Does ekg show blockage

ECG (Electrocardiogram): When you need it and when you don’t

An ECG (electrocardiogram) records the electrical activity of your heart at rest. It provides information about your heart rate and rhythm, and shows if there is enlargement of the heart due to high blood pressure (hypertension) or evidence of a previous heart attack (myocardial infarction). However, it does not show whether you have asymptomatic blockages in your heart arteries or predict your risk of a future heart attack. The resting ECG is different from a stress or exercise ECG or cardiac imaging test. You may need an ECG test if you have risk factors for heart disease such as high blood pressure, or symptoms such as palpitations or chest pain. Or you may need it if you already have heart disease. But in other cases, you may think twice about having this test. Here’s why:

Usually, you do not need an ECG if you don’t have risk factors for heart disease or symptoms that suggest possible heart disease.

The test is not useful in routine checkups for people who do not have risk factors for heart disease such as high blood pressure or symptoms of heart disease, like chest pain. Yet, many people with no risk factors or symptoms have an ECG as part of their routine checkups. There are better ways to prevent heart disease than routine ECGs. The ECG will not harm you. However, it can sometimes show mild nonspecific abnormalities that are not due to underlying heart disease, but cause worry and lead to follow-up tests and treatments that you do not need.

When are ECGs needed?

In some cases, it can be important to get this test. You should probably have an ECG if you have risk factors for an enlarged heart such as high blood pressure or symptoms of heart disease, such as chest pain, shortness of breath, an irregular heartbeat or heavy heartbeats. You may need the test for screening or occupational requirements, or if you have a personal or family history of heart disease, diabetes or other risks and you want to start exercising.

How should you protect your heart?

These steps can help protect your heart, whether you have heart disease or just want to prevent it.

Know your risks. Talk to your health care provider. Your risk of heart disease depends on many things, such as your age, sex, ethnicity, cholesterol, blood pressure, and if you smoke or have diabetes. Use the risk assessment test atwww.heartandstroke.ca/ehealth.

Lower your risks. The best ways to lower your risk of heart disease are to:

  • Be aware of your risk factors.
  • Be smoke-free.
  • Be physically active.
  • Know and control your blood pressure.
  • Eat a healthy diet that is high in fibre, lower in fat, especially saturated and trans fats, lower in sodium, includes lots of fruit and vegetables, and includes portions of food that are in line with your level of physical activity.
  • Achieve and maintain a healthy weight.
  • Manage your diabetes.
  • Limit alcohol use.
  • Reduce stress.
  • Visit your health care provider regularly and follow your health care provider’s advice.
  • Know and control your blood cholesterol.

Have your blood pressure, blood cholesterol, and blood sugar tested according to your health care provider’s recommendations. These tests are proven to help measure your risk of having heart disease.

Blood pressure. You should be tested at least once a year using a blood-pressure cuff. If you have been diagnosed with high blood pressure (or other related conditions), your health care provider will recommend that your blood pressure be checked more often. Be sure to ask your health care provider how often you should have your blood pressure checked.

Cholesterol. You should have a blood test for cholesterol if you are a male and over 40, female and over 50 or post-menopausal, you have heart disease, stroke, diabetes or high blood pressure, your waist measures more than 102 cm (40 in) for men or 88 cm (35 in) for women, you have a family history of heart disease or stroke. Your health care provider can advise how often you should have your cholesterol tested.

Blood sugar. If you’re over 40, you should have a blood test once every three years to measure your blood sugar (glucose). Too much glucose can harm your blood vessels. If you have risk factors for diabetes or are pregnant, your blood sugar levels should be tested. Speak to your health care provider about whether you need a blood sugar test.

If your blood pressure, blood cholesterol, or blood sugar are too high, work with your health care provider to lower them. Most people can lower cholesterol and blood pressure, and manage diabetes with lifestyle changes and medicine. This reduces the risk of heart attacks and strokes.

Cardiac (Heart) Screening

What are the benefits and risks of heart tests?

