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If you experience shortness of breath, chest discomfort, lightheadedness, leg swelling, or fainting spells, you might suspect that you have a heart problem. Dr. Jeffrey Leavitt, a cardiologist at Mount Auburn Hospital, a teaching hospital of Harvard Medical School, says that these symptoms should prompt an immediate cardiac evaluation.

Dr. Leavitt says, “There are a variety of non-invasive tests that your doctor may recommend to determine if you actually have a problem going on with your heart. The type of tests ordered will depend on your specific symptoms, your medical history, and your risk factors.”

There is minimal discomfort for the patient having these non-invasive tests and the results can be extremely helpful in diagnosing the patient’s specific heart problem.

Dr. Leavitt describes some of the most common tests:

An echocardiogram uses sound waves to create an image of the heart, which will show the doctor the heart’s structure and how efficiently it is pumping. As a result of this test, the doctor can determine the percentage of blood pumped out of the left ventricle, which is the heart’s main pumping chamber. This percentage is called the “ejection fraction” and if it is too low, it may indicate heart failure.

An echocardiogram is also the best test for looking at the heart’s valves. There are four valves in the heart, each of which could be functioning abnormally as a result of various conditions. Specialized studies can reveal whether the valves are leaking or narrowing. This test is performed by trained echo technicians who place an ultrasound probe in various places on the patient’s chest. A gel is placed on the chest to improve the images, which are interpreted by a cardiologist.

An electrocardiogram (EKG) is a very common test also regularly performed in physicians’ offices. During this procedure, sticky pads with electrodes are placed on the chest in appropriate locations and impulses are recorded as waves displayed on a monitor or on paper. This is the best way to record the electrical activity of the heart and will detect rhythm problems or damage from a heart attack that may be causing symptoms.

Stress tests are taken as the patient walks on a treadmill while an EKG is being conducted. The treadmill is programmed to move at an increasing speed and elevation. Patients are asked to exercise as long as they are comfortable, with the goal of reaching a predetermined heart rate. This test can provide valuable information about a person’s cardiac condition since it shows endurance levels on the treadmill, evaluates the person for coronary artery disease, and indicates problems with heart rhythms. During a stress test, the doctor looks for cardiac symptoms like chest tightness or shortness of breath, and blood pressure is continually checked.

Imaging can also accompany the stress test. Stress echocardiograms compare a baseline image of the pumping heart to another echocardiogram taken right after exercise. This can reveal abnormalities in the left ventricle’s wall motion that are induced by exercise, which can be an indication of coronary artery disease and a poor blood supply to the heart. During a nuclear stress test a small amount of radioactive dye is injected into the veins. Then a small camera is used to detect the radioactive material as it flows through the heart. If there is an area of the heart where the dye does not show up, this can indicate decreased blood supply. This test can also reveal deficiencies in the heart’s pumping function.

Holter monitoring is another test that can effectively detect some heart problems. The patient wears a device that produces long-term, continuous recordings of the heartbeat, revealing changes that may briefly occur and otherwise escape notice.

Many times these tests show that the heart is pumping normally and the person tested can be fairly sure they don’t have a cardiac problem. Other times, if the test results are not normal, further evaluation will be necessary. A patient may be referred for a cardiac catheterization, an interventional procedure which can detect blockages in arteries.

Dr. Leavitt says, “These non-invasive tests for detecting heart problems are generally very safe to perform and well tolerated by the patient. They provide important information about the structure and function of the heart and can give the patient’s physician excellent guidance in deciding on the best approach for treatment.”