What tests are done for heart disease?

Pulse

• Purpose: Assess heart rate, rhythm, and strength
• Method: Palpation of peripheral pulses (e.g. radial, carotid)
• Normal range: 60-100 beats per minute (bpm) at rest

Taking a radial pulse

• Definition: Pressure within blood vessels as the heart contracts and relaxes
• Measurement: Recorded as systolic (higher) and diastolic (lower) pressures
• Normal range: Approximately 100/70 to 135/85 mmHg
• Variability: Fluctuates throughout the day; can be affected by activity, stress, and the ‘white coat effect’
• Monitoring: May involve 24-hour ambulatory monitoring (at home).

Electrocardiogram (ECG)

• Purpose: Record electrical activity of the heart
• Method: Non-invasive, painless test with electrodes placed on the chest
• Duration: Approximately 5-10 minutes.

• Purpose: Monitors cardiac activity over 24 hours
• Method: Wearable device with electrodes attached to a belt
• Use: Records abnormalities and symptoms during daily activities.

• Purpose: Assess cardiac function during exercise
• Method: ECG recording while walking on a treadmill
• Use: Evaluates heart response to physical stress.

Echocardiogram

• Purpose: Ultrasound scan of the heart
• Method: Transducer placed on the chest with gel
• Use: Assesses heart size, muscle contraction, valve function, and blood flow.

• Purpose: Evaluate heart size and detect chest disorders
• Method: Standard radiographic imaging
• Use: Provides information on heart size, shape, and lung abnormalities.

• Purpose: Detailed imaging of heart structure and blood vessels
• Method: Painless scan using a magnetic field
• Use: Useful for assessing cardiac anatomy and blood supply.

• Purpose: Detailed 3D imaging of the heart
• Method: Specialised x-ray machine
• Use: Evaluates coronary arteries and cardiac structure (alternative to coronary angiogram).

• Purpose: Assess blood flow to the heart muscle
• Method: Injection of radioactive substance (thallium) and imaging with a special camera
• Use: Alternative to stress test; evaluates coronary artery disease.

• Purpose: Examine coronary arteries for disease
• Method: Insertion of catheter into a blood vessel, injection of contrast dye, and x-ray imaging
• Use: Diagnoses coronary artery disease, assesses narrowing or blockages.

• Purpose: Rule out underlying causes of cardiac symptoms, monitor medication
• Common tests:
  • Full Blood Count (FBC)
  • Urea and Electrolytes (U&Es)
  • Glucose
  • Liver and thyroid function tests
  • Troponin (for suspected myocardial infarction)
  • Cholesterol and lipid profile
  • Natriuretic peptides (e.g. BNP) for heart failure.

Tilt Test

• Purpose: Assess symptoms of light-headedness or dizziness
• Method: Monitor blood pressure and heart rate while lying down and standing up
• Use: Evaluates orthostatic intolerance (blood pressure falls too much on standing) and autonomic function.