Whether you’re cycling around Lake Harriet or cycling through your monthly to-do list, keeping an eye on your heart health should be an important part of your routine. And this is especially true as you age, if you’ve had a heart event (like a heart attack) in the past, or you have a family history of heart disease.
But how do you know how healthy your heart is? From routine screenings to more advanced assessments, there are several heart tests and heart screenings doctors use – some of which you’ve already experienced and others that may be in your future.
Regular check-ins and checkups with your primary care doctor or cardiologist are key to having the right tests at the right time. This can help you prevent heart disease, manage any chronic conditions, identify heart issues, and promote your overall health and well-being. But why and when are certain heart tests recommended? How do they work and what do they tell you?
Below we break down common heart tests and screenings, why they’re useful, when you need them and how to get started on next steps.
Blood pressure tests
More than likely, every time you visit the doctor an inflatable cuff is placed around your upper arm to measure your blood pressure. In fact, a blood pressure test is one of the most common medical tests performed. But why?
Maintaining a normal blood pressure range is key for heart health. Blood pressure tests, which record the pressure in your arteries as your heart pumps blood around your body, can help monitor heart health and identify issues such as high blood pressure.
High blood pressure, also called hypertension, can mean you’re at higher risk of heart attack, congestive heart failure, stroke, heart arrhythmias and other problems. Because high blood pressure usually doesn’t have any symptoms, it’s important to get your blood pressure checked proactively.
When should I get a blood pressure test?
Make sure you have your blood pressure checked at least once every year. If you’re 40 or older, African-American, overweight or you’ve had elevated blood pressure in the past, you may need to talk to your doctor about more regular testing.
Usually, getting a blood pressure test doesn’t require any extra work on your part. Remember: A nurse or other health care technician will typically get your blood pressure numbers every time you come in for an appointment. Taking your blood pressure is a typical part of many routine screenings and checks, just like recording your height and weight.
Blood tests for heart disease
While these tests may sound like they require a whole bunch of different techniques or specialists, they actually all begin with the same sample: your blood.
Blood tests and lipid panels measure a number of different indicators in your body that can point toward your heart health, plaque buildup and heart disease risk factors. Your doctor can use this information to recommend next steps in your care or treatment.
For example, blood tests and lipid panels can reveal your cholesterol levels, triglyceride levels, blood glucose and more. High levels of good cholesterol (HDL) generally mean good heart health, while high levels of bad cholesterol (LDL and VLDL) or triglycerides can indicate more heart disease risk. By getting these tests done regularly, you and your doctor will be more informed. That way, you can be more proactive.
When should I get a blood test?
Whether or not you need a blood test depends on many different factors, including your overall health, family history and other heart disease risk factors like diet, exercise habits, lifestyle and age. Your primary care doctor can help you determine what’s right for you.
In general, some organizations recommend that people aged 20 or older should have blood tests every 4-6 years, while the US Preventive Services Task Force recommends people between ages 40 and 75 have more regular tests.
You may also hear about some more specialized blood tests, like C-reactive protein (CRP) tests, which measure levels of inflammation in your body. These tests generally aren’t necessary unless you have other heart disease risk factors.
Calcium scoring tests
Calcium scoring? Is that where we rate our favorite kinds of dairy? Not quite.
Calcium scoring tests use highly accurate CT scans to check for small deposits of calcium in your coronary arteries. These deposits indicate plaque buildup that can lead to clogged arteries – and put you at increased risk for heart attack and heart disease. With the results from a calcium scoring test, you and your doctor may be able to care for your heart more proactively to prevent heart attacks and other problems.
Do I need a calcium scoring test?
Everyone is different, but generally, if you’re a man younger than 40 or a woman younger than 50, you probably don’t need this test. That’s because you likely don’t have much calcium in your arteries yet.
You’ll get the most benefit from a calcium scoring test if you’re at medium risk for heart disease, based on other health considerations like high blood pressure, high cholesterol, diabetes, family history and smoking. If you’re at low or high risk of heart disease, the results from a calcium scoring test probably won’t tell you or your doctor anything you don’t already know.
If you have questions about whether or not a calcium scoring test is right for you, your doctor can help you determine your personal heart disease risk level and whether or not calcium scoring from a cardiologist would be useful.
Electrocardiogram (EKG or ECG)
If you’re a fan of any medical TV shows or movies, you’ve probably noticed that patients often have a beeping monitor next to them. The monitor shows both their heart rate, and also displays squiggly lines in pointy peaks and valleys. This is a classic electrocardiogram test, also known as an EKG or an ECG.
An EKG shows your heart’s electrical activity, or how rapidly and effectively your heart is beating. By learning more about your heartbeat patterns, your doctor can detect heart rhythm problems (like arrhythmia) and assess how your heart is working.
Do I need an EKG test?
If you’re in good health and don’t have any symptoms of heart trouble, then an EKG test usually isn’t necessary. EKGs are typically used when further testing is indicated by risk factors or other heart tests. Your doctor will let you know what they recommend.
If you do need an EKG test, it usually only takes a few minutes spent right in your doctor’s office, or you’ll get an easy-to-use wearable device (with clear instructions) to take home.
Echocardiogram (echo test)
While this test is similarly named to the electrocardiogram, it’s not quite the same. An echocardiogram (echo test) is when your doctor uses ultrasound imaging to take pictures of your heart as it beats. Where an electrocardiogram records heartbeat patterns, an echocardiogram allows your doctor to watch those heartbeats happen.
Echocardiograms are typically used to diagnose heart trouble symptoms you report experiencing. They’re also used to check how your heart pumps blood and analyze how your heart valves are working.
