Tests to diagnose heart disease
A doctor will make a diagnosis of heart disease after assessing a person's risks, and arranging some tests.
Heart disease risk factors include being overweight, smoking and having a family history of heart problems.
Tests used to evaluate heart disease include:
Blood pressure. People don't usually know they have high blood pressure or hypertension until blood pressure is checked during a routine appointment. Hypertension can lead to heart disease.
Cholesterol levels. High cholesterol also usually has no symptoms but can damage the heart. Cholesterol levels should be measured at least once every 5 years for everyone over 40 using a fasting blood test - no food for 12 hours before blood is taken. The screening test checks total cholesterol, LDL (low density lipoprotein cholesterol, also called 'bad' cholesterol) and HDL (high density lipoprotein cholesterol, also called 'good' cholesterol)
To confirm a heart disease diagnosis a doctor may arrange further tests which may include imaging to see inside the body and more blood tests:
Electrocardiogram (ECG). Electrodes are stuck to the arms, legs and chest and the ECG machine records heart rhythm and electrical activity. Abnormal readings don’t always mean there are problems. Exercise ECG test or stress tests may also be arranged with the readings taken while the patient is on a treadmill or exercise bike. This often helps diagnose angina due to heart disease.
X-rays. Heart, lungs and chest X-rays can help to rule out other conditions.
Echocardiogram. This ultrasound scan looks at the structure, thickness and movement of heart valves and heart chambers as blood is pumped giving a picture of how well the heart is working.
Cardiac enzyme blood tests. These can help diagnose heart muscle damage.
Coronary angiography. Carried out under local anaesthetic, a coronary angiography or catheter test gives information about blood pressure inside the heart, how well the heart is working and whether coronary arteries are narrowed or blocked.
Radionuclide tests. A small amount of radioactive isotope is injected into the blood, sometimes during exercise. A special camera near the chest follows the radiation as it travels through the heart. This test helps diagnose heart disease and shows how strongly the heart is pumping.
Magnetic resonance imaging (MRI). This uses magnets to give detailed images of your heart.