Learn about the most important cardiac screening tests for those being evaluated for heart disease One common question that I‘m asked by those concerned about their risk for heart disease is, what heart function tests should be included in a good preventive and diagnostic cardiac screening? From all the options available in the massive cardiologist toolbox to assess basic heart function, these are the tests I recommend: Electrocardiogram (EKG) Echocardiogram Exercise/Nuclear Stress Test Holter Monitoring BNP Test Electrocardiogram (EKG) An electrocardiogram or EKG (kardio in German, hence the “EKG” shorthand) should be done on everyone on their first visit to a cardiologist. An EKG establishes baseline information about the structure of your heart, its electrical conduction patterns, and possible arrhythmias. The “12 lead” EKG measures the electric potential of your heart from 12 different directions. A resting EKG gives us information about the heart‘s conduction system, including current baseline heart rate and rhythm, and possible heart blocks. Voltage measurements (signal strength) indicate relative chamber sizes. An EKG also shows things like heart position and signs of possible ischemia (poor oxygen delivery). A record of your EKG when you are healthy is a good baseline for comparison, but resting EKGs have limitations. We can miss problems that might be more evident when your heart is beating faster—hence the need for further testing when your heart rate is elevated during exercise (see Exercise/Nuclear Stress Test below). Back to Top Echocardiogram An echocardiogram or “echo” is a noninvasive ultrasound of the heart that records specific geographical areas of the beating heart, revealing blood flow patterns, and allowing us to measure size and wall thickness of the heart‘s chambers. We can get a good sense of where valves may be too loose and leaky, or too tight and restrictive. In addition, an echo can detect possible enlargement of the heart as well as potential presence of fluid around the heart. Your echocardiogram results are replayed on a video for a specially trained physician to review and interpret. Still images are printed in the report. I use the echo to get a dynamic picture of how the heart is functioning as a pump. It also provides information on ejection fraction —the percentage of blood that is moving out of your heart on each heartbeat—an overall indicator of heart health. With a stress echocardiogram, the images are taken at rest and then compared to images taken immediately after exercise. In short, this test combines the diagnostic benefits of real-time ultrasound images and the exercise stress test. Blood flow to specific regions of the heart muscle can be inferred from how well the heart wall is moving in that area.
Posted on: Thu, 21 Nov 2013 21:48:13 +0000