Diagnosis

If you have symptoms of a heart problem, your doctor will perform a physical exam and order tests to determine if your heart is enlarged and to find the cause of your condition. These tests may include:

• Chest X-ray. X-ray images help your doctor see the condition of your lungs and heart. If your heart is enlarged on an X-ray, other tests will usually be needed to find the cause.
• Electrocardiogram. This test records the electrical activity of your heart through electrodes attached to your skin. Impulses are recorded as waves and displayed on a monitor or printed on paper. This test helps your doctor diagnose heart rhythm problems and damage to your heart from a heart attack.

• Echocardiogram. This test for diagnosing and monitoring an enlarged heart uses sound waves to produce a video image of your heart. With this test, the four chambers of the heart can be evaluated.

  Your doctor can use the results to see how efficiently your heart is pumping, determine which chambers of your heart are enlarged, look at your heart valves, look for evidence of previous heart attacks and determine if you have congenital heart disease.

• Stress test. A stress test, also called an exercise stress test, provides information about how well your heart works during physical activity.

  An exercise stress test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure and breathing are monitored.

• Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI). During a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest.

  In a cardiac MRI, you lie on a table inside a long tubelike machine that uses a magnetic field and radio waves to produce signals that create images of your heart.

• Blood tests. Your doctor may order blood tests to check the levels of certain substances in your blood that may point to a heart problem. Blood tests can also help your doctor rule out other conditions that may cause your symptoms.

• Cardiac catheterization and biopsy. In this procedure, a thin tube (catheter) is inserted in your groin and threaded through your blood vessels to your heart, where the doctor takes a small sample (biopsy) of your heart to be tested.

  Pressure within the chambers of your heart can be measured to see how forcefully blood pumps through your heart. Pictures of the arteries of the heart can be taken during the procedure (coronary angiogram) to check for a blockage.