Cardiac CT for Calcium Scoring

Benefits

  • Cardiac CT for calcium scoring is a convenient and noninvasive way of evaluating whether you may be at increased risk for a heart attack.
  • The exam takes little time, causes no pain and does not require injection of contrast material.
  • No radiation remains in a patient’s body after a CT examination.
  • X-rays used in standard CT scans have no immediate side effects.
  • Cardiac CT for calcium scoring can document or exclude the presence of calcified plaque in the coronary arteries—a marker of coronary artery disease.
  • The exam can guide medical treatment.

Risks

  • Women should always inform their physician and x-ray or CT technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.
  • CT scanning is, in general, not recommended for pregnant women unless medically necessary because of potential risk to the baby.
  • A high calcium score may sometimes be followed by other diagnostic tests for heart disease, which may or may not provide results with clinical value and can be associated with side effects.
  • Radiation may slightly increase your life time risk of cancer. However, the benefit of an accurate diagnosis will generally outweigh the risk. The amount of radiation is minimized as much as possible.
  • The amount of radiation for this procedure varies. See the Safety page for more information about radiation dose.

Coronary CT angiography (CTA)

  • Coronary CTA is not invasive. An alternative test, cardiac catheterization with a coronary angiogram, is invasive, has more complications related to the placement of a long catheter into the arteries and the movement of the catheter in the blood vessels, and requires more time for the patient to recover.
  • Coronary CTA can non-invasively detect or exclude coronary artery blockages and plaque build-up.
  • A major advantage of CT is that it is able to view bone, soft tissue and blood vessels all at the same time. It is therefore suited to identify other reasons for your discomfort such as an injury to the aorta or a blood clot in the lungs.
  • CT examinations are fast.
  • CT has been shown to be cost-effective for a wide range of medical problems.
  • CT is less sensitive to patient movement than MRI.
  • CT can be performed if you have an implanted medical device of any kind, unlike MRI.
  • No radiation remains in a patient’s body after a CT examination.
  • X-rays used in standard CT scans have no immediate side effects.
  • In some people with abnormal kidney function, the contrast material used in CT scanning may worsen kidney function.
  • If a large amount of contrast material leaks out from the vessel being injected and spreads under the skin where the IV is placed, skin damage or damage to blood vessels and nerves, though unlikely, can result. If you feel any pain in your arm at the location of the IV during contrast material injection, you should immediately inform the technologist.
  • The amount of radiation for this procedure varies. See the Safety page for more information about radiation dose.
  • Women should always inform their physician and x-ray or CT technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.
  • CT scanning is, in general, not recommended for pregnant women unless medically necessary because of potential risk to the baby.
  • Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is given. However, both the American College of Radiology (ACR) and the European Society of Urogenital Radiology note that the available data suggest that it is safe to continue breastfeeding after receiving intravenous contrast. For further information please consult the ACR Manual on Contrast Media and its references.
  • The risk of serious allergic reaction to contrast materials for CT examinations is extremely rare, and radiology departments are well-equipped to deal with them. If you have a history of previous reaction to CT contrast, you may be required to take premedication with a steroid prior to the examination to limit risk of a second reaction occurring.
  • Radiation may slightly increase your life time risk of cancer. However, the benefit of an accurate diagnosis will generally outweigh the risk. The amount of radiation is minimized as much as possible.

Myocardial perfusion imaging, also called a nuclear stress test

  • Nuclear medicine examinations offer information that is unique—including details on both function and structure of the heart muscle—and often unattainable using other imaging procedures.
  • For many diseases, nuclear medicine scans yield the most useful information needed to make a diagnosis of ischemic heart disease or to determine appropriate treatment, if any.
  • If you have coronary artery disease, it is possible that you could experience chest pain during the exercising or when a drug is given for the stress test. However, your heart will be monitored and if necessary, medication can be given for your chest pain.
  • The risks of the treatment are always weighed against the potential benefits for nuclear medicine therapeutic procedures. You will be informed of all significant risks prior to the treatment and have an opportunity to ask questions.
  • Allergic reactions to radiopharmaceuticals may occur but are extremely rare and usually mild. Nevertheless, you should inform the nuclear medicine personnel of any allergies you may have or other problems that may have occurred during a previous nuclear medicine exam.
  • Injection of the radiotracer may cause slight pain and redness which should rapidly resolve.
  • Women should always inform their physician or radiology technologist if there is any possibility that they are pregnant or if they are breastfeeding. See the Safety page for more information about pregnancy, breastfeeding and nuclear medicine exams.
  • Radiation may slightly increase your lifetime risk of cancer. However, the benefit of an accurate diagnosis will generally outweigh the risk. The amount of radiation is minimized as much as possible.

