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Diagnosis

Physical Examination

Your doctor will review your medical history, family history, and lifestyle. During a physical examination, your doctor will check your heart, lungs, abdomen, and legs to see if signs of heart failure are present.

Diagnostic Tests

Your doctor may also perform one or more of the following tests.

Electrocardiogram (ECG)


ECG/EKG Waves

Painless, Noninvasive Test Using Electrodes

This is a painless, noninvasive test in which patches with electrodes are attached to your skin to measure electrical impulses produced by your heart. These impulses are recorded as waves displayed on a monitor or printed out on graph paper.

Shows Heart Rate and Rhythm

It shows how fast your heart is beating and its rhythm (steady or irregular). It also records the timing of the electrical signals as they pass through each part of the heart.

Holter Monitor


Records Heartbeats for 24 or 48 Hours

This is a portable device that records all of your heartbeats over an extended period, usually either 24 or 48 hours.

  • You wear small patches with electrodes on your chest that are connected by wires to a small, portable recorder.
  • The recorder can be clipped to a belt, kept in a pocket, or hung around your neck.
  • During the time you're wearing a Holter monitor, you do your usual daily activities.
  • You can press a button if you are experiencing symptoms, so your doctor will know what your heart rhythm was at the time of the symptoms.

Event Monitor


Records Electrical Activity When You Push A Button

This machine is similar to the Holter monitor, except that not all of your heartbeats are recorded.

  • You wear the device continuously, but it only records electrical activity when you push a button -- and you only push the button when you feel symptoms.
  • These devices may be worn for as long as one to two months.

Reveal Monitor


Useful For Monitoring Infrequent Episodes

This is an implantable cardiac monitor which is placed under your skin.

  • It allows your heart rhythm to be monitored for up to three years.
  • This is a particularly useful type of monitor for people who have infrequent episodes of fainting or other symptoms of heart arrhythmia.

Blood Tests

These tests are used to detect:

  • Level of thyroid hormones
  • Balance of your body's electrolytes, minerals in your blood and body fluids that are essential for normal health and functioning of your body's cells and organs

Abnormal levels of these substances may cause heart rhythm disturbances.

Electrophysiology (EP) Study


Helps Pinpoint the Arrhythmia Location

Tests to help pinpoint the location, the type of arrhythmia, and how the arrhythmia responds to treatment.

  • During an EP study, you are sedated and small catheters are guided to your heart.
  • Your heart's rhythm is recorded as small amounts of electricity are delivered through the catheter.

Tilt Table Test


Helps Identify the Causes of Fainting

The tilt-table test is a simple, inexpensive, and informative test that can help identify the causes of fainting.

  • You are placed on a table with a foot-support and then the table is tilted upward.
  • The tilt-table may start off in a horizontal position and be tilted by degrees to a completely vertical position.
  • Your blood pressure, pulse and symptoms are monitored throughout.
  • The non-invasive test is done on an outpatient basis and takes about 45 minutes.

Exercise Stress Test


Examines Heart Rhythms During Exercise

This test reveals how well your heart functions when you exercise. It is usually conducted while you walk or jog on a treadmill.

Contact Information

Cardiovascular Medicine
Division of the CardioVascular Institute
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
617-667-8800

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