Heart

It's time to get heart smart.
Heart

Heart Disease Symptoms & Diagnosis

Signs and Symptoms

Men may have chest pain or other discomfort such as:

  • Heaviness or a tightening pressure, squeezing, ache in the chest.
  • “Heartburn-like” discomfort in the front of the chest.
  • Pain that radiates to one or both arms. This may spread. Usually it goes to your jaw, throat or shoulders.
  • Breaking out in a sweat. Some may have nausea, vomiting, shortness of breath or dizziness.

Women may have some chest pain or discomfort such as:

  • Uncomfortable pressure. It may feel like a fullness, squeezing or pain in the chest. It usually lasts more than a few minutes. It may go away and come back.
  • Chest discomfort in the upper back between the shoulder blades. Pain may spread to the shoulders, neck or arms.
  • Heart pain may be felt in the stomach or abdomen.
  • Chest discomfort with other complaints such as shortness of breath, sweating or nausea, and feeling faint or lightheaded.
  • Being short of breath without chest pain. You may have unexplained weakness or fatigue. You may feel anxiety, unusual heart beats, cold sweat or be pale.

Diagnostic tests

Certain tests can determine the health of your heart while assessing any damage or disease. We offer the latest in diagnostic testing for measuring the electrical activity of your heart, measuring muscle or pumping function and identifying abnormalities or blockages in your arteries.

Often, your best chance of preventing or slowing the progress of heart disease depends on the accuracy of the initial diagnosis. Because of their special training, Heart Care doctors and staff are experts at interpreting test results.

Blood tests

After the heart muscle has been injured, heart enzymes and muscle proteins are released into the bloodstream. Confirmation of a heart attack and the extent of the damage can be determined when there are elevated levels of these enzymes and proteins in your blood. A series of blood samples may be needed for diagnosis. It may take up to 24 hours to determine if there are any changes in these blood levels.

Calcium scoring CT scan

A calcium scoring CT (computed tomography) scan shows calcium in the major arteries of the heart. This test does not use iodine contrast. The amount of calcium correlates with heart attack risk. Those without calcium build up have a very low risk of heart attack.

CT angiograms

CT angiograms are non-invasive scans to see the blood flow in the arteries in the heart. Iodine contrast is injected in a vein so that the scanner can see the arteries in the heart.

Echocardiogram

An echocardiogram uses sound waves to make pictures of your heart muscle, its valves and the pumping function of your heart. A special instrument called a "transducer" is held on the chest by a technologist. The transducer emits sound waves and uses their reflection to create and project a picture of your heart on a screen. A recording is made for the cardiologist to review at a later time. The test takes approximately 30 minutes.

Electrocardiogram (EKG/ECG)

For this test, electrodes are placed on the chest, arms and legs. This test may show signs of injury to the heart muscle and can help your doctor determine the location and extent of heart damage. It is our best initial test to evaluate irregular heart beat symptoms.

Electrophysiology (EP) studies

An electrophysiology study (EP) is our most accurate method of evaluating heart rhythms. This test may be prescribed if you have symptoms of palpitations, arrhythmia or abnormal heart beats.

During an EP study, a specially trained cardiologist called an electrophysiologist collects data on the flow of electricity in your heart. EP studies can help locate the specific areas of heart tissue that give rise to abnormal electrical impulses that cause arrhythmias. This detailed information allows the cardiac specialist to evaluate the abnormal heart beat to determine possible treatments.

Heart catheterizations and angiograms

Heart (cardiac) catheterization involves passing a thin, flexible tube called a catheter through an artery or a vein to the heart and its associated structures. This procedure may also include making images or "angiograms" of the coronary arteries by injecting iodine contrast into the arteries. This procedure gathers information about blockages in the arteries and is often recommended when you have an artery that is partially or completely blocked.

Cardiac catheterizations are also used to gather samples of heart muscle that may be damaged, aid in the diagnosis of heart valve disease, or measure blood pressure and oxygen samples on the heart and arteries of the lungs.

Holter monitoring

A small electronic recorder is used to record your heart's rhythm while you continue your normal at-home or at-work activities. The monitoring will take 24 hours, during which time you will be asked to keep a diary of your activities and symptoms.

Ambulatory Cardiac Telemetry (ACT) monitoring

An ACT monitor provides continuous monitoring of heart rate and rhythm and automatically captures an arrhythmia when it occurs. The ACT monitor provides critical ECG information by capturing the onset and termination/escape of an arrhythmia to assist in correctly identifying and treating the concerns. You are monitored for up to 30 days depending on your doctor's preference.

 

Nuclear studies

For nuclear studies, a tracer (a small amount of radioactive material) is given through a vein in your arm. A camera scans the tracer as it flows through your heart. Areas of the heart muscle that have good blood flow pick up the tracer material quickly, while areas that have less blood flow do not. The test takes approximately three to four hours and can also be used with stress testing (below).

Stress testing

A stress test measures your heart's function during physical activity. It shows the changes in the electrical system of the heart during physical stress. These changes often do not show up on a resting electrocardiogram alone. Your heart rate and EKG will be monitored continuously throughout the test, and your blood pressure will be checked at specific times.

Depending on your physical ability, the test may be done while you walk on a treadmill - your doctor may choose to give you a drug that simulates exercise by dilating the arteries of your heart.

Types of stress tests:

  • Exercise or treadmill - This test is done on a motorized treadmill. The belt will start moving slowly and the walking surface will be flat. At intervals, the slope and speed of the treadmill will gradually increase until you reach an appropriate heart rate for your age and fitness level. The test is over when you reach a predetermined heart rate or signs of significant EKG changes are noted.
  • Drug induced stress tests - This test, done while you are lying down, is usually prescribed for those who are unable to do an exercise stress test. Lexiscan or dobutamine are medications given through an IV while you are resting. These medications allow the heart team to evaluate your heart's condition without exercise.
  • Nuclear stress test - When a nuclear scan is ordered along with the stress test, an intravenous (IV) line is started prior to the test. A small amount of a radioactive material is injected through the IV, allowing pictures of your heart to be taken with a scanner. These images show how much blood is getting to all areas of the heart muscle, both at rest and during exercise. This will help the doctor determine if there are any blockages in the blood vessels that supply blood to your heart. This procedure takes three to four hours. The radioactive material is easily eliminated through the urine and stool. If you are flying in the next week, the technician will give you a card for the TSA screening process.

Tilt table studies

Fainting spells can occur when your body does not properly regulate it’s blood pressure. To help diagnose the cause and treat fainting spells we offer a non-invasive test called a title table study.

During the test, you  will be secured to a special table called a "tilt table." You will begin the test lying flat for approximately 20 to 30 minutes. The tilt bed will then change to an almost vertical position for another 20 to 30 minutes. You may feel dizzy, lightheaded, nauseous or even faint. It is important to let the staff know how you are feeling during the test. You will then be returned to a horizontal position and monitored for another 20 to 30 minutes. Your doctor may decide to give you some IV medication as part of your test. You may feel your heart pounding. Your test may last up to 2 to 3 hours.