Coronary catheter angiography

  • Catheter angiography presents a very detailed, clear and accurate picture of the blood vessels. This is especially helpful when a surgical procedure or percutaneous intervention is being considered.
  • Unlike computed tomography angiography (CTA), use of a catheter makes it possible to combine diagnosis and treatment in a single procedure. An example is finding an area of severe arterial narrowing, followed by angioplasty and placement of a stent. See the Angioplasty and Vascular Stenting page for more information.
  • The degree of detail displayed by catheter angiography may not be available with any other noninvasive procedures.
  • No radiation remains in a patient’s body after an x-ray examination.
  • X-rays usually have no side effects in the typical diagnostic range for this exam.
  • If you have a history of allergy to contrast material, your doctor may advise that you take special medication for 24 hours before catheter angiography to lessen the risk of allergic reaction. Another option is to undergo a different exam that does not call for contrast material injection.
  • If a large amount of contrast material leaks out under the skin where the IV is placed, skin damage can result. If you feel any pain in this area during contrast material injection, you should immediately inform the physician or technologist.
  • Women should always inform their physician or X-ray technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.
  • Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is given. However, both the American College of Radiology (ACR) and the European Society of Urogenital Radiology note that the available data suggest that it is safe to continue breastfeeding after receiving intravenous contrast. For further information please consult the ACR Manual on Contrast Media and its references.
  • The risk of serious allergic reaction to contrast materials that contain iodine is extremely rare, and radiology departments are well-equipped to deal with them.
  • There is a small risk that blood will form a clot around the tip of the catheter, blocking the artery and making it necessary to operate to reopen the vessel.
  • If you have diabetes or kidney disease, the kidneys may be injured due to the contrast material. In most cases, the kidneys will regain their normal function within five to seven days.
  • Rarely, the catheter punctures the artery, causing internal bleeding. It also is possible that the catheter tip will separate material from the inner lining of the artery, causing a blockage downstream in the blood vessel.
  • Radiation may slightly increase your lifetime risk of cancer. However, the benefit of an accurate diagnosis will generally outweigh the risk. The amount of radiation is minimized as much as possible.

Medical tests

Angiogram

Coronary angiogram

A coronary angiogram may be done during or after a heart attack or angina. It’s sometimes called ‘cardiac catheterisation’.

A catheter (a small tube) is put into an artery in your groin, arm or wrist under local anaesthetic. The catheter is moved up inside the artery until it reaches your heart. You will not feel this.

A special dye is injected into your coronary arteries and an X-ray is taken. It may make you feel hot and flushed for a few seconds. The X-ray shows your doctor where and how much your coronary arteries are narrowed. It also shows how well your heart is pumping.

Coronary angiograms help your doctor decide the best treatment for you. Sometimes it is best to go straight on to coronary angioplasty while you are in the laboratory having a coronary angiogram and the tubes are in place. The cardiologist will discuss this option with you before the procedure and it is your choice whether to proceed.

Coronary computed tomography angiogram (CCTA)

This is a type of computed tomography (CT) scan that can help diagnose coronary artery disease. It gives a 3-dimensional image of the heart chambers and coronary arteries supplying blood to the heart.

A CCTA is a non-invasive test for people who may be experiencing unusual cardiac symptoms.

Download: Fact sheet — What is coronary angiography? (PDF)

Blood tests

When your heart muscle has been damaged, as in a heart attack, your body releases substances in your blood. Blood tests can measure the levels of these substances and show if, and how much of, your heart has been damaged.

