Your Physical Exam




The Cardiovascular Exam

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There are a number of tests used to diagnose the presence of heart and cardiovascular disease and determine its extent.  Your doctor will consider your symptoms, your medical and family history, your risk factors, and the results of a physical exam to determine which tests will be most appropriate. Here are some of the more common tests.

Angiography (Arteriography)
Angiography (or arteriography) is a procedure to x-ray blood vessels. Coronary angiography (or arteriography) is a test used to explore the coronary arteries. A fine tube (catheter) is put into a blood vessel and maneuvered into a coronary artery. Once the tube is at the heart, dye is injected through this tube. The heart and blood vessels are then filmed while the heart pumps. The picture that is seen, called an angiogram or arteriogram, will show problems such as a blockage caused by heart disease or other problems.

Cardiac catheterization is a test used to explore the coronary arteries, using a fine tube (catheter) that's put into an artery or vein of an arm or leg and maneuvered into the arteries of the heart. It can be used in the diagnosis of heart disease.

Chest x-ray
A chest x-ray takes a picture of your heart and lungs. Usually two views are taken - one from the front and one from the side. It can be used in the diagnosis of a variety of heart and lung problems.

Computed Axial Tomography (CAT) Scan
This procedure (also called computerized axial tomography, CT scan or CAT scan) uses x-rays and computer technology to produce cross-sectional or three-dimensional images of the body or head. It can be used in the diagnosis of different cancers, stroke or brain injury. Electron beam computed tomography (EBCT) is a type of CAT scan that can be used in the diagnosis of heart disease risk.

Duplex Doppler Ultrasound
This is a diagnostic imaging technique in which an image of an artery can be formed by bouncing sound waves off the moving blood in the artery and measuring the frequency changes of the echoes. It can be used to diagnose the presence of blood clots or blood flow problems in arteries or veins.

This test uses sound waves to create a picture of the heart. It works in much the same manner as the ultrasound test performed during pregnancy.  The picture is more detailed than an x-ray image. This test can be used in the diagnosis of a number of heart conditions including valve disorders, cardiomyopathy, congestive heart failure and heart attack.

Electrocardiogram (ECG or EKG) is a graphic record of the electrical activity of the heart as it contracts and rests. It can be used in the diagnosis of a number of heart conditions including arrhythmias, and heart attack.

Electron beam Computed Tomography (EBCT)
This test can be used to identify and measure calcium buildup in and around the coronary arteries. Calcium build-ups can indicate an increased risk of heart disease.

Event Monitor
An event monitor is a device used by a patient for a 30-day period, to provide an EKG recording of the heart's rhythm. It can be activated when the patient feels chest pain, dizziness or an irregular heartbeat coming on and can be used in the diagnosis of arrhythmias.

Functional Magnetic Resonance Imaging (fMRI)
This is a type of imaging that measures increases in blood flow within the brain. It can be used in the diagnosis of a number of brain disorders such as cancer and stroke

Holter Monitor
A Holter monitor is a device worn by a patient for a continuous period of time (usually 24-48 hours) to provide an EKG recording of the heart's rhythm during the time it is worn. It can be used in the diagnosis of arrhythmias.

Magnetic Resonance Angiography (MRA)
This is an imaging technique involving injection of a contrast dye into a blood vessel and using magnetic resonance techniques to create an image of the flowing blood through the vessel; it can be used in the diagnosis of heart disorders, stroke, blood vessel disorders and to detect stenosis of the brain arteries inside the skull.

Magnetic Resonance Imaging (MRI) Scan
This is a type of imaging involving the use of magnetic fields to look inside the body and head, and detect subtle changes in the water content of tissues. MRI can be used in the diagnosis of cancer, as well as to identify damage from a heart attack, diagnose certain congenital heart defects, evaluate blood vessel problems, and aid in the evaluation of stroke damage.

Nuclear Heart Scan
Nuclear heart scans (also called Radionuclide Imaging or Radionuclide Ventriculography) use radioactive tracers (such as technetium or thallium) to outline heart chambers and major blood vessels leading to and from the heart. A nuclear heart scan shows any damage to your heart muscle. It can be used in the diagnosis of heart disease, valve disorders or heart failure.

This is a device used to measure blood pressure. By using a special cuff wrapped around your arm, the sounds of your blood rushing through an artery can be heard through a stethoscope. Two readings are given - one when your heart is contracting, one when it's at rest.

Stress Test
A stress test is used to record the heartbeat during exercise. This helps a doctor determine how well your heart can handle work. The exercise can involve walking on a treadmill, or pedaling a stationary bicycle, or you may receive medicine to make your heart beat faster. When you take the stress test, you will be hooked up to a variety of monitors, so that EKG, blood pressure and other readings can be taken before, during, and/or after the procedure. This lets the doctor see how your heart responds to exercise, and also what level of exercise is appropriate for you. This test can be used in the diagnosis of heart disease.  It can also be used to help diagnose the cause of problems you may be having such as angina or chest pain.  It can help to predict your risk of dangerous heart-related conditions such as a heart attack.  If you already have had a heart attack or heart surgery, it can also help your doctor monitor your progress during cardiac rehabilitation.

Thallium stress test (nuclear stress test)
A thallium stress test (or nuclear stress test) shows the working of the heart muscle. A small amount of radioactive material is injected into a vein and a camera shows how well blood flows to the heart muscle. It's usually done in conjunction with an exercise stress test on a treadmill or bicycle.

Tilt Table Test
A tilt table test can be used to diagnose patients with unexplained fainting spells called syncope. During the test, heart rate, blood pressure or other measurements can be made while the patient lies on a table which is tilted so he or she can be monitored in different positions from lying down to standing upright.


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