Diagnosing Heart Disease

Treating heart disease starts with an accurate diagnosis — and that’s where Northwestern Lake Forest Hospital excels. We perform an extensive array of diagnostic heart tests in Diagnostic Cardiology, including:

• Cardiac Catheterization, or Coronary Angiogram
• Cardiac CT Scan
• Cardiac MRI
• Chest X-ray
• Echocardiogram: Transthoracic, Transesophageal, Stress and Pediatric
• Electrocardiogram: 12-lead, 18-lead and Stress
• Electrophysiology Study
• Heart Monitoring: Holter Monitor, Event Monitor and Implantable Loop Recorder
• Nuclear Stress Test
• Oximetry
• Tilt Table Test

The tests you’ll need to diagnose your heart disease depend on what condition your doctor thinks you may have. A physical exam, personal and family medical history can help shed some light onto if you have heart disease. But apart from simple blood tests to look for high cholesterol and factors, your cardiologist may recommend some additional tests to diagnose coronary artery disease.

As for diagnosing arrhythmias, the process is complex and intricate. It requires special expertise, unique testing equipment and often monitoring over a period of time. This is because many arrhythmias can come and go, making it difficult to capture an event in any single test. Thankfully, Northwestern Lake Forest Hospital’s cardiac electrophysiologists, cardiologists and Cardiac Catheterization Lab make arrhythmia testing available to our community.

By identifying early-stage heart disease, Northwestern Lake Forest Hospital aims to help you avoid long-term problems. Learn more about each of Northwestern Lake Forest Hospital’s diagnostic cardiology tests below.

To learn more about these options for diagnosing heart disease, contact Northwestern Lake Forest Hospital Diagnostic Cardiology at (847) 535-8072. To find a Northwestern Lake Forest Hospital physician or cardiologist, visit our Online Physician Directory or contact (847) 535-6171.

Learn more about how Northwestern Lake Forest Hospital treats heart disease >

Cardiac Catheterization, or Coronary Angiogram

A catheter is a flexible tube that a physician guides through an artery from your groin to your heart. To view blood flow through your heart, your doctor injects a special dye into your arteries via the catheter that outlines any possible obstruction.

A serial X-ray image is obtained (15 frames per second) to record the blood flow through the coronary arteries and show how your heart pumps blood; seeing these images occur in real-time helps your doctor find where problems occur. This procedure is known as an angiogram, or a coronary angiogram. Doing it via catheter is called cardiac catheterization. These images are stored electronically to be used later by physicians.

Cardiac CT (Computerized Tomography) Scan

Collects images of your heart and chest used to check for heart failure or arrhythmias. In a cardiac CT, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest.

Northwestern Lake Forest Hospital has the first dual-source CT scanner in Illinois, which detects artery blockages in the entire body with extreme accuracy. The scanner utilizes imaging dye injected into your arm, and thus does not need placement of a catheter into your heart.

Learn more about CT Scans at Northwestern Lake Forest Hospital >

Cardiac MRI, or Magnetic Resonance Angiogram (MRA)

This procedure uses MRI technology, often combined with an injected contrast dye, to check for areas of narrowing or blockages. In a cardiac MRI, you lie on a table inside a long tube-like machine that produces a magnetic field. The signals from the magnet create images of your heart that can help your doctor determine the location of blockages or the cause of your heart arrhythmia.

Learn more about MRIs at Northwestern Lake Forest Hospital >

Chest X-ray

Shows if your heart is enlarged, a sign of some forms of heart disease. Performed in Northwestern Lake Forest Hospital’s Diagnostic Imaging Centers.

Learn more about X-rays at Northwestern Lake Forest Hospital >

Echocardiogram

Also referred to as a “transthoracic echocardiogram” or “doppler echocardiogram.” This noninvasive ultrasound of your chest uses sound waves to produce detailed images of your heart and how it functions. Your doctor can then determine whether all parts of the heart wall and heart valves are contributing normally to your heart’s pumping activity. An echocardiogram can be used as part of a stress test or with an electrocardiogram to help your doctor learn more about your heart.