The most common test after a heart attack checks levels of troponin in your blood. Blood tests are also done to measure the level of other substances in your blood, such as blood fats (e.g. cholesterol and triglycerides) and minerals.

Blood pressure monitoring

Your doctor may arrange for you to wear a blood pressure monitor for 24 hours (during day-to-day activity and sleep). This light-weight, easy to wear monitor will help your doctor get accurate information about your blood pressure.

Your doctor may ask you to measure and record your own blood pressure at home.

Chest X-ray

Using an X-ray, pictures are taken of the structure and organs inside your chest, like your heart, lungs and blood vessels.

They can show if there are signs of heart failure.

Echocardiogram (heart ultrasound)

An echocardiogram is a common test. It gives a picture of your heart using ultrasound. It uses a probe either on your chest or sometimes can be done down your oesophagus (throat).

It helps your doctor check if there are any problems with your heart’s valves and chambers, and see how strongly your heart pumps blood.

An echocardiogram performed before and after exercise is also used to detect areas of the heart where the blood supply through the coronary arteries to the heart muscle is reduced (see stress tests below).

Electrocardiogram (ECG)

An ECG reads your heart’s electrical impulses. Small sticky dots and wire leads are put on your chest, arms and legs. The leads are attached to an ECG machine which records the electrical impulses and prints them out on paper.

Your doctor may use an ECG to diagnose a heart attack or abnormal heart rhythms (called ‘arrhythmias’).

Electrophysiology studies

Electrophysiology studies use a computer to help find out about an abnormal heartbeat (arrhythmia).

Special tubes (catheters) are inserted, via a vein in your leg, into your heart. The catheters record your heart’s electrical activity and test its response to various stimuli. Your heart’s electrical response to these stimuli helps doctors to determine the type and cause of your arrhythmia.

MRI

An MRI uses very strong magnets and radio waves to create detailed images of your heart on a computer. It can take still or moving pictures of your heart. It does not involve radiation and the main thing you will notice is a drumming noise while the scanning is being done.

Sometimes a special dye is used to make parts of the heart and coronary arteries easier to see.

This test shows your doctor the structure of your heart and how well it is working, so they can decide the best treatment for you.

Stress tests

Stress tests help your doctor find out how well your heart works when you’re physically active, using exercise machines (e.g. a treadmill).

Exercise stress test

This is an electrocardiogram (ECG) done while you exercise. The doctor checks your heart rate, heart rhythm and blood pressure.

The test will show how your heart works during exercise.

Sometimes it’s called a treadmill test or exercise test.

Stress echocardiogram (stress echo)

A radioactive substance (a tracer) is injected into your bloodstream. The stress echo uses an ultrasound to detect differences in your heart’s chambers and valves and how strongly your heart beats when exercised, or when stressed using a medicine (e.g. dobutamine).

Nuclear cardiac stress test

This test is sometimes called an ‘exercise thallium scan’, a ‘dual isotope treadmill’ or an ‘exercise nuclear scan’.

A tiny dose of a radioactive substance called a ‘tracer’ is injected into your bloodstream. It goes to your heart and releases energy. Special cameras take a picture of this energy from outside your body.

Your doctor uses this picture to see how much blood flows to your heart muscle and how well your heart pumps blood when you are resting and doing physical activity. This test also helps your doctor to see if your heart muscle is damaged.

Tilt tests

Doctors use tilt tests to see whether different body positions will trigger an abnormal heart beat (arrhythmia). They’re especially useful for investigating the hearts of people who faint without explanation.

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Four Things an EKG Can Tell You About Your Heart’s Health

An electrocardiogram (also referred to as an ECG or EKG) is a test that analyzes the electrical activity of your heart. The test, which takes approximately ten minutes to perform, involves a technician attaching twelve leads to your chest and then getting a 12-line printout that reflects your heart’s activity during a 10-second window.

So, what exactly can an EKG tell you about your heart’s health?

