Diagnosis of Arrhythmias (Heart Rhythm Disturbances)
Arrhythmias may be identified either during routine health check-ups or when you first report having symptoms. In either case, the doctor will ask about your symptoms and medical history, and perform a physical exam, which includes listening to your heart. For older patients and those with symptoms or risk factors for heart disease, the healthcare provider will focus extra attention on cardiovascular health.
Tests may include:
Blood Tests —These tests evaluate your overall health, the function of your kidneys, the levels of various electrolytes, and may provide clues about your heart's health.
Urine Tests —These tests assess your general health and look for certain markers in the urine that may determine what is happening with your heart.
24-hour Holter Monitor —If your rhythm disturbance does not happen in the doctor's office, you may be given a portable EKG machine to take home with you. The machine will be belted around your waist and will record your heart rhythm over 24 hours or more.
Transtelephonic Monitoring —Instead of a 24-hour monitor, you may take home a device that allows you to send your EKG recording over the telephone at the moment you feel symptoms of an arrhythmia.
Implantable Loop Recorder —Sometimes, a longer period of recording is necessary. A small, about 2" x 1" rectangular recording device may be surgically implanted underneath the skin of the chest. This device can record EKG-like information over a longer period of time. If the information recorded falls within certain normal limits, the device erases the data. Any episodes of abnormal heart rhythms are retained in the device until retrieval by the physician.
Nuclear Scanning —A radioactive material is injected into a vein and observed as it is absorbed by the heart muscle. This test is not specific for rhythm disturbances. It is used to visualize the blood supply to the heart. Areas with poor blood supply can potentially generate abnormal rhythms.
Tilt Table Testing —This test is usually ordered for patients with fainting episodes. Your heart rate and blood pressure are closely monitored while you are first lying flat on a table and then when the table is tilted.
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