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Diagnosing Heart Disease: The 8 Key Tests You Need to Know

In this video, doctors explain some of the tests used to examine the heart and diagnose heart disease.

Lauren Smith, MAMera Goodman, MD, FAAP
Written by Lauren Smith, MA | Reviewed by Mera Goodman, MD, FAAP
Updated on February 16, 2021

The heart is a complex muscle. Like a car engine, it has multiple parts and connects to key organs around it. Both an engine and a healthy heart require all parts to do their job, or trouble can ensue.

[The heart] has chambers, it has valves, but it also has its own electrical system,” says Paul Knoepflmacher, MD, clinical instructor in medicine at The Mount Sinai Hospital. “It also has blood vessels in it, and any of these components can go wrong and have problems.”

That means a single test may not be able to fully diagnose heart disease, or the extent of it. To get the most accurate picture and treatment game plan, doctors have a variety of tests to examine the heart’s function and the effectiveness of each of the heart’s individual components.

While doctors have a lengthy list of tests to choose from, your doctor won’t use every single one. “You really direct the tests to the patient’s needs,” says Nieca Goldberg, MD, medical director at NYU Langone Health, Joan H. Tisch Center for Women’s Health.

Tests to Diagnose Heart Disease

Your doctor may want to test for heart disease if you have symptoms of heart disease or have significant risk factors like high blood pressure or high cholesterol. These are some of the tests they may use.

  1. An EKG (electrocardiogram) records the electrical activity of the heart and its contractions. EKGs are used for any patient who’s showing symptoms of heart disease, like fatigue or shortness of breath, according to Satjit Bhusri, MD, cardiologist at Lenox Hill Hospital.

  2. An echocardiogram might be used if your EKG results are abnormal. “An echocardiogram is basically a test that uses sound waves to get an image of the heart,” says Dr. Knoepflmacher. (It’s similar to an ultrasound that pregnant women get to see their baby in the womb.) It gives doctors a good look at how blood is flowing in the chambers and valves of the heart.

  3. A stress test measures how well your body handles a workload by monitoring its activity during and after exercise, according to the American Heart Association (AHA). You will walk or run on a treadmill under the supervision of a doctor, and an electrocardiography machine will measure your heartbeat.

  4. A nuclear stress test lets doctors see photos of your heart after exercise using a special camera.

  5. A stress echocardiogram compares ultrasound pictures of the heart before and after exercise, according to Michelle Weisfelner Bloom, MD, cardiologist at Stony Brook University Medical Center.

  6. A coronary angiogram (or cardiac catheterization) uses dyes to take X-rays of the arteries, according to AHA. A thin catheter is inserted into an artery from your groin or arm, and up to the heart. A special dye in the catheter lights up the arteries and makes them visible on the X-ray. This test can “determine if there’s a blocked artery that needs opening,” says Dr. Goldberg. If a major blockage is discovered during a coronary angiogram, an angioplasty may be done, which is a procedure in which a balloon is inserted to the blockage and expanded to open up the artery. After that, doctors may insert a stent (a wire mesh tube) to keep the artery open after the procedure.

  7. A cardiac CT scan is another way to check the health of your arteries. It takes X-rays of the heart and blood vessels to check for calcium buildup in the arteries. Using a measuring system called a “calcium score,” doctors can predict your risk of having a heart attack and assess how aggressive treatment should be, according to AHA.

  8. A cardiac MRI is “the best way we know to tell what the pumping function and relaxing function is of the heart,” says Dr. Weisfelner Bloom. It also gives a good image of the walls of the heart. “With a cardiac MRI, we can also diagnose myocarditis, which is an infection of the heart,” says Dr. Weisfelner Bloom.

If your doctor requests certain tests to diagnose your heart symptoms, it’s a good idea to get informed. You want to understand “what the test is about, what it’s used for, and why your doctor has recommended it,” says Dr. Weisfelner Bloom. As always, asking your doctor plenty of questions can empower you to make the best choices for your healt

Additional Medical Contributors (4)
  • Paul Knoepflmacher, MDDr. Knoepflmacher is a clinical instructor of medicine at The Mount Sinai Hospital in New York City, where he also maintains a private practice.
    • Nieca Goldberg, MDDr. Goldberg is a cardiologist and medical director of the NYU Langone Health Joan H. Tisch Center for Women’s Health.
      • Michelle Weisfelner Bloom, MDDr. Bloom is an associate professor of medicine at Stony Brook University Medical Center, a fellow of the American College of Cardiology, and a fellow of the Heart Failure Society of America.
        • Satjit Bhusri, MD, FACCDr. Bhusri is an attending cardiologist at the Lenox Hill Heart & Vascular Institute and an assistant professor of cardiology at Hofstra Northwell School of Medicine.


          Cardiac computed tomography (multidetector CT, or MDCT). Dallas, TX: American Heart Association. (Accessed on February 15, 2021 at http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Cardiac-Computed-Tomography-Multidetector-CT-or-MDCT_UCM_446370_Article.jsp#.WtENDJM-fVo.)

          Coronary artery disease. Dallas, TX: American Heart Association. (Accessed on February 15, 2021 at http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary-Artery-Disease---Coronary-Heart-Disease_UCM_436416_Article.jsp#.WtD3n5M-fVo.)

          View All References (6)

          Echocardiogram - echo. Dallas, TX: American Heart Association. (Accessed on February 15, 2021 at http://www.heart.org/HEARTORG/Conditions/HeartAttack/DiagnosingaHeartAttack/Echocardiogram---Echo_UCM_451485_Article.jsp#.WtD-WJM-fVo.)

          Heart CT scan. Washington, DC: U.S. National Library of Medicine. (Accessed on February 15, 2021 at https://medlineplus.gov/ency/article/007344.htm.)

          Heart disease: symptoms, diagnosis, treatment. Bethesda, MD: National Institutes of Health. (Accessed on February 15, 2021 at https://medlineplus.gov/magazine/issues/winter09/articles/winter09pg25-27.html.)

          Nuclear stress test. Washington, DC: U.S. National Library of Medicine. (Accessed on April 13, 2018 at https://medlineplus.gov/ency/article/007201.htm.)

          What is a coronary angiogram? Dallas, TX: American Heart Association. (Accessed on April 13, 2018 at https://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300436.pdf.)

          What is a stress test? Dallas, TX: American Heart Association. (Accessed on April 13, 2018 at https://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300453.pdf.)

          GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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