Diagnosing Heart Disease

When patients experience symptoms suggestive of heart disease, the clinician will consider the medical history and normally perform a physical examination. Tests are then used to reach a diagnosis, determine the extent of the disease, and help in the planning of treatment.

The ECG is the primary investigative tool in the diagnosis of cardiac conditions. For arrhythmia it is the ‘gold standard’ and for coronary artery disease it is the first line test.

Different ECG tests have been developed, dependent on the conditions requiring investigation — the frequency and context of the symptoms will dictate the monitoring strategy. The options available include:

a 12-lead ECG,
a stress test (or exercise tolerance test),
or an ambulatory ECG.
In addition, other diagnostic tests for heart disease include:

echocardiography,
thallium stress test, and
cardiac catheterisation and coronary angiography.