How is heart disease diagnosed?

Some conditions, including heart attack (myocardial infarction), are characterized by the presence of disease-specific markers in the blood which, in some cases, can also serve as prognostic markers. In the case of bacterial infections affecting the heart valves, blood cultures can be used to help identify the causative agent(s).

This imaging technique is crucial when cross-sectional images are required that can be used to map exact anatomical structures and anatomical correlations, such as in preparation for surgery, or when a patient has a tumor that is located inside the chest cavity. If used in combination with contrast agents, this imaging technique can also be used to visualize blood vessels.

An echocardiogram can provide a uniquely detailed picture of the heart's structure and function. Echocardiography is indispensable to cardiac medicine, as it provides the physician with the ability to determine and monitor the nature and severity of a patient's heart failure, heart valve disease or atrial septal defect.

An electrocardiogram (ECG) is an essential and simple diagnostic technique that measures the electrical activity inside the heart. Many different conditions - not just acute heart attack - become apparent through characteristic ECG changes, including chronically reduced blood flow (myocardial ischemia) and cardiac arrhythmias, which can be detected using a resting ECG, ambulatory ECG or exercise ECG.

Cardiac magnetic resonance imaging (cardiac MRI) is one of the most important non-invasive diagnostic techniques available. A cardiac MRI can provide the physician with a clear insight into the processes taking place inside the heart, as well as differentiating between different types of tissues and allowing an assessment of heart function.

Myocardial perfusion scintigraphy, another specialist imaging technique, uses radioactive markers to assess myocardial (heart muscle) perfusion and vitality, for example in patients with suspected coronary heart disease.

Exercise challenge spirometry - or cardiopulmonary stress testing - measures the amount of air that can be inhaled and exhaled following exertion. This test can be used to assess a patient's exercise capacity, and can help to establish whether a patient's exercise capacity is impaired or how severe a patient's heart disease is.

Telemetry, or real time monitoring, can be used in conjunction with electrocardiography (ECG) to monitor the heart's activity and detect or confirm cardiac arrhythmias. This technology can provide the physician with information on different treatment options available.

Catheter-based investigations such as angiography have a uniquely important role in cardiac medicine due to the fact that, in many patients with heart disease, they offer diagnostic as well as therapeutic applications.

Intracoronary pressure measurements provide direct measurements of blood pressure inside the coronary arteries. This procedure allows an exact assessment of the extent to which blood flow is reduced inside a narrowed blood vessel.

Intravascular ultrasound uses a special catheter fitted with an ultrasound probe. This catheter is advanced into the coronary arteries, where it can examine the coronary arteries using ultrasound (ultrasonography).

Coronary angiography is a diagnostic procedure that takes x-ray images (angiograms) of the coronary arteries. The procedure involves the visualization of the coronary arteries using a contrast medium that is injected into the coronary arteries using a catheter.