Cardiac Diagnostic Tests
Because the electrical system of the heart is complex, cardiologists or heart rhythm experts who use special testing equipment are required to diagnose abnormal heart rhythm (arrhythmias). To unearth the problem, the physician will ask about symptoms. obtain a medical history, give a thorough physical exam, and order the following specific tests:
- Electrocardiogram (ECG/EKG)
Electrodes from a ECG machine are attached to sticky patches that are placed on the arms, legs, and chest in order to record the electrical signals that generate heart rhythms. - Echocardiogram
An imaging machine that contains a microphone-like attachment probe is able to generate a videotaped image of the heart, showing the valves, four heart chambers, and heart movements. - Holter Monitoring
In order to detect abnormal heart rhythms, patients wear a small recorder, with 5 -7 electrodes attached to their chest for 24 – 48 hours. - Loop Event Recorder
Patients can carry an event recording machine to make a one to two-minute recording of a heart rhythm when their symptoms occur. About the size of a deck of cards, the recorder is very helpful for patients with who have sporadic or short-lived or symptoms. - Tilt Table Test
A tilt table test is used to uncover why fainting, or temporary passing out (syncope) occurs. Blood pressure and heart rhythm are monitored while the patient rests on a special table. The table then tilts the patient upright at a 75 degree angle for approximately 40 minutes. If the patient faints, it likely means that the patient has a non-life threatening condition called vasovagal fainting. - Electrophysiology Study (EPS)
In a hospital setting, thin catheters are placed into a vein in the groin or neck area and guided into the heart to record its electrical signals under X-ray guidance. An electrophysiologist (EP; a heart rhythm specialist), studies the flow and speed of those signals to pinpoint areas in the heart that is causing rhythm problems. An EP study can diagnose potentially life-threatening fast and slow heart rates. - Cardiac Catheterization
In a hospital setting, thin catheters are placed into an artery in the groin area and guided into the heart under X-ray guidance. Special heart catheters can confirm heart valve disease, gather tissue samples of damaged heart muscle, show heart blood vessel blockage and measure the pressure in the heart.
Diagnosis Difficulties
Since arrhythmias can be sporadic, they may not show up during a test. Sometimes either the heart needs to be monitored over time over specialists may need to induce the abnormal heart rhythms in a safe environment to unearth the problem.
Some arrhythmias are caused by other factors unrelated to the heart. Metabolic diseases, medications, the environment, stress and diet can all cause abnormal heart rhythms in otherwise normal healthy people. Specialists will take all of these factors into account when they choose the test to uncover the true cause of an arrhythmia.
