Common Tests for Congenital Heart Disease
Your cardiologist may order tests to see how well your heart is working. Your healthcare team will talk with you about how the test works and what it measures. Later, your cardiologist will explain the results and possible next steps.
Common tests for heart function include:
Electrocardiogram (EKG)
An EKG measures the electrical activity of the heartbeat. It can show:
- How fast your heart beats
- If your heartbeat is steady or irregular
- The strength and timing of electrical signals in each part of the heart
- If parts of the heart are larger than expected
An EKG receives tiny electrical impulses that the beating heart makes and records them in a zigzag pattern on a moving strip of paper.
Stickers are placed on your arms, legs and chest. The stickers are then connected to separate wires or leads that connect to the EKG machine. Once the leads are placed, the test is recorded in seconds.
Learn more about EKGs.
Chest X-rays
A chest X-ray gives details about your lungs and the heart’s size and shape. The amount of radiation from a chest X-ray is extremely small and doesn’t cause any long-term side effects.
Learn more about chest X-rays.
Echocardiogram
An echocardiogram uses sound waves to make pictures of your heart. It can detect most congenital heart defect or many problems with how the heart muscle works.
The test requires a few stickers, like those used for an EKG, to be placed on your chest to record the heart’s rhythm. A sonographer will use an ultrasound device on the front of your chest, upper abdomen and the root of the neck to record pictures of the heart. An echocardiogram usually takes 40-60 minutes.
Find out more about an echo.
Cardiac Catheterization and Angiogram
Cardiac catheterization is a procedure to see how well your heart works. A coronary angiogram is a special X-ray test that shows blood flow through the heart and blood vessels.
Patients may be admitted to the hospital on the day of the catheterization or the day before. Cardiologists usually perform angiograms during a catheterization.
Sometimes doctors can treat a heart defect during a cardiac catheterization. This is called an interventional or therapeutic catheterization. These treatments can include:
- Opening a hole in the wall between the upper chambers
- Opening a blocked valve or vessel
- Closing an unnecessary vessel
- Closing unnecessary holes in the heart
Your cardiologist will discuss these treatments with you before the procedure.
Find out more about cardiac catheterization and coronary angiogram.
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging is a way to take clear pictures of the heart and measure heart function. The MRI uses painless magnetic waves to evaluate the heart and blood vessels connected to the heart and lungs.
Often, a small IV will be placed in your hand. The test usually takes 30-60 minutes. You will need to lie as still as possible on a table for the test. Most of your body will be within a small tunnel in the center of the magnet. If needed, your cardiologist can give you medication to reduce any anxiety during the test.
Learn more about MRI.
CT (Computerized Tomography) of the Heart
The CT scan uses multiple X-ray images to create detailed pictures of the heart and lungs without using catheters. This test sometimes takes clearer pictures than an angiogram.
It requires an IV in the hand and can be done more quickly than an MRI. The amount of radiation depends on the type of CT scan and the imaging protocol used.
Learn more about a CT.
Transesophageal Echocardiogram (TEE)
A transesophageal echocardiogram uses ultrasound to make clearer pictures than a standard echocardiogram. To complete the study, the doctor places a long tube, called a TEE probe, in your esophagus while you are sedated.
A TEE may be needed when a standard echocardiogram doesn’t provide enough detail. The test also helps the surgical team determine if a procedure has been successful or if additional repair is needed before leaving the operating room.
The risks of a TEE are usually low, but your healthcare team will review them with you before the test.
Learn more about TEE.
Special Heart Rhythm Testing
Holter Monitor
A Holter monitor is a way to record your heart’s activity for 24-48 hours. It can be used to check for dangerous heart rhythms that might need more treatment.
A small recorder is attached to your body with stickers similar to those used in an EKG. You will also keep a diary of events during the time that you wear the monitor. This record will help the doctors know when you are active, sleeping or having any symptoms that might be caused by a heart rhythm problem.
Once you have completed the recording, you will return the recorder. A report will be prepared for your cardiologist.
Access a printable Holter Monitor Diary (PDF).
Learn more about Holter monitors.
Event Monitor
Event monitoring is a way to record the heart rhythm when your symptoms occur less than once a day. The event monitor is a recorder even smaller than a Holter monitor. You will wear it for most of each day, typically for 30 days at a time. \When you have a symptom, you push a button on the recorder to save the rhythm just at that time. When a recording has been made, you’ll send it using your mobile device to either the doctor’s office or a monitoring company that works with your doctor.
Implantable Event Recorder
An implantable event recorder, also known as an implantable loop recorder, can record your heart rhythm for up to three years. This device is placed under the skin through a minor procedure to record serious rhythm problems that may be happening rarely. Your cardiologist can display and print the heart rhythms that the recorder saved.
Learn more about cardiac event recorders.
Pacemaker/Implantable Cardioverter-Defibrillator (ICD) Transmission
People with a pacemaker or an ICD routinely send a rhythm strip or a recording to check how it’s working. Newer technology allows people with a pacemaker or ICD to send all their device information, including settings and arrhythmia recordings, to their doctors via mobile devices.
Learn more about devices for arrhythmias.
Exercise Stress Testing
Depending on age and development, children may use a treadmill or stationary bike during the test. Younger children may have difficulty using a bike or treadmill safely, so the type of exercise is chosen based on the child’s size, coordination and ability to follow instructions.
The stress test gives information about the effect of exercise on your blood pressure, heart rate, heart muscle and heart rhythm. If you have symptoms during exercise, this test will help to recreate them to see whether they are caused by the heart.
The test takes about 10-15 minutes to set up, 10-15 minutes to do and an additional 10-15 minutes of observation afterward. You should bring clothes and sneakers suitable for jogging.
Learn more about exercise stress testing.
Electrophysiology (EP) Study
An electrophysiology study is a specialized cardiac catheterization that looks at the heart’s electrical or rhythm function. The heart’s rhythm function initiates each heartbeat and regulates the heart rate.
An EP study can offer information about abnormal rhythms (arrhythmias).
Learn more about electrophysiology studies.
