Introduction to diagnosis of heart and blood vessel disorders

[Monty]

Sometimes, medical history and physical examination alone suggest to a doctor that the person has a heart or blood vessel disorder. However, special diagnostic procedures are often needed to confirm the diagnosis, determine the extent and severity of the disease, and help plan treatment.
Diagnostic procedures can be

Noninvasive
Minimally invasive

Noninvasive tests do not require an incision or a needle puncture other than sometimes a blood draw or a standard short intravenous (IV) catheter placed into a vein in the arm. These tests include

Electrocardiography (ECG)
Stress testing
Tilt table testing
X-rays
Ultrasonography (including echocardiography)
Magnetic resonance imaging (MRI)
Radionuclide imaging
Positron emission tomography (PET)
Computed tomography (CT)

Fluoroscopy (a procedure that uses continuous x-rays) is used infrequently. Blood tests to measure levels of sugar (to test for diabetes), cholesterol, and other substances are often done to look for disorders that can cause heart disease.
Minimally invasive testing typically requires a long flexible catheter, which is inserted into a blood vessel in the wrist, neck or thigh and advanced inside of the blood vessel to the heart. These tests include

Electrophysiologic testing
Cardiac catheterization
Central venous catheterization
Angiography

Most of these procedures carry very small risk, but the risk increases with the complexity of the procedure, the severity of the heart disorder, and the severity of any other medical conditions the person has.
Sometimes treatments can be given during certain invasive diagnostic tests. For example, percutaneous coronary intervention for people with coronary artery disease may be done during cardiac catheterization and radiofrequency ablation for people with abnormal heart rhythms may be done during electrophysiologic testing.