What are some of the tests that may be performed to evaluate my condition?

stress tests

Blood test

Various blood tests provide information about your kidneys, liver, thyroid, blood cell count, electrolytes, and blood cholesterol. Your physician will review blood test results you had in the past and determine if any additional testing is required. A blood test called Brain Natriuretic Peptide or “BNP” may be performed to help determine the presence of heart failure. This blood test measures a hormone secreted from the lower chambers of your heart and can help monitor for worsening heart failure over time.

Electrocardiogram (ECG or EKG)

10 electrode patches are applied to the legs, arms, and chest and attached to a machine that records the heart's electric signals. The EKG machine reads and prints your heart rhythm, which can help your physician diagnose different causes of heart failure.


Echocardiograms are heart exams that use high frequency sound waves (ultrasound) to produce a real-time image of the motion of the heart valves and heart chambers. The same ultrasound technology is used to examine fetuses in the womb. Echocardiography is a low risk procedure, and can generally be performed with minimal discomfort. The echocardiogram is the most important test for making the diagnosis of heart failure and determining your response to treatments. This test tells your doctor how much blood your heart pumps out (ejects) or how well your heart is pumping. Often, you will hear this measurement referred to as your ejection fraction or “EF”.

Stress Tests

Exercise Stress Test (also referred to as Treadmill Test or Regular Exercise Test or Exercise Cardiac Stress Test):

During this test you will be connected to a heart monitor while walking on a treadmill. Information about your heart function is gathered through measurement of your heart rate, breathing, blood pressure and heart rhythm findings as well as how tired you become when exercising. This test can help diagnose coronary artery disease, provide information about symptoms such as chest pain, and determine a safe level of exercise.

Exercise Perfusion Stress Test (Exercise Thallium Stress Test):

An exercise perfusion stress test is similar to an exercise stress test, except a perfusion test measures blood flow to your heart using small amounts of radioactive tracers. These tracers are safe and help provide an image of the blood flow to your heart during exercise (walking on a treadmill or pedaling on a stationary bicycle) and while at rest.

Stress Nuclear Perfusion Test (also called a Nuclear Stress Test):

Like an Exercise Thallium Stress Test, this test also uses special pictures of the heart to measure blood flow at rest and under stress. While an exercise perfusion stress test uses a treadmill or a stationary bicycle to stress your heart, this nuclear perfusion test stresses the heart with medication. The exercise response is achieved by giving you an intravenous drug to raise your heart rate, which mimics an exercise response. Once the target heart rate is achieved, a small dose of radioactive tracer (thallium or technetium) is injected to create the pictures.

Stress Echocardiography (also referred to as a Dobutamine Stress Echocardiogram):

An echocardiogram ultrasound of your heart is performed at rest and with exercise. If you cannot exercise, an infusion of a medication through an intravenous (IV) line may be used to mimic exercise. You are closely monitored during this test while information is obtained about your heart chambers and heart valve functioning.

Cardiopulmonary exercise test

A Cardiopulmonary Exercise Stress Test (CPX) determines how well your heart, lungs, and muscles respond to increasing levels of exercise. This test will tell your physician if you have a normal or abnormal response to exercise. Furthermore, this test can help your physician determine why you cannot tolerate higher levels of activity or exercise and to facilitate recommendations for a more tailored exercise program.

Sleep study/Polysomnogram

A sleep study, or polysomnogram, is a painless test administered during sleep and records multiple body functions including brain waves, eye movement, respiration, oxygen level in the blood, and audio emissions (snoring or other sounds during sleep). A polysomnogram is an over night test where you are monitored in a sleep lab by a sleep technologist.

Coronary Angiogram

A cardiac catheterization is a commonly performed procedure that looks for narrowing or blockages in the heart blood vessels (arteries). This test also offers information about the inside heart chamber size, outside heart size, heart pumping ability, and how well the valves open and close. A small flexible tube (catheter) is inserted into an arm or leg blood vessel and gently advanced to the heart. Blood pressure measurements are taken and several X-ray pictures (angiograms) are recorded using digital imaging and/or 35mm film.

Heart PET Scan

Positron Emission Tomography (PET) scans show the chemical functioning of organs and tissues while other imaging techniques [such as X-ray, MRI and CT scans] show structure. This difference is what makes PET technology particularly useful for the detection of coronary artery disease (blockages of blood vessels to the heart). PET permits evaluation of myocardial perfusion (blood flow to the heart) and metabolism with superior accuracy. The results help your physician identify the extent of heart disease and decide if treatment for blockages of blood vessels is needed. The most common use of PET imaging in cardiology is to identify heart muscle weakened, but not irreversibly damaged, by blocked vessels.

Cardiac Magnetic Resonance Imaging (Cardiac MRI)

MRI uses a large magnet and radiofrequency waves to produce high quality images of the heart. It is a non-invasive test that does not use ionizing radiation (X-rays) or iodinated contrast agents.

MRIs allow physicians to obtain detailed pictures of the heart and blood vessels which are reconstructed to provide live, moving images of the beating heart from different angles. MRI provides accurate recreations of heart chamber size, valve function, and may help detect the presence of congenital heart disease, coronary artery disease, and aortic disease. MRI image quality is unparalleled.

CT Coronary Angiography (CTA)

CT coronary angiography (CTA) is a newly developed technique for non-invasive evaluation of coronary artery disease. CT scan is an X-ray procedure which, combined with iodine-based contrast agents, generates cross sectional views of the heart and coronary arteries. The Emory Cardiac Imaging Center uses a state of the art multi-detector CT system to acquire high-resolution images of the heart and great vessels. This advanced technology is being used more and more to identify calcified and non-calcified plaques in the coronary arteries or to exclude the possibility of stenosis (narrowing) due to atherosclerosis. Early stages of coronary atherosclerosis can be detected before the development of coronary arterial narrowing.

Chest X-Ray

A small dose of radiation is used to create a chest X-ray which is a photograph-like image, or black and white picture, of the heart and lungs. Chest X-rays are performed to identify abnormalities of the heart, lungs, bones, or blood vessels in the chest. Common symptoms requiring a chest X-ray include:

  • Bad or persistent cough
  • Chest pain
  • Chest injury
  • Coughing up blood
  • Fever
  • Shortness of breath
  • Falls

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