Cardiac Testing

Woman taking cardiac stress test.jpg

Types of Cardiac Tests

If you have or are at risk for a heart condition, proper heart or cardiac testing allows your cardiologist to make an accurate diagnosis. This is the first step towards a great recovery. Your personalized heart care will often start with one or more of the cardiac tests listed below. Testing options may vary by UnityPoint Health location.

  • Heart Imaging Studies - Heart imaging studies capture detailed images of your heart and the structures inside it.
  • Cardiac magnetic resonance imaging (MRI) - A large magnet, radio waves and a computer capture detailed, 3D images of the heart. An MRI can check your heart structures and function. It enables us to spot diseased tissue, including damage from a heart attack.
  • Computed tomography (CT) angiogram - A CT angiogram takes X-ray images of your heart from different angles. Then special technology processes them to form 3D images of the heart. This study helps doctors examine blood vessels, including narrowing and potential blockages.
  • Echocardiogram - An echocardiogram uses soundwaves (ultrasound) to produce real-time images of the heart's muscles and other structures. We use echocardiograms to evaluate problems such as shortness of breath, possible heart attack, valve issues and more.
  • Electrocardiogram (EKG) - An EKG records electrical signals that trigger movement throughout the heart. We use EKGs to diagnose many heart problems, including arrhythmias, heart valve issues and coronary artery disease. If we suspect a heart attack, this may be one of the first tests you receive.
  • Transesophageal echocardiogram (TEE) - TEE provides more information than a standard echocardiogram, including the force of blood flow through different areas of the heart. Typically, a thin ultrasound device is slid down your throat, past the esophagus and near the heart. Medications to numb your throat help you relax during this procedure.
  • Cardiac Catheterization - Doctors insert a thin, flexible tube (catheter) through a small incision in your groin or wrist. They then guide the catheter through a blood vessel to access the heart. Instruments at the catheter's tip show us your heart in detail. You may receive light sedation (medication), so you are awake but comfortable, or medication to put you to sleep during your procedure. We also use cardiac catheterization to deliver certain treatments.
  • Coronary angiogram - Doctors inject a liquid dye through the catheter and capture images as the dye travels through your heart. This test evaluates artery narrowing, measures your heart's structures and assesses its pumping ability.

Arrhythmia Testing

You may need arrhythmia testing if you have signs of a heart rhythm disorder (arrhythmia). We offer a variety of options, including:

  • Electrophysiology (EP) study - This test assesses the heart's electrical activity, enabling doctors to confirm or rule out arrhythmia and pinpoint its source. Typically, a thin wire is guided through a small incision in your groin, up an artery and to the heart. Sensors at the wire's tip record electrical activity. You may receive medication from an anesthesiologist to put you to sleep. Or you may receive light sedation medications so you are slightly awake but comfortable during the procedure.
  • Holter monitor - A Holter monitor is a small, wearable device that continuously records heart activity. Your doctor may order Holter monitor testing if an EKG does not provide enough information to diagnose an arrhythmia accurately.
  • Loop or event recorder - These wearable devices are similar to Holter monitors. They can be useful in detecting arrhythmias that occur infrequently.
    • Event recorder: When you feel symptoms, you press a button, and the device records heart activity. The device transmits this information to your care team. If we detect a life-threatening problem, we contact you and coordinate emergency care.
    • Loop recorder: The device automatically records heart activity for as long as a few years.
  • Subcutaneous implantable cardioverter defibrillator (SubQ ICD) - An ICD is for people at risk for sudden, life-threatening arrhythmias. When the ICD detects an abnormal rhythm, it can shock your heart to correct the rhythm and prevent cardiac arrest. Traditional ICDs have leads (wires) that go into your heart. Surgeons implant the SubQ ICD under the skin, leaving your blood vessels and heart untouched.

Advanced Heart Imaging Scans (Nuclear Studies)

These tests use safe levels of a radioactive substance to capture cell activity that doctors can't detect using other methods. A nuclear imaging study makes it possible to assess tissue damage from a heart attack or measure how well your heart pumps blood. Options can include positron emission tomography (PET) and myocardial perfusion scans.

Other Cardiac Tests

Your care may include additional cardiac tests, such as:

  • Stress test - A stress test assesses how your heart works during physical activity. You walk at a comfortable pace on a treadmill while we watch your heart rhythm, blood pressure and breathing. These tests check for coronary artery disease and arrhythmias. They also guide treatments for other conditions.
  • Stress echocardiogram - For a stress echocardiogram, ultrasound images of your heart are taken before and after you walk on a treadmill. This test assesses signs of coronary artery disease that may only be noticeable during physical activity.