1. An EKG can reveal an arrhythmia (an abnormal heart rhythm).

A healthy heart should be pumping in a steady rhythm. However, when there is dysfunction in the electric signals sent from one part of your heart to another, the heart beats abnormally, which produces an arrhythmia. Since an EKG is measuring the electrical activity of your heart, it quickly picks up these arrhythmias.

2. An EKG can reveal if your heart is getting enough oxygen.

Your heart is a hard-working muscle that requires plenty of oxygen in order to stay strong and function properly. However, due to blockages or constrictions in the coronary blood vessels, the heart can experience ischemia, a dangerous state in which the cardiac tissue is underperfused. If your heart experiences prolonged ischemia, the muscle can actually start to die, leading to heart failure and even death. An EKG is a useful tool that helps medical providers evaluate how much oxygen your heart is getting and intervene immediately if your heart is ischemic to prevent catastrophic complications.

3. An EKG can reveal if your heart is enlarged.

A healthy heart is about the size of your fist, located just left of center in your chest. However, there are some medical conditions that can cause cardiomegaly (an abnormally enlarged heart.) Causes include untreated high blood pressure, viral infections of the cardiac muscle, advanced age and heart failure. Often cardiomegaly shows up on an EKG as abnormally large waveforms, which can alert your medical provider to a serious underlying condition

4. An EKG can tell you if you’ve had a heart attack in the past.

While heart attacks often cause significant symptoms that prompt patients to seek immediate medical attention, in 45% of cases, symptoms are so mild that patients don’t realize there’s anything wrong with their heart. These are referred to as “silent” heart attacks, which often show up weeks or months later as characteristic abnormalities on an EKG that alert your medical provider that you have a potentially dangerous blockage in your coronary arteries that has led to ischemia in the past and will likely lead to an even worse event in the future if left untreated.

If you’re having significant symptoms, including chest pain, shortness of breath, dizziness, or pain in your arm or jaw, go immediately to the closest E.R. or call 9-1-1.

At GoHealth Urgent Care, we offer EKGs at all our locations to help you be as heart healthy as possible! We’re open seven days a week to care for you. If you have a minor injury or illness, don’t put off getting the care you need. We offer an easy check-in process and short wait times. Just walk-in or save your spot online. Select your location below to find the urgent care center nearest you.

Sources:

Angina Pectoris

How is angina pectoris diagnosed and evaluated?

In order to diagnose the cause of angina, the following tests may be performed:

  • Electrocardiogram (ECG): This test records the electrical activity of the heart, which is used to diagnose heart abnormalities such as arrhythmias or to show ischemia (lack of oxygen and blood) to the heart.
  • Stress test without imaging: This heart-monitoring test is used to help evaluate how well the heart performs with activity. During a stress test, you will usually be asked to perform physical exercise, like walking on a treadmill. An ECG is recorded during the period of exercise. The ECG is assessed by your doctor to see if your heart reached an appropriate heart rate and if there were any changes to suggest decreased blood flow to your heart. If you are unable to perform exercise, pharmaceuticals that mimic the heart’s response to exercise may be used.
  • Blood tests: The tests can identify certain enzymes such as troponin that leak into the blood after your heart has suffered severe angina or a heart attack. Blood tests can also identify elevated cholesterol, LDL and triglycerides that place you at higher risk for coronary artery disease and therefore angina.

Additionally, the following imaging tests may be performed:

