Screening tests play an important role in diagnosing heart problems in people who have certain symptoms or heart disease risk factors. But some commonly prescribed tests probably don’t help people who are at low risk and who lack symptoms such as chest pain or shortness of breath. What’s more, they may lead to false positive results, which can trigger more invasive tests. The government-backed U.S. Preventive Services Task Force advises against routine screening for heart disease for people at low risk (risk factors include family history, older age, high blood pressure, obesity or diabetes, and smoking). Here, tests healthy people might second-guess.
1) ECG (EKG)
A readout of your heart’s electrical activity recorded by electrodes on the chest; costs about $50. An ECG (also called electrocardiogram) may help identify irregular heart rhythms, heart attacks, and other problems. No trials have looked at whether ECGs help detect the risk of disease in those without symptoms.
Whom does it help? For those with an irregular heart rate, unexplained fainting, or risk factors like a family history of heart disease, an ECG can be helpful, says cardiologist Sarah Samaan, MD, author of Best Practices for a Healthy Heart. The test is also used to screen athletes for risk of sudden death and for people with high blood pressure (to find signs of abnormal heart-muscle thickening).
A moving ultrasound of the heart, which can show how well it pumps blood and whether it has structural problems; costs between $200 and $500.
Whom does it help? An echo can help spot heart failure, atrial fibrillation, and murmurs, which are often caused by leaky or stiff valves. It can help people with high blood pressure because the test can find enlargement, weakness, or stiffness in the heart muscle. Some abnormal ECGs should prompt an echo, which can detect congenital and inheritable heart problems.