If you have been experiencing issues with your heart, your provider will ask you for your medical history. They will also assess your risk factors, which may include high blood pressure, diabetes or coronary artery disease.
Your provider can use a variety of cardiac imaging tests to diagnose heart failure.
Coronary angiography, also called a coronary angiogram, is a test that checks your coronary arteries to see if there are any narrow or blocked areas.
A coronary angiogram is performed in the cardiac catheterization lab. You will receive sedation to help you relax. Depending on your health and the reason for your test, you may be awake or you may receive general anesthesia so that you’re completely asleep.
Your provider makes a small incision in your groin or wrist. A catheter is then inserted into the incision. This flexible tube is guided to the heart, then a special dye is released from the tube. The contrast dye spreads through your heart and blood vessels. X-ray pictures then highlight blocked arteries causing your symptoms.
If you have a blockage, your doctor may choose to treat it right away. This may be done by inflating a balloon on the end of the catheter to expand the artery and remove the blockage. During this procedure, known as angioplasty, a mesh tube called a stent is often placed to help the artery stay open.
Depending on your condition, you might be able to go home the same day as your coronary angiogram, or you might need to stay in the hospital longer.
A chest X-ray takes pictures of your heart, lungs and arteries. It can reveal signs of heart disease, such as enlarged areas or calcium deposits in your heart and fluid in your lungs.
An echocardiogram (echo) records activity of the heart using high-frequency sound waves, or ultrasound. A technologist called a sonographer conducts this test by applying gel to your chest that makes it easier for sound waves to reach your heart. The sonographer will then wave a transducer across your chest to send sound waves to your heart. The echo created by those waves is translated into images of your heart as it beats.
An electrocardiogram (EKG or ECG) provides information about your heart’s electrical activity. It can help your provider understand your heart rate and whether you have an arrhythmia, or irregular heartbeat. As another option, your provider might ask you to wear a monitor for a day or two to record how well your heart’s circuitry is working.
Cardiopulmonary exercise testing (CPET) measures how well your heart, lungs and muscles work together during exercise. It helps doctors understand how your body responds to physical activity and can help diagnose heart failure. Cardiopulmonary exercise testing can guide doctors in deciding if advanced treatments – like ventricular assist devices or heart transplant – are right for you.
During the test, you will:
- Wear a mask – This measures how much oxygen you take in and how much carbon dioxide you breathe out.
- Be hooked up to heart monitors – Small sticky patches (electrodes) are placed on your chest to track your heart’s electrical activity.
- Exercise on a treadmill or bike – The intensity gradually increases while your breathing and heart rate are monitored.
Also called a heart biopsy or cardiac biopsy, myocardial biopsy is a medical procedure in which a small piece of heart muscle tissue is removed and examined under a microscope. It helps doctors diagnose certain heart conditions, such as inflammation (myocarditis), rejection after a heart transplant, or rare heart diseases like amyloidosis.
A local anesthetic is applied to numb the area where the catheter (a thin tube) will be inserted — usually in the neck (jugular vein) or groin (femoral vein). Your doctor will then insert a small tube (catheter) into the vein and guide it toward your heart using X-ray or ultrasound imaging. A special tool called a bioptome (tiny forceps at the tip of the catheter) is used to snip small samples of heart muscle.
A heart biopsy is generally an outpatient procedure, and you can go home the same day.
Magnetic resonance imaging (MRI) captures highly detailed images of the muscles, organs, soft tissues and other structures inside your body, including the heart.
During this test, you’ll lie on a table that slides inside the MRI machine. As you lie in the MRI machine, magnets and radio waves create images of your heart and arteries, showing how efficiently the heart pumps blood. In some cases, you may receive contrast dye during the exam.
An MRI test is an outpatient procedure. In most cases, an MRI takes between 30 minutes and an hour. You can return home after your test is complete.