Do I need an echocardiogram?
If you’re healthy and don’t have any heart disease symptoms or risk factors, then you probably don’t need an echocardiogram. Echocardiograms also aren’t usually done for certain heart diseases, like coronary artery disease or heart murmurs.
However, if you have – or your doctor suspects – valvular heart disease or heart failure, then echocardiogram testing may be performed. There are different types of echocardiogram tests, but your doctor can let you know which will be most beneficial for you.
Cardiac imaging tests
When you have a cut, a bump or a bruise that’s bothering you, your doctor can easily see what’s wrong and start to diagnose the situation. But for problems inside your body, like heart issues, cardiac imaging may be necessary for your doctor to get the full picture and begin treatment.
Different types of cardiac imaging tests include:
- Chest X-rays
- Cardiac CT scans
- Cardiac MRIs
- Angiograms
- Stress testing
All of these draw on different techniques and technologies to create images of your heart and blood vessels. Your doctor can then use these images to diagnose conditions such as chest pain (angina), look for signs of disease, check the structure and function of your heart, see how blood flows through your arteries, and determine what additional tests may be necessary.
Cardiac imaging tests are routinely used to check for coronary artery disease, valvular heart disease, heart failure, heart attack damage and other heart disease problems.
Do I need a cardiac imaging test?
Imaging tests are usually only performed when you report symptoms of heart trouble. If you feel healthy and don’t have any signs of heart disease, these tests probably aren’t needed. If your doctor thinks you need a cardiac imaging test, there isn’t usually any special preparation you need to do.
Cardiac stress test
When most of us think about stress, we typically want to reduce the amount we have in our lives. But for cardiac stress tests, stress is a good thing – and it can actually help improve your health and well-being.
A cardiac stress test is when your doctor looks at how your heart performs when it’s working hard, or “stressed” (hence the name). During a cardiac stress test, you’ll typically walk, jog or bicycle in a doctor’s office while heart measurements like blood pressure and heart rate are taken. Doctors use the results of cardiac stress tests to diagnose symptoms or examine how your heart’s performance changes under certain conditions.
There are different types of cardiac stress tests, including:
- Graded exercise tests (also known as GXT or treadmill tests)
- Stress echocardiograms
- MRI stress tests
- Nuclear stress tests using a special dye to further analyze your blood flow
If you can’t exercise, a cardiac stress test can still be performed using a drug that mimics the effects of exercise.
Do I need a cardiac stress test?
If you don’t show any signs or symptoms of heart problems, then a cardiac stress test probably isn’t for you. Typically, cardiac stress tests are used later in the diagnosis and treatment process after other testing has already been performed.
Electrophysiology testing and rhythm monitors
If your doctor suspects heart rhythm problems like atrial fibrillation or another arrhythmia, they may suggest an electrophysiology test or rhythm monitor. These help your doctor understand the electrical pathways of your heart as well as where within your heart an irregular heartbeat may be causing you trouble.
With the results from an electrophysiology or rhythm monitor test, your doctor can see how medication is working, or check whether a pacemaker or ICD (implantable cardioverter-defibrillator) is right for you.
Do I need an electrophysiology test or rhythm monitor?
Probably not – unless your doctor suspects that you may have a heart rhythm problem. Electrophysiology tests and rhythm monitors aren’t generally recommended for other heart disease conditions, or for people who are otherwise healthy.
Abdominal aortic aneurysm (AAA) screening
“AAA” doesn’t just have to do with roadside assistance for cars. In medical terms, it also stands for abdominal aortic aneurysms, which are bulges in your aorta (your main artery).
Many AAAs are natural and don’t cause problems. But sometimes they can burst. Screening for AAAs can help find and treat potentially risky aneurysms before they cause more serious problems. With the results from an AAA screening, you and your doctor can discuss what treatment, if any, would be right for you.
Do I need an abdominal aortic aneurysm screening?
Men between the ages of 65 and 75 who have ever smoked or who have other risk factors may want to consider an abdominal aortic aneurysm screening.
But keep in mind: AAA screening isn’t appropriate for everyone. Sometimes, test results may cause you to seek treatment where the risks outweigh the benefits. Talk with your doctor if you’re curious about AAA screening.
Heart tests and heart screenings: Your next steps
Keeping your heart as healthy as possible is essential to living your best life. To make sure you’re keeping a pulse on your heart health and getting the right tests at the right time, we recommend that you:
- Make regular check-ins and checkups with your primary care doctor a priority. You and your primary care doctor can monitor your overall well-being plus your heart health, and you can discuss heart disease risk factors or any concerns you have.
- Ask your primary care doctor about specific heart tests and screenings, and whether you’re a good candidate for them. If your doctor does recommend certain tests or screenings, some may be done the same day, or you might need to make an appointment for a different day. Also, it’s important to remember that you’re always in control of your health care, so it’s okay to request any additional screenings. (But check in first with your insurance to learn more about what they will and won’t cover.)
- Keep an eye out for heart disease symptoms as you age. If you start to experience any symptoms of heart trouble, tell your doctor so they can work with you to create the right action plan. That may include connecting you with a cardiologist sooner rather than later.
- Seek care from a cardiologist when the time is right. If you’ve already been diagnosed with a chronic condition such as high blood pressure or high cholesterol, or if you have a family history of heart disease, ask your doctor if you should be seeing a cardiologist, too. Cardiologists specialize in maximizing your heart health.
Remember, now is always the right time to take care of your heart. If you’re ready to get started but unsure of what your next steps should be, call your doctor or make an appointment today.