Top Tests to Diagnose Heart Disease (Did Your Doctor Miss Something?)

Over 600,000 people die of heart disease in the United States every year, making it the number one cause of death, even ahead of cancer, which take the number two spot. Heart disease is a complex problem, but because it is so prevalent, much effort has gone into finding better ways to diagnose and treat it. Just because a test exists, however, doesn’t mean that a doctor will use it. And if a test is conducted, there is always a chance that it will be performed wrong or that its results will be incorrectly interpreted. You may assume that your doctor knows what he or she is doing, and most of the time that is probably true. That said, it is important to educate yourself and ask questions. Your doctor should be able to tell you why he or she is, or isn’t, ordering a certain test, and what the results mean. Here are some of the top tests to diagnose heart disease.

Serial Cardiac Enzyme Tests

When the heart muscle is damaged, such as during a heart attack, certain enzymes are released into the bloodstream. A blood test can reveal whether these enzymes (including creatine phosphokinase or creatine kinase) are elevated. If they are, it is a sign that the patient has had a heart attack.

If you go to the emergency room complaining of chest pain, a cardiac enzyme test should be performed. Because it is a simple, non-invasive, and reliable test, it may be performed two or three times during your stay, a few hours apart. This repeated, or serial, testing can help paint a more complete picture of what is going on with your heart.

Troponin Testing

Troponin is a protein found in cardiac and skeletal muscle. Elevated levels of cardiac-specific troponin in the blood may indicate that you have had a heart attack. Like cardiac enzyme tests, troponin is tested by taking a blood sample. Another protein, myoglobin, may also be tested. Increased myoglobin levels are detectable sooner than increased troponin levels, but does not stay elevated as long and is not as specific to heart disease as troponin, so troponin levels are more commonly tested.

Electrocardiogram (EKG or ECG)

An EKG is one of the most common tests for heart disease. Electrodes are placed on your torso and possibly your limbs and left in place for a few minutes. These sensors detect the electrical activity of your heart. The test produces a visual trace on either a screen or a paper printout showing your heart’s electrical activity.

An EKG is quick, non-invasive, and reliable. It may be performed in your doctor’s office, in an ambulance, and should certainly be performed in the emergency room if you show up complaining of chest pain.

Echocardiogram

It is easy to confuse an echocardiogram with an electrocardiogram because their names look so similar, but they are very different tests. An echocardiogram is an ultrasound of the heart muscle. It can show how well the heart is pumping blood, whether there are problems with the heart valves, and whether there is any thickening of the heart muscle. Thickening of the heart muscle can be a cause of cardiac arrest (heart attack).

Cardiac Catheterization

This procedure involves the insertion of a catheter into a blood vessel in your groin (or arm or neck). This long, thin, tube then makes its way to your heart via your blood vessels. Your medical team can both diagnose and treat heart disease during catheterization. Treatments performed using cardiac catheterization includes angioplasty and placement of a coronary stent.

Radionuclide Ventriculography

Radionuclide ventriculography is also known as multi-gated acquisition scanning, or MUGA. Harmless radioactive substances are injected into the bloodstream; computer-generated images then show their location in the heart. MUGA can show damage to the heart muscle from a heart attack, as well as how well the heart is supplied with blood and how well the heart’s chambers are working.

Stress Testing

A stress test is sometimes called an exercise stress test. It is designed to show your doctor how physical activity affects your heart function. The test usually involves walking on a treadmill or riding a stationary bike while your blood pressure, heart rate, and respiration (breathing) are monitored.

This is not a test to diagnose a heart attack, but can show abnormalities with your heart’s blood flow, and guide treatment decisions if heart disease is suspected or already diagnosed.

Magnetic Resonance Imaging (MRI)

Magnetic waves are passed through your body, allowing your doctors to see a detailed image of your heart. MRI is used for many health issues besides cardiac problems.

If you present at the ER complaining of chest pain or other heart attack symptoms, the medical team may not need to perform all of these tests. But they should certainly perform some of them, along with taking a detailed medical history.

Unfortunately, many people, especially women, go to the ER with heart attack symptoms and are not properly tested, only to be discharged and later have a serious cardiac event. Failure to diagnose a heart attack may be medical malpractice.

If you believe that your doctor or ER staff did not properly diagnose your heart disease, you should consult with an experienced Oregon medical malpractice attorney. You have only a limited amount of time in which to file a claim if you were injured by medical malpractice. We invite you to contact The Fraser Law Firm P.C. to schedule a consultation and get your questions answered.