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Which Tests Diagnose Heart Problems?

What can EKGs, stress tests, and other diagnostic tests tell you about your heart?

By
Rob Lamberts, MD,
March 2, 2010
Episode #037

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The previous two articles have covered how to tell if chest pain is serious and what exactly causes a heart attack.  This final article will explain common tests used to diagnose problems with the heart.

What is an EKG?

The first test I’ll discuss is the electrocardiogram, or EKG.  EKG’s can be used to diagnose a heart attack (past or present), abnormal heart rhythms, and other things that can go wrong with the heart.

How Does an EKG Work?

The heart has special cells that act like wires to tell the heart when to beat and make sure it does so in the right rhythm.  An EKG looks at that electrical flow through the heart as it beats.  During an EKG, electrical sensors are placed across the chest and on the arms and legs. These sensors pick up the electrical flow and can tell if the heart’s electrical flow is messed up.

What Does an Abnormal EKG Mean?

An abnormal EKG means one of three things:

  1. Something happened to the heart in the past.

  2. Something is happening to the heart right now.

  3. Nothing is wrong; the person just has abnormal electrical flow in the heart to begin with.

That last point underlines how tough it is to read EKG’s; it takes a lot of experience to properly interpret one. EKGs provide the most information when a person has an old one to use for comparison.

What Does a Normal EKG Mean?

A normal EKG, on the other hand, does not mean:

  1. There’s nothing wrong with the heart because the test can miss lots.

  2. Nothing bad is going to happen.

An abnormal EKG is far more telling than a normal one. 

Doctors use EKGs a lot because they’re cheap and very easy.  But further testing needs to be done if you want more information about what’s going on with the heart.

What Is a Stress Test?

The most common test chosen after the EKG is the stress test.  A standard stress test consists of an EKG done while the heart is beating hard.  The easiest way to do this is to put the person on a treadmill (although other things can be used to increase the heart as well, such as medications, watching congressional hearings, or having a person’s spouse say: “we need to talk.”).

To make them even more accurate, sometimes a dye is injected that shows blood flow in the heart.

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