Introduction to Diagnosis of Heart and Blood Vessel Disorders

Sometimes, medical history and physical examination alone suggest to a doctor that the person has a heart or blood vessel disorder. However, special diagnostic procedures are often needed to confirm the diagnosis, determine the extent and severity of the disease, and help plan treatment.

Diagnostic procedures can be

• Noninvasive

• Minimally invasive

Noninvasive tests do not require an incision or a needle puncture other than sometimes a blood draw or a standard short intravenous (IV) catheter placed into a vein in the arm. These tests include

• Computed tomography (CT)

• Electrocardiography (ECG)

• Magnetic resonance imaging (MRI)

• Positron emission tomography (PET)

• Radionuclide imaging

• Stress testing

• Tilt table testing

• Ultrasonography (including echocardiography)

• X-rays

Fluoroscopy (a procedure that uses continuous x-rays) is used infrequently. Blood tests to measure levels of sugar (to test for diabetes), cholesterol, and other substances are often done to look for disorders that can cause heart disease.

Minimally invasive testing typically requires a long flexible catheter, which is inserted into a blood vessel in the wrist, neck or thigh and advanced inside of the blood vessel to the heart. These tests include

• Angiography

• Cardiac catheterization

• Central venous catheterization

• Electrophysiologic testing

Most of these procedures carry very small risk, but the risk increases with the complexity of the procedure, the severity of the heart disorder, and the severity of any other medical conditions the person has.

Sometimes treatments can be given during certain minimally invasive diagnostic tests. For example, percutaneous coronary intervention for people with coronary artery disease may be done during cardiac catheterization and radiofrequency ablation for people with abnormal heart rhythms may be done during electrophysiologic testing.