  • Chest x-ray: This noninvasive imaging test helps your doctor rule out other sources of chest pain such as pneumonia. Imaging with x-rays involves exposing the chest to a small dose of radiation to produce pictures of the chest and heart. See the Safety page for more information about x-rays.
  • CT of the chest: Chest CT is a more sensitive test than chest x-ray that can identify other causes of chest pain such as aortic disease or blood clots in the blood vessels of the lungs. This imaging test combines special x-ray equipment with sophisticated computers to produce multiple images of the chest and heart. See the Safety page for more information about x-rays.
  • Coronary computed tomography (CT) angiography: This exam evaluates the coronary arteries (blood vessels that supply blood and oxygen to the heart) to determine the extent of narrowing of the arteries due to plaque without the need for an invasive catheter feed through the arteries into the heart. Contrast material is injected through a small line in the arm vein, similar to the ones used to draw blood.
  • Magnetic resonance (MR) imaging: The primary purpose of this exam is to determine whether there is good blood flow to the heart muscle. If there are areas with decreased blood flow, this could indicate plaque with blood vessel narrowing. This blood flow evaluation may be done twice during the exam with the use of a contrast material. The first time may be performed after the administration of a pharmaceutical, which stresses the heart like exercise. The second time will be at rest. Performing the evaluation both with stress and rest helps determine if the decreased blood flow only occurs with exercise. This exam can also assess function of the heart and determine if there is any scar in the heart muscle. MRI machines use a powerful magnetic field, radio waves and a computer to produce detailed images. See the MRI Safety page for more information about MRI.
  • Catheter angiography: In this invasive imaging test, a thin, long plastic tube, called a catheter, is inserted into an artery in your groin or hand using a needle. The catheter is guided with a wire into the coronary arteries and is used to inject contrast material directly into the coronary arteries to determine whether there is any narrowing of the blood vessels. Images of the contrast material in the blood vessels are captured using x-rays. Narrowed portions of the vessels can be reopened using either a balloon or stents.
  • Echocardiogram: During this test, a transducer that produces high-frequency sound waves is used to create moving images of the heart. The motion of the walls of the heart is evaluated. If there is decreased motion within a portion of the wall of the heart, this could indicate decreased blood flow from narrowing of the coronary artery. Imaging can also be performed with a pharmaceutical agent stressing the heart to detect decreased motion in a portion of the heart muscle with stress.
  • Myocardial Single Photon Emission Computed Tomography (SPECT): This stress test with imaging is performed with a nuclear medicine tracer. During an imaging stress test, the patient is usually asked to perform some kind of physical exercise like walking on a treadmill. If the patient is unable to perform exercise for any reason, drugs that mimic the heart’s response to exercise may be used. A radioactive tracer will be injected into the blood during the peak of exercise and images of the heart will be taken. The radioactive tracer flows with the blood and will show whether there is an area of the heart with decreased blood flow.

Learn more about common tests you may need to take.

Electrocardiogram (EKG / ECG)

(Also known as Electrocardiography)

What the Test Does
Records the electrical activity of the heart including the timing and duration of each electrical phase in your heartbeat.

Reason for Test

  • Determines that a heart attack has occurred.
  • Helps predict if a heart attack is developing.
  • Monitors changes in heart rhythm.

Learn more about electrocardiogram (ECG or EKG).

Ambulatory Electrocardiography and Holter Monitoring

(Also known as Holter Monitoring or Ambulatory ECG or Ambulatory EKG)

What the Test Does
Records the electrical activity of the heart during daily activities.

Reason for Test

  • Documents and describes abnormal electrical activity in the heart during daily activities to help doctors determine the condition of the heart.
  • Helps determine the best possible treatments.

Learn more about Holter Monitors.

Chest X-Ray

What the Test Does
Takes a picture of the heart, lungs and bones of the chest.

Reason for Test

  • Determines whether the heart is enlarged or if fluid is accumulating in the lungs as a result of the heart attack.

Learn more about chest x-rays.

Echocardiogram (echo)

What the Test Does
A hand-held device placed on the chest that uses high-frequency sound waves (ultrasound) to produce images of your heart’s size, structure and motion.

Reason for Test

  • Provides valuable information about the health of your heart.
  • Helps gather information about abnormal rhythms (arrhythmias) in the heart.

Learn more about echocardiograms.

Cardiac Computed Tomography

(Also known as Tomography. This section includes CT, CAT scan, EBCT, PET, DCA, DSA, Multidetector CT or MDCT, MRI and SPECT)

What the Test Does
Computer imaging (tomography) refers to several non-invasive diagnostic-imaging tests that use computer-aided techniques to gather images of the heart. A computer creates three-dimensional (3-D) images that can show blockages caused by calcium deposits you may have in your coronary arteries.

