardiac arrhythmias, conduction abnormalities, heart damage and potential heart attack candidates, including stress testing (treadmill). The heart function is monitored and measured at rest and under the stress of increasing physical exertion.

Head Upright Tilt (HUT) Tests determine the cause of fainting spells. You will be tilted, always with the head up, at different angles for a period of time while heart rhythm, blood pressure and other symptoms are closely monitored and evaluated with each change in position.

Stress Tests provide information about how the heart responds to stress and usually involve walking on a treadmill at increasing levels of difficulty while the electrocardiogram, heart rate and blood pressure are monitored. Your physician may order this test to determine whether there is adequate blood flow to your heart during increasing levels of activity and to evaluate the effectiveness of your cardiac treatment plan.

Echocardiography (M-mode, two dimensional) ultrasound tests evaluate valve function, heart chamber size, heart muscle thickness and intracardiac abnormalities.

Transesophogeal Echocardiograms (TEE) create a graphic outline of the heart's movement, valves and chambers using high-frequency sound waves that come from a small transducer placed down your throat. TEE provides clear images of the heart's movement and assesses the function of its chambers and valves, determines the presence of disease and evaluates the effectiveness of medical or surgical treatments.

Carotid Doppler Studies are ultrasound tests that use sound waves to assess arterial blockage in the main arteries in the neck feeding the brain.

Pacemaker Evaluation

Nuclear Medicine thallium/adenosine scans test a small amount of radioactive dye infused intravenously. The dye is distributed to the heart muscle and then examined with a special camera to pick up portions of the heart muscle that are deprived of oxygen.

Cardiac Catheterization determines the location and degree of coronary artery disease, valvular disease and other intracardiac abnormalities by injecting a dye into the heart vessels and the heart chambers and recording it using an X-ray.

Common Procedures

  • Cardioversion
  • Catheter ablation
  • Coronary artery bypass surgery
  • Implantable cardioverter defibrillator (ICD)
  • Interventional procedures
  • Lead extraction
  • Pacemaker implant