Tests for heart problems

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If you have problems with your heart, several different tests can help to reveal what is causing them.

ECG (electrocardiogram)

This is the simplest test you can have. It records your heart's activity while you're resting. Many people have an ECG for one reason or another at their general practice, in a heart clinic or in hospital. It's also called a heart tracing.

An ECG is quick and painless – it takes about 20 minutes. A technician or nurse attaches sensors (electrodes) to your chest, arms and legs to record your heart activity. This is then printed as a graph that a doctor analyses.

Exercise stress test

This is also sometimes called an exercise tolerance test. You'll be linked to an ECG machine, which takes a continuous recording while you do increasing exercise, usually on a treadmill.

Holter monitor

A Holter monitor continuously records your heartbeat and rhythm over time (usually 24 hours). It shows how your heart reacts to your normal daily activities, not just while you're resting. It's simple and painless.

For this test, electrodes are placed on your chest to send your heart signals to a small, portable recorder. You wear this for 24 hours. You're also given a diary to record your activities and any symptoms you have.

You return the recorder and diary the next day and a doctor analyses the results.

You cannot have a bath or shower while you're wearing a Holter monitor.

24-hour blood pressure monitor

Everyone's blood pressure changes during the day. Sometimes it can be useful to see how your blood pressure changes.

This is a 24-hour test. A blood pressure monitor is put on your arm. This includes a cuff that inflates every 15 minutes during the day and every 30 minutes while you're sleeping, so you need to wear loose sleeves. You're also given a diary to record your activities and any symptoms you have.

You return the monitor and diary the next day and a doctor analyses the results.

Echo tests (echocardiograms)

Echocardiogram tests use ultrasound waves to produce a live picture of your heart (similar to how ultrasound waves show images of a baby inside its mother's womb). An ultrasound probe is held against your chest to show the shape of your heart, how it's beating and how its valves are working.

A dobutamine stress echocardiogram test is like an echocardiogram test but uses a drug to make your heart beat more forcefully, as it does when you exercise.

A transoesophageal echocardiogram test (TOE) is an echocardiogram test in which the probe is put down your oesophagus (gullet) to view your heart from a different angle. You'll be sedated if you have this test.

Angiogram

An angiogram looks at the blood vessels in your heart to check for any blockages or narrowed arteries that could cause angina or a heart attack.

Coronary angiography involves having a small tube inserted into an artery and threaded through to the blood vessels of your heart. A special dye is injected through the tube. Special X-ray pictures are then taken to show the blood vessels.

Electrophysiology study

This is a test that looks at the electrical circuits in your heart.

Fine tubes (electrode catheters) are fed into a blood vessel, usually in your groin. They're then gently moved into your heart, where they stimulate your heart and record its electrical activity.

CT angiogram

This is a special X-ray of your heart using a CT scanner. It can look for narrowing or blockages in the blood vessels of your heart (coronary arteries).

CT calcium score (coronary artery calcium score)

A CT calcium score test uses a CT scan to measure calcium deposits in the walls of the blood vessels (arteries) of your heart and calculate a calcium score. The more calcium in your coronary arteries, the higher your risk of heart disease.

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