Reason for Test

  • Evaluates aortic disease (such as aortic dissection), cardiac masses and pericardial disease.

Learn more about Cardiac Computed Tomography.

Exercise Stress Test

(Also known as Treadmill Test, Exercise Test, Exercise Cardiac Stress Test and ECST)

What the Test Does
A monitor with electrodes that are attached to the skin on the chest area to record your heart function while you walk in place on a treadmill. Many aspects of your heart function can be checked including heart rate, breathing, blood pressure, ECG (EKG) and how tired you become when exercising.

Reason for Test

  • Helps diagnose coronary artery disease (CAD).
  • Helps diagnose the possible cause of symptoms such as chest pain (angina).
  • Helps determine your safe level of exercise.
  • Helps predict dangerous heart-related conditions such as heart attack.

Learn more about exercise stress test.

Thallium Stress Test (MPI or MUGA)

(Also known as Myocardial Perfusion Imaging (MPI), Multigated Acquisition (MUGA) Scan, Radionuclide Stress Test and Nuclear Stress Test)

What the Test Does
Similar to a routine exercise stress test but with images. Uses radioactive substance called thallium injected into the bloodstream when patient is at maximum level of exercise to take pictures with a special (gamma) camera of the heart’s muscle cells.

Reason for Test

  • Helps measure blood flow of your heart muscle at rest and during stress.
  • Helps determine extent of a coronary artery blockage.
  • Helps determine extent of damage from heart attack.
  • Helps determine cause of chest pain (angina).
  • Helps determine level of safe exercise for patients.

Learn more about Radionuclide Ventriculography or Radionuclide Angiography (MUGA Scan).

Related Information:

  • Learn about invasive tests and procedures

I Had a Perfectly Normal EKG at My Check-Up—and the Next Day I Had a Heart Attack

On the day of my annual physical, I wasn’t worried about my heart: At 63, I was a non-smoker with a BMI of 20 who got (mostly) regular exercise and took no daily medication.

A blood test the week prior had shown my total cholesterol was 187, with a good HDL/LDL ratio and low triglycerides. The report included this reassuring notation: “lower relative cardiovascular risk according to American Heart Association/Centers for Disease Control guidelines.”

At my check-up, my blood pressure registered at 110/70. And I had an electrocardiogram (EKG), which showed no abnormalities. I left my doctor’s office with a clean bill of health.

That was on July 7th. On July 8th—in a scenario that sounds unlikely even for fiction—I had a heart attack.

RELATED: Heart Attack Signs Every Woman Should Know

I awoke that morning with vague jaw pain. Was it sinus-related? I also had an odd, persistent ache in my left arm. Could that be from the booster shot I had the day before?

While I mulled over the possibilities, I noticed a tightness in my chest—not exactly painful, but uncomfortable and strange. My first impulse was to give it time, have my usual cup of coffee, and wait for the symptoms to subside.

My daughter had a better idea. She told me to get dressed pronto, and she would take me to the emergency room.

On a short drive to the hospital, the chest discomfort seemed to be getting worse. I also had a dry, throat-clearing cough, and I had begun to feel queasy.

All classic signs of a heart attack—but as I checked in to the ER, I half-apologized for presenting with symptoms that “…are probably due to a vaccine I got yesterday.” Nonetheless, I was whisked to a treatment room quickly. And within minutes, a doctor sternly rejected my Google-inspired diagnosis: “This is NOT related to any shot.”

That was the first hint things might be serious. My second clue was seeing the energy in the room change; there was a sudden sense of urgency. But ironically, it wasn’t until a nurse put an aspirin under my tongue and said, “You’re going to be fine,” that I began to panic—as in, You mean, ‘”being fine’”is even a question?

RELATED: 9 Subtle Signs You Could Have a Heart Problem

Within minutes, I was wheeled into the hospital’s cath lab, where a cardiac team got ready to perform an emergency angioplasty. I would later learn that a bit of plaque had erupted in my Left Anterior Descending Artery (LAD), causing a blockage; a stent was needed to open the blood vessel and restore blood flow.

