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How Is Heart Disease Diagnosed?

Testing for heart disease

Heart disease is any condition that affects your heart, such as coronary artery disease and arrhythmia. According to the Centers for Disease Control and Prevention (CDC), heart disease is responsible for one in every four deaths in the United States each year. It’s a leading cause of death in both men and women.

To diagnose heart disease, your doctor will perform a series of tests and evaluations. They may also use some of these tests to screen you for heart disease before you develop noticeable symptoms.

Symptoms of heart disease

Symptoms of a heart problem can include:

  • fainting
  • slow or fast heartbeat
  • chest tightness
  • chest pain
  • shortness of breath
  • sudden swelling in your legs, feet, ankles, or abdomen

If you have any of these symptoms, you should schedule an appointment with your doctor. Getting diagnosed and treated early can help lower your risk of complications, like heart attack or stroke.

Physical exam and blood tests

During your appointment, your doctor will ask you about your symptoms and your family medical history. They will also check your heart rate and blood pressure.

Your doctor may also order blood tests. For example, cholesterol tests measure the levels of fat and cholesterol in your bloodstream. Your doctor can use these tests to help determine your risk of heart disease and heart attack.

A complete cholesterol test checks four types of fats in your blood:

  • Total cholesterol is the sum of all cholesterol in your blood.
  • Low-density lipoprotein (LDL) cholesterol is sometimes called "bad" cholesterol. Too much of it causes fat to build up in your arteries, which reduces blood flow. This can lead to a heart attack or stroke.
  • High-density lipoprotein (HDL) cholesterol is sometimes called "good" cholesterol. It helps carry away LDL cholesterol and clear your arteries.
  • Triglycerides are a type of fat in your blood. High levels of triglyceride are often associated with diabetes, smoking, and excessive alcohol consumption.

Your doctor may also order C-reactive protein (CRP) tests to check your body for signs of inflammation. They can use the results of your CRP and cholesterol tests to assess your risk of heart disease.

Noninvasive tests for heart disease

After completing a physical examination and blood tests, your doctor may order additional noninvasive tests. Noninvasive means the tests do not involve tools that break the skin or physically enter the body. There are many noninvasive tests available to help your doctor check for heart disease.


An electrocardiogram (EKG) is a short test that monitors the electrical activity in your heart. It records this activity on a strip of paper. Your doctor may use this test to check for an irregular heartbeat or heart damage.


An echocardiogram is an ultrasound of your heart. It uses sound waves to create a picture of your heart. Your doctor may use it to evaluate your heart valves and heart muscles.

Stress test

To diagnose heart problems, your doctor may need to examine you while you’re doing strenuous activity. During a stress test, they may ask you to ride a stationary bicycle or walk or run on a treadmill for several minutes. They will monitor your body’s reaction to stress as your heart rate increases.

Carotid ultrasound

A carotid ultrasound uses sound waves to create pictures of your carotid arteries on both sides of your neck. It allows your doctor to check for a buildup of plaque in your arteries and assess your risk of stroke.

Holter monitor

If your doctor needs to monitor your heart over a period 24 to 48 hours, they will ask you to wear a device called a Holter monitor. This small machine works like a continuous EKG. Your doctor can use it to check for heart abnormalities that can go undetected on a normal EKG, such as arrhythmias.

Chest X-ray

A chest X-ray creates images of the inside of your chest, including your heart and blood vessels. It can help your doctor determine the cause of shortness of breath or chest pains.

Tilt table test

Your doctor may perform a tilt table test if you’ve fainted. They will ask you to lie on a table that moves from a horizontal to a vertical position. As the table moves, they will monitor your heart, blood pressure, and oxygen level. The results can help them determine whether your fainting was caused by heart disease or another condition.

CT scan

A computed tomography (CT) scan uses multiple X-ray images to create a cross-sectional image of your heart. Your doctor may use different types of CT scans to diagnose heart disease. For example, they may use a calcium score screening heart scan to check for calcium deposits in your coronary arteries. Or they may use coronary CT angiography to check for fat or calcium deposits in your arteries.

Heart MRI

In magnetic resonance imaging (MRI), large magnets and radio waves create images of the inside of your body. During a heart MRI, a technician creates images of your blood vessels and heart while it’s beating. After the test, your doctor can use the images to diagnose many conditions, such as heart muscle diseases and coronary artery disease.

Invasive tests to diagnose heart disease

Sometimes noninvasive tests don’t provide enough answers. Your doctor may need to use an invasive procedure to diagnose heart disease. Invasive procedures involve tools that physically enter the body, such as a needle, tube, or scope.

Coronary angiography and cardiac catheterization

During cardiac catheterization, your doctor inserts a long flexible tube through a blood vessel in your groin or other part of your body. Then they move this tube toward your heart. Your doctor can use it to conduct tests to check for blood vessel problems and heart abnormalities.

For example, your doctor may complete a coronary angiography with catheterization. They will inject a special dye into the blood vessels of your heart. Then they will use an X-ray machine to look at your coronary arteries. They can use this test to look for narrowed or blocked arteries.

Electrophysiology study

If you have abnormal heart rhythms, your doctor may conduct an electrophysiology study to determine the cause and best treatment plan. During this test, your doctor feeds an electrode catheter through your blood vessel to your heart. They use this electrode to send electric signals to your heart and create a map of its electrical activity.

Your doctor may try to restore your natural heart rhythm by prescribing medications or other treatments.

When to see your doctor

If you suspect you may have heart disease, make an appointment with your doctor. Factors that put you at a higher risk for heart disease include:

  • family history of heart disease
  • history of smoking
  • obesity
  • poor diet
  • age    

Your doctor may perform a physical examination, order blood tests, or use other tests to check for problems with your heart or blood vessels. These tests can help them diagnose heart disease and develop a treatment plan.

Complications of heart disease include heart attack and stroke. You can reduce the risk of complications with early diagnosis and treatment. Talk with your doctor if you have any concerns. They will teach you how to identify symptoms of heart disease and maintain a healthy heart.

Content licensed from:

Written by: Valencia Higuera
Medically reviewed on: May 06, 2016: Debra Sullivan, PhD, MSN, RN, CNE, COI

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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