If your cardiologist recommends heart testing, hearing the names of several different tests can feel overwhelming. The good news is that many commonly used cardiovascular tests are straightforward and provide your care team with valuable information about different aspects of your heart.
An EKG, echocardiogram, stress test and Holter monitor do not all measure the same thing. Each gives your cardiologist a different view of your heart’s electrical activity, structure, rhythm or performance.
Here is what each test is designed to evaluate.
An electrocardiogram, commonly called an EKG or ECG, records the electrical activity of your heart.
Small electrodes are placed on your chest and other areas of the body. These electrodes detect the electrical signals that cause your heart to beat. The test is painless, usually takes only a short time and does not send electricity into your body.
An EKG can provide information about your heart rate and rhythm and may help identify certain abnormalities in the heart’s electrical activity.
Because an EKG captures your heart rhythm during a relatively short period of time, an intermittent rhythm problem may not always occur while the test is being performed. In those situations, your cardiologist may recommend longer-term monitoring.
An echocardiogram, often simply called an “echo,” uses ultrasound technology to create images of the heart.
Rather than focusing primarily on electrical activity, an echocardiogram helps your care team evaluate the structure and movement of the heart. It can provide information about the heart’s chambers, valves and pumping function.
The most common type is a transthoracic echocardiogram. A transducer is moved across the chest to send and receive ultrasound waves, which are converted into images of the heart.
Your physician may recommend an echocardiogram when additional information about the heart’s structure or function is needed.
Some cardiovascular problems are more noticeable when the heart is working harder. That is where a stress test can be helpful.
During an exercise stress test, your heart rhythm, heart rate and blood pressure are monitored as you gradually exercise, often by walking on a treadmill. For patients who cannot exercise adequately, certain types of stress testing may use medication instead.
Depending on the reason for the test, additional imaging may also be performed.
Stress testing can help your cardiologist evaluate how your heart responds to physical exertion and investigate symptoms such as chest discomfort, shortness of breath, dizziness or an irregular heartbeat that may occur during activity.
Your care team will provide specific instructions before your test, including whether you need to temporarily adjust medications, caffeine intake, food or physical activity.
What happens if you feel an occasional racing heartbeat, fluttering sensation or dizziness but your EKG looks normal during your office visit?
Your cardiologist may want to monitor your heart for a longer period of time.
A Holter monitor is a small portable device that continuously records your heart’s electrical activity while you go about your normal routine. Because the monitoring period is much longer than a standard EKG, it may capture rhythm changes that happen only occasionally.
Patients are often asked to note when symptoms occur so their care team can compare those times with the recorded heart rhythm.
There is no single heart test that answers every cardiovascular question.
An EKG evaluates electrical activity at a particular point in time. An echocardiogram provides images of the heart’s structure and function. A stress test evaluates how the heart responds when it is working harder. A Holter monitor records heart rhythm over a longer period.
Your cardiologist will determine which test—or combination of tests—makes sense based on your symptoms, medical history and individual risk factors.
Understanding why a test has been ordered can make the experience much less stressful.
Baltimore Heart Associates provides a range of diagnostic and cardiovascular services, including echocardiography, stress testing, Holter monitoring, event recording, peripheral vascular imaging, transesophageal echocardiography and nuclear cardiology.
Our team is here to explain your testing, answer your questions and help you understand the next steps in your care.
If your physician has recommended cardiovascular testing or you would like to discuss concerns about your heart health, contact Baltimore Heart Associates to request an appointment.
This article is intended for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment.