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Heart Disease Center

Heart Disease Diagnosis

Several combined symptoms of heart disease can help make a diagnosis certain. Many people, unfortunately, do not know they are experiencing coronary heart disease until they notice symptoms of angina (temporary chest pain or discomfort usually occurring during exertion or emotional stress) or have a heart attack. Some doctors who specialize in heart problems and that may be involved in the diagnosis, treatment or ongoing care of heart disease include:

  • Cardiac Surgeons
  • Cardiologists
  • Cardiovascular Disease Physicians
  • Family Practice Physicians
  • General Practice Physicians
  • Internal Medicine Physicians

Medical history
Doctors begin to identify symptoms by interviewing the person to obtain the medical history. Some information you may be required to present will be about your past health and medical history as well as possible risk factors for heart disease. You might also be also to outline medications you are taking, symptoms or warning signals you had before your heart attack or stroke, your family history of stroke or heart disease (if any).

Medical exams
A medical history is followed by the doctor performing a physical examination. An initial physical exam may include:

  • assessing breathing
  • checking for edema, especially of the legs
  • listening to the abdomen
  • listening to the heart
  • looking in the eyes
  • observing how you look, act and respond
  • taking blood pressure
  • taking pulse

Several tests are usually conducted to diagnose possible heart disease. The choice of which (and the number of) tests to perform depends on several variables. These include:

  • current symptoms
  • history of heart problems
  • individual risk factors
  • the doctor's interpretation of these factors

If your doctor suspects that you may have coronary heart disease or coronary heart disease symptoms, or is assessing your risk of possibly developing the disease, he or she will arrange a number of tests. People being evaluated for possible heart disease primarily are usually given simple tests first. Then more complicated ones may follow, if needed. Specific tests are dependent on the patient's particular problem(s) and the results of the physician's assessment. Tests to diagnose heart disease include:

  • Angiography

  • Blood tests - depending upon what diagnosis a doctor suspects, any of the following may be tested:

    • blood calcium levels
    • blood cholesterol levels
    • blood clotting factors and components
    • blood flow through the vessels
    • blood sugar (glucose) level
  • Cardiac catheterization
  • Chest x-ray
  • Doppler ultrasound
  • Echocardiogram electrocardiogram (ECG/EKG)
  • Electrophysiology studies
  • Exercise electrocardiogram (stress test)

    • ABP-Holter for blood pressure
    • ECG-Holter continuous 24 hours ECG, usually for rhythm monitoring

  • Thallium or cardiolite scan - These tests use radioactive tracer to see how much blood is reaching different parts of your heart and are performed to determine the size and location of injured muscle after a heart attack and will help your doctor find out more about the heart's cells and its blood supply.
  • Tilt table exam - This exam is especially useful if you have been fainting without any explanation and analyze how body posture affects blood pressure. The goal is to find out if different drugs or different body positions will initiate an arrhythmia (abnormal heartbeat) or symptoms.
  • Holter or event monitoring - doctors use two types of holter monitoring:
  • Transesophogeal echocardiogram (TEE) - This is a special type of echocardiogram that uses high-frequency sound waves (ultrasound) to examine the structures of the heart. TEE is performed to view the heart more closely to see if it could be producing blood clots.

Once a diagnosis of heart disease is determined, you can begin appropriate treatment.  Treatment of heart disease focuses on correcting or managing the disease in order to allow you to continue to participate in daily activities at an optimal level. Read the following section to learn about the most common forms of treatment for heart disease here.

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