Q: How is cardiovascular disease diagnosed?

A: A thorough history and physical exam are the foundation of cardiac assessment. Those exams are augmented with many tests, beginning with painless, noninvasive ones: EKG, ECHO, and CT scan.

EKG is a surface mapping of the heart's electrical activity. The heart rate, rhythm (regular or irregular), and origin of irregularities are detected. It gives clues as to whether cardiac enlargement and other diseases are present. It is the main tool to diagnose heart attack.

Echocardiography (ECHO) is a noninvasive ultrasound procedure that assesses heart muscle function and is the main tool to diagnose heart valve disease. By assessing areas of scarring and muscle contraction, your provider can infer if coronary artery disease is present. Individuals with hypertension, coronary disease, and heart murmurs usually get an ECHO to help define the extent of disease and plan for care.

CT scanning helps assess the presence of calcium in the coronary arteries. It correlates with blockage within the vessel and "hardening of the arteries" that is associated with heart attacks and high risk of cardiac events. CT scans are also used to visualize the coronary arteries.

The results of these noninvasive tests may lead your doctor to recommend more invasive testing with cardiac cath and peripheral artery cath, and treatment, including surgery to correct vessels and valves.

Heart disease is preventable by controlling, treating and modifying risk factors such as high blood pressure, cholesterol, overweight/obesity, tobacco use, lack of physical activity and diabetes.

- Dr. Thomas Metkus

Thomas Metkus is a cardiologist at Mercy Cardiology, Nazareth Hospital.