In lay terms, I was having a heart attack—and because it occurred in the LAD, it’s the kind they call the ‘widowmaker.’ No surprise why: This is the biggest of the three arteries that supply blood to the heart—so a blockage in the LAD can be particularly deadly.

RELATED: 8 Causes of Chest Pain That Aren’t a Heart Attack

Image zoom Courtesy of subject

My recovery protocol was fairly standard: A few days in the hospital, regular visits to a cardiologist, and a regimen of medications designed to prevent another attack.

Of course, the looming question: Why did a “low cardiac risk” person like me have such a major cardiac event? Could stress be to blame? A troubling family issue had reached a crescendo earlier that week. Was family history a factor? Relatives on my father’s side succumbed to heart-related ailments, though not until they were in their 80s.

My doctors said my heart attack was an unusual case, and there’s no way to pinpoint the cause with 100% certainty. But I learned a crucial lesson: low risk doesn’t mean no risk. My experience taught me a few key things I wish I’d known sooner:

Minutes count

If you have heart attack warning signs, every moment wasted can mean more heart cells are dying. The American Heart Association advises calling 911 immediately, since an ambulance often gets you to the hospital fastest; plus, EMS professionals can start treating you as soon as they arrive. Hospitals are rated on their “door-to-balloon time,” a measure of how long it takes for a balloon/stent to be inserted after a patient enters the ER or ambulance.

An EKG has limits

It measures heart rate and rhythm—but it doesn’t necessarily show blockages in the arteries. My EKG the day before didn’t detect anything. Now that EKGs are available with some smart phone apps and fitness trackers, it’s important to know what this test can and can’t do.

Heart attacks aren’t always obvious

Not everyone experiences the “chest grabbing” drama shown on TV. Symptoms can be subtle and not overly painful—and women’s symptoms may differ from men’s.

All cardiac symptoms—including chest tightness; shortness of breath; pain in the jaw, arm or back—need to be taken seriously, even if you think you couldn’t possibly be having a heart attack. Sure, it might be embarrassing to take action and discover it was just indigestion, or stress. But despite the cliché, nobody has ever died of embarrassment.

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Heart Block: Diagnosis and Tests

How is heart block diagnosed?

If your primary care physician suspects that you have heart block, he or she probably will refer you to a cardiologist for a complete cardiac evaluation. At the Sydell and Arnold Miller Family Heart & Vascular Institute, our cardiologists will start by obtaining your medical records from your primary care physician, including records of any heart tests you have had done.

Your cardiologist will review your complete medical history with you and ask you questions about your overall health, your diet and activity level, and your family medical history. The cardiologist also will want to know about any medications you are taking (prescription or over the counter) and whether you smoke or use drugs.

You will undergo a complete physical exam during which the doctor will listen to your heart and check your pulse to measure your heart rhythm and heart rate. He or she will check you for signs of heart failure, such as fluid retention in the legs and feet.

An ECG is a useful test to diagnose heart block. An ECG records the heart’s electrical activity. The test produces a graph that shows the heart rate and rhythm and the timing of the electrical signals as they move through the heart.

Cardiologists can look at the graph created during an ECG and determine whether a patient has heart block and how severe it is, based on the patterns of the heartbeat, rhythm and signal timing.

Your cardiologist may want to record your heart’s electrical signals over a longer period of time. If so, you will be asked to wear a portable ECG. A Holter monitor is a type of portable ECG that is worn for 24 to 48 hours. The Holter monitor continuously records the heart’s electrical activity. An event monitor is another type of portable ECG that is worn for a longer period of time and records the heart’s electrical activity at specified times, rather than continuously.

An electrophysiology study is another useful tool to help diagnose heart block. This minimally invasive test uses thin, flexible wires (catheters) that are placed onto the heart’s surface to record the heart’s electrical activity. The Miller Family Heart & Vascular Institute includes some of the world’s leading experts in electrophysiology who are highly skilled at creating “maps” of the heart’s electrical activity using electrophysiology studies for the most accurate diagnosis and treatment.

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