 

Other types of echocardiograms include: 

Transesophageal Echocardiogram

Also referred to as “transesophageal ultrasound”. During this test, a flexible tube is guided down your throat and produces images of your heart from inside your body. This test shows clearer pictures of your heart, since the probe is located closer to the heart and your lungs and bones don’t block the sound waves. This test also shows images from the back of your heart, which is often unable to be seen with a regular echocardiogram. A sedative and anesthetic applied to the throat are used to make you comfortable during this test.

 

Stress Echocardiogram

Similar to a regular echocardiogram, this test looks at images of your heart before and during exercise, or “stress”, from riding a stationary bike or walking on a treadmill. For people who cannot comfortably exercise, a drug called Dobutamine can be given to simulate the effects of exercise. A stress echocardiogram measures the blood flow to various areas of your heart and can detect decreased blood flow due to plaque buildup in the arteries.

 

Pediatric Echocardiogram

Northwestern Lake Forest Hospital performs echocardiograms for children, which requires additional training and sensitivity to their unique needs.

Electrocardiogram (ECG or EKG)

Also referred to as a “12-lead EKG” for the readings coming from 12 different points on your body. This noninvasive test records the electrical impulses that make your heart beat and can detect irregularities in your heart’s rhythm and structure. EKGs can happen at rest or while exercising (stress electrocardiogram). An 18-lead EKG can also be performed, which also looks at electrical impulses from the back wall of your heart.

 

Other types of electrocardiograms include: 

Stress Electrocardiogram

Also referred to as a Stress Test, “GXT”, or Graduated Stress Test, since the level of resistance will increase periodically during the test. This is an electrocardiogram that occurs while you are exercising. For people who cannot comfortably exercise, a drug called Dobutamine can be given to simulate the effects of exercise.

Electrophysiology Study

An electrophysiology study precisely records the electrical activity inside the heart. One or more thin, flexible wires with electrical conductors are threaded into the heart and measure its electrical signals. Electrical currents can also be sent through the wires into the heart, a process called pacing. This determines whether abnormal rhythms can be triggered in the heart, allowing your doctor to determine the type of heart rhythm abnormality and the best way to treat it.

Heart Monitoring

Holter Monitor

A Holter monitor is a small, wearable device that records your heart rhythm through electrodes that are attached to your chest. You usually wear a Holter monitor for one to three days; during that time, the device will record all of your heartbeats and provide your doctor a prolonged look at your heart rhythms. The Holter monitor may be able to detect irregularities in your heart rhythm that an electrocardiogram can’t, since an electrocardiogram usually lasts for only a few minutes.

 

30-, 60- or 90- day Event Monitor

Similar to a Holter Monitor, your doctor may prescribe a portable Event Monitor to record arrhythmias that regular electrocardiograms are unable to detect. However, you manually activate the Event Monitor when you experience symptoms of an arrhythmia; this lets your doctor check your heart rhythm at the time of your symptoms. You may use an Event Monitor to monitor your heart activity over a few weeks to a few months.

 

Implantable Loop Recorder

This is similar to a Holter or Event monitor in that it measures and records arrhythmias as they happen. However, whereas Holter and Event Monitors record from outside your body, an Implantable Recorder is inserted just under the skin through a minimally invasive procedure. This test can be more accurate, since your physician can set the recorder’s settings to record arrhythmias automatically.

Nuclear Stress Test

This is similar to an exercise stress test in that it measures blood flow to your heart before and during exercise, but it can provide a more accurate diagnosis. A radioisotope is injected into a vein, and technologists observe how much of the isotope is absorbed into your heart muscle. Once recorded, you then will have images taken of how your heart functions during exercise, and these images will be compared.

Oximetry

Measures the oxygenation in the blood, often before and during exercise. This can be called a Pulmonary Stress Test, and can be done at the same time as a Cardiac Stress Test. A small device placed on one of your fingers measures the amount of oxygen that your heart and lungs produce.

Tilt Table Test

This test can be used to detect why certain people get sudden drops in blood pressure that can cause dizziness or even fainting. During the test, you will lay on a vertical table that then lowers to 80 or 70-degree angles. Technologists monitor the effect this has on your blood pressure and heart rate.