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Diagnostic Testing for Heart Disease

The first step toward successful treatment is fast, accurate and complete diagnosis. The Washington University and Barnes-Jewish Heart & Vascular Center offers the latest advances in cardiac imaging and diagnostic tests. 

Our heart specialists, radiologists, imaging technologists and other providers work as a team in our thorough evaluation process. We take a conservative approach, using appropriate testing to confirm a diagnosis and tailor a treatment plan for you.

Cardiac Testing and Diagnosis at Barnes-Jewish Hospital

Our team offers the full spectrum of cardiac testing, with expertise in using and interpreting all of the most advanced diagnostic technologies. Our center offers:

  • Expertise in evaluation: Our cardiologists have years of advanced training and experience assessing all types of heart disease. Whether you already have a diagnosis or need an initial evaluation, we review your previous testing before deciding whether you need more. We take time to explain your test results and diagnosis to help you fully understand the condition and our recommendations.
  • Multidisciplinary approach: Our specialists bring together their expertise from cardiology, cardiac surgery, cardiac imaging, cardiovascular pathology (diagnostic analysis) and other fields. You are in good hands with our heart experts who specialize in diagnosing and treating rare and complex conditions.
  • Advanced cardiac imaging: Our Heart & Vascular Center offers the most sophisticated imaging equipment available for diagnosing heart disease. Your care team includes skilled imaging cardiologists, radiologists and other doctors with experience using specialized cardiac imaging and interpreting the results.

Heart Disease: Our Diagnostic Process

Our heart doctors carefully evaluate you to find out what is causing your symptoms. We begin by reviewing your previous tests and imaging reports. Our thorough process helps us create a detailed picture of what you are experiencing.

We ask you about your symptoms, possible risk factors, and your personal and family medical history. We also perform a complete physical exam. If we need additional information to confirm a diagnosis, our cardiologists may recommend one or more tests.

Cardiac Imaging

Our Cardiac Diagnostic Laboratory is the largest of its kind in the St. Louis region. Together with the Mallinckrodt Institute of Radiology, we provide comprehensive imaging to diagnose all types of heart diseases. 

Our cardiac imaging doctors and technologists specialize in performing and interpreting diagnostic imaging studies, including: 

Echocardiogram (echo)

This painless test is a heart ultrasound, which uses sound waves to create moving images of your heart and blood vessels. An echo shows the structure of your heart, such as its size, shape and any damaged areas. We also use ultrasound imaging to show details about arteries and veins throughout the body.

We often use echo types and techniques such as:

  • Doppler: This ultrasound technique shows blood flow through the heart, arteries and veins.
  • Transesophageal: We guide a transducer (a long, thin probe) down your throat and into the esophagus (tube connecting your mouth to your stomach). Transesophageal echo (TEE) provides more detailed images of the heart from inside the body without other structures in the way.

Computed tomography angiogram (CTA)

This noninvasive imaging test uses CT scans, X-ray technology that combines multiple, cross-sectional pictures into 3D images. You first have an IV to deliver contrast, a dye that makes blood vessels more visible on the CT scan. 

We use CTA to check blood vessels for blockages, damage or blood clots. Another type is coronary CTA, which looks for blockages inside coronary (heart) arteries.

Magnetic resonance imaging (MRI)

MRI uses a powerful magnetic field and radio waves to produce still images and video of the heart and blood vessels. MRI is a painless, noninvasive imaging test. Some common types of MRI in cardiovascular diagnosis include:

  • Cardiac MRI: We can view the heart’s chambers, walls and valves; check for damaged heart muscle; and assess blood flow.
  • MR angiography (MRA): Similar to CTA, MRA shows the structure of blood vessels, allowing us to look for problems. You may or may not need a contrast dye with MRA.

Cardiac positron emission tomography (PET) scan

This noninvasive scan shows blood flow to the heart muscle and signs of tissue damage. You receive an injection of a small amount of radioactive tracer, which flows to your heart. A special camera shows the tracer in imaging. 

Cardiac PET/MRI scan

This noninvasive imaging test combines blood flow imaging from a PET scan with structural details from an MRI. You have the scans at the same time. Cardiac PET/MRI provides more detailed images for evaluating blood flow to the heart, using less radiation than a CT scan.

Catheterization for Diagnosis

We use minimally invasive catheterization to diagnose many heart diseases. In this procedure, the doctor inserts a catheter (long, thin tube) with a camera on the tip into a blood vessel. We guide the catheter to the area of the heart or its arteries to assess the condition.

Catheterization procedures we perform include:

  • Angiogram: We use the catheter to place a contrast dye into a heart artery that may be blocked. The contrast dye makes blood vessels appear bright white on X-rays, to show blood flow, blockages and other details.
  • Cardiac biopsy: The catheter has a tool that takes a tiny sample of heart tissue, which our cardiovascular pathologists examine under a microscope. A cardiac biopsy shows signs of infection or diseases such as amyloid heart disease or hypertrophic cardiomyopathy.
  • Electrophysiology (EP) study: This test uses a catheter with an electrode to measure the heart’s electrical activity. We use an EP study to evaluate and diagnose irregular heart rhythms.
  • Intravascular ultrasound: Also called ultrasound angiography, this procedure uses a catheter with ultrasound to create images inside blood vessels. This imaging test doesn’t use an injection of contrast dye.

In many cases, we can treat a condition during the same catheterization procedure. Learn more about cardiac catheterization and interventional cardiology

Other Diagnostic Tests for Heart Disease 

Depending on what we find during your evaluation, you may need other tests, such as:

  • Blood tests: We take a small sample of your blood to check for a wide range of underlying causes. These may include diseases, infections or other conditions that affect the heart and blood vessels.
  • Electrocardiogram (EKG or ECG): This test measures the heart’s electrical activity to check for irregular heartbeats (arrhythmias).
  • Holter monitor: This wearable EKG device records your heart’s electrical activity over 3 days. A Holter monitor shows abnormal heartbeats that come and go or occur only during certain activities.
  • Stress test: You walk or run on a treadmill or ride a stationary bicycle as we monitor you with an EKG, echo or CT scan. A stress test shows how well your heart works during physical activity.

Heart Disease Diagnosis: Research and Clinical Trials

Our heart specialists participate in research to help develop the latest tests and imaging for heart diseases of all kinds. As our patient, you may be eligible to participate in our clinical trials. These research studies offer access to promising new treatments and diagnostic methods before they’re available to the public. Learn more about our innovation.

Contact Us

To make an appointment with a Washington University cardiologist at Barnes-Jewish Hospital, call 314-362-1291.