The first steps for diagnosing arrhythmia are reviewing your medical history and having a complete physical examination. Your doctor may be able to detect abnormal rates and rhythms using a stethoscope. Further tests are often done to determine the cause or severity of arrhythmia.
Electrocardiograms (EKGs) and echocardiograms (echo) are the most common tests used to diagnose any type of heart disease or abnormality. EKGs are simply measurements of the heart’s electrical activity, while an echo is a detailed ultrasound of the heart that allows doctors to see how the blood flows through it. The echo also measures the size and shape of the heart, how well the valves are functioning, how the left and right side communicate, and the speed of the blood leaving it.
There are several types of echocardiograms:
Stress echocardiogram: You exercise on a treadmill while a device attached to the chest sends out high frequency sound waves. Images are generated from the echoes to show any heart damage.
Transthoracic echocardiogram:A hand-held device placed on the chest send ultrasonic sound waves. The echoes produce an image on a monitor to show cardiac disease or damage.
Transesophageal echocardiogram (TEE): A tourniquet is applied to your arm, and a needle is inserted into the vein. Three sticky patches are attached to an EKG to record cardiac activity. A blood pressure cuff is placed on your arm to record blood pressures during the exam. A small clip placed over your finger records the oxygen level in your blood during the exam. An ultrasound probe is placed into the esophagus to create clear images of the heart. You will remain under observation for 30 minutes after the exam.
Dobutamine stress echocardiogram: An IV line is inserted into an arm vein after a tourniquet is applied. Stress is produced through drugs inserted through the IV, rather than exercise, to measure heart function with stress. The test takes about an hour and when done, you will be asked to remain in the waiting room until you are symptom-free.
Intravascular ultrasound: An ultrasound wand is attached to the top of a thin tube called a catheter. This ultrasound catheter is inserted into an artery in your groin area and moved up to the heart. A computer measures how the sound waves reflect off blood vessels, and changes the sound waves into pictures.