Heart Tests – When Do You Need to Have One?

What is heart test? And who needs to do heart test?

Well, the answer is, if one leads a healthy life-style, probably no need to do heart test.

There are many types of heart test, all with pros and cons. Not everybody needs a heart test. But in Malaysia many above 30 years of age probably need one, especially those with chest pain/tightness/discomfort and those with reduced effort capacity.

Other than heart test/tests, a blood test with fasting sugar/fasting cholesterol etc is important. Risk factors like Diabetes, High Cholesterol, Hypertension, smoking status and family history of heart disease, especially heart attack, are all important in assessing for heart disease.

The most basic heart test is ECG, or “Electrocardiogram”. It involves attaching 6 “wires” to front chest and another 3 to both hands and 1 leg. It is a basic test, but not sensitive enough to detect all the heart disease. Another commonly used heart test is Exercise Stress Test. Similar to ECG, in Exercise Stress Test, 9 “wires” will be attached and the tested one need to walk and then run on a track mill. It is much better test than ECG. If one can run up to 10 minutes or more, with target heart rate achieved, and no angina and no ECG changes, the chances of having heart attack in the next one year is near to 0%.

Another heart test to detect blockage in the heart blood vessel is CT Coronary Angiogram. Need newer generation of CT scan machine to do that, at least 64 slices (64 “cameras”) or more. Every seconds it will spin few hundreds time, eg 700 times, depends on manufacturer. So every second, there would be 700X64 pictures taken. Awesome technology. But a needle still need to be put on the hand/arm to inject “dye” into the blood vessel, to take the pictures. CT scan can be done as outpatient clinic setting. Just come for the scan and then go back home.

However the gold standard to detect blockage is still the good old Coronary Angiogram. A small tube will be put in from the hand or leg, travel through the blood vessel, and “dye” (similar dye as the CT scan) injected into the blood vessel of the heart. This would be 100% accuracy. The shortfall is one need to stay in the hospital for Coronary Angiogram. But of course with the new technique and advances, Coronary Angiogram can be done as “Day Case”. Admit to the hospital in the morning, perform the Coronary Angiogram then after a few hours, can go back to sleep at home.

All said, best is to stay healthy and be happy.