Testing & diagnosis

The first step to determine what treatment you need for a heart condition is to get a proper diagnosis. At Advocate Heart Institute, we offer a wide range of heart tests to help our cardiologists understand your heart health.

Why choose us for heart tests

Our experienced physicians, radiologists and technicians perform thousands of advanced tests every year to diagnose heart disease and treat heart conditions.

It’s important to get the correct diagnosis for a heart condition and proper treatment to avoid further heart damage. At Advocate Heart Institute, we have both tertiary and quaternary care at our hospitals. This means we offer the highest level of specialized care available in the area for treating all types of heart and vascular diseases.

How to diagnose heart disease

Primary care providers typically order initial heart tests. Our cardiology specialists will perform a physical exam and review results from previous tests. They may also order additional tests if necessary, including a chest X-ray. The results will help them get a better diagnosis and provide the right treatment for your needs.

Initial tests for heart disease

The first test that most doctors order is a blood test. The tests can reveal higher-than-normal levels of substances in your blood, such as:

• Cholesterol, including “good” cholesterol (HDL or high-density lipoprotein), “bad” cholesterol (LDL or low-density lipoprotein) and total cholesterol levels
• Triglycerides, or fat in your blood
• Troponin proteins, which can show if your heart muscle was injured or damaged
• Blood glucose, which can show if you have diabetes (a risk factor for heart disease)

Types of heart tests at Advocate Heart Institute

With initial results in hand, your cardiologist may recommend further tests. These tests can be:

• Noninvasive: Performed outside of your body
• Invasive: Accomplished with needles, tubes, scopes or other tools inside your body

At the Advocate Heart Institute we offer:

Cardiac catheterization tests

Specialists perform the following tests in a catheterization (cath) lab:

• Angiogram: We use X-ray images to see the blood vessels in and around your heart. Doctors inject a special dye into your veins that shows up on X-ray machines to see if blood is flowing properly.
• Electrophysiology studies: We use these tests to assess electrical activity in your heart and look for arrhythmias.
• Fractional flow reserve (FFR): FFR lets us measure different pressures in your arteries to see if enough oxygen is getting to the heart.

Cardiac imaging

Cardiac imaging tests create an image of your heart for the doctor to view. They can show more detail than chest X-rays to help your doctor diagnose your heart condition. Cardiac imaging tests available at Advocate Heart Institute include:

• Cardiac MRI: MRI uses magnets and radio waves to create a picture of the soft tissues and muscles in and around your heart.
• Calcium scoring: This type of CT scan looks for deposits of plaque with calcium in the arteries of your heart.
• Coronary computed tomography angiography (CCTA): CCTA takes multiple X-rays of your heart to make a 3D model with more detail than a typical X-ray. You’ll have iodine with a contrast material injected into your blood so doctors can visualize blood flow.
• Cardiovascular PET: A PET scan uses radioactive tracers that circulate from blood vessels into your heart muscle. A special detector takes the signals and creates images of your heart, which show damage after a heart attack or low blood flow from narrow or blocked arteries.
• Nuclear single-photon emission computerized tomography (SPECT): This test uses radioactive material injected into your body and a special camera to create 3D pictures of your heart.
• Vascular ultrasound: Sound waves from a small wand placed against your skin allow doctors to see blood flowing through your arteries. We also use intravascular ultrasound (IVUS). To perform IVUS, we insert a small tube with an ultrasound wand into the groin and advance it up to your heart.

Echocardiogram

An echocardiogram is a type of cardiac imaging test that uses high-frequency sound waves (ultrasound). Ultrasound creates images of internal body structures, such as heart valves, so doctors can see how they are functioning. We offer several different types of echocardiogram tests including:

• 2D echocardiogram: This test uses ultrasound waves generated from a small device placed on your chest (transducer) to create a two-dimensional image of your heart.
• 3D echocardiogram: We use this test to create a three-dimensional image of your heart. We create pictures using a transducer on your chest or by inserting a tube down into your throat (transesophageal).
• Transesophageal echocardiogram: Doctors put a small ultrasound device through your mouth and down your throat to obtain images of your heart. Your throat is numb so you don’t have any discomfort. This test provides a clearer picture of your heart than a traditional echocardiogram since the ultrasound device is in your esophagus and is close to your heart.

Stress tests

These tests show what happens to your heart while it is under stress. The stress can come from medications that make your heart beat faster, or from exercise on a treadmill or stationary bike. We offer:

• Cardiopulmonary stress test: This test monitors your heart rate, blood pressure and breathing during exercise.
• Nuclear stress test: We inject radioactive dye into your veins to show blood flow to and from your heart when resting and under stress while taking images of your heart with a camera.
• Stress echocardiogram: This type of echocardiogram uses ultrasound to see how your heart performs when it’s under stress.

Other noninvasive tests

We provide additional noninvasive tests to help doctors diagnose heart conditions, including:

• 24-hour blood pressure monitor: We use this to record blood pressure continuously for 24 hours using a small device attached to a strap or belt.
• Coumadin monitoring: These tests show how well Coumadin (a blood thinner) works to prevent blood clots.
• Electrocardiogram (EKG or ECG): We use this to see the electrical signals from your heart as it beats.
• Holter monitors and heart event monitors: Holter monitors record electrical activity from your heart for 24-48 hours while you’re at home. Doctors use this to observe over a longer period than an in-office ECG provides. Patients typically wear a symptom event monitor for more than 24 hours, but it only records when activated.
• Home sleep tests: We use these tests to track breathing and oxygen levels while you sleep. You wear a small device at home overnight that records the information so your doctor can review it.
• Remote monitoring of implanted devices: Doctors review the information from your implanted devices, such as pacemakers, defibrillators and loop recorders. The device sends data wirelessly to the doctor’s office either during your visit or at regular intervals remotely from home.
• Tilt-table testing: This test measures blood pressure and heart function when your body is in different positions. To perform this test, a technician straps you to a table and slowly tilts it while monitoring your vital signs.