Medically Reviewed by Brian P. Wall, MD

Heart disease is a leading cause of health concerns for many people, but how do you know if you’re at risk? When heart disease is suspected, there are several tests that can help healthcare providers determine the next steps. Dr. Brian Wall, an Interventional Cardiologist at McLeod Health, explains the diagnostic process, symptoms of heart disease, and how to navigate life after a diagnosis.

Testing for Heart Disease

Dr. Wall says he breaks this in to two categories: individuals who are experiencing symptoms and those who are not. If you’re having symptoms, one of the most common tests is a stress test. This involves walking on a treadmill while we monitor your heart’s electrical activity using an EKG. During the test, we look for changes in the EKG that could indicate blockages in the arteries of the heart.

For individuals who aren’t currently showing symptoms but are concerned about their risk due to family history or other factors, a calcium score is a great option. The calcium score is a non-invasive test that looks for the likelihood of blockages in your heart’s blood vessels. It’s particularly useful for patients who want to know where they stand in terms of coronary artery disease risk.

Heart Disease Symptoms

“When we think of heart disease, many of us picture the classic image of someone clutching their chest in pain. However, that’s only true for about 50 percent of people with heart disease,” Dr. Wall says.  “The other half might experience a variety of symptoms, which could include anything from acid reflux-like sensations to lightheadedness, dizziness, and shortness of breath.

“For some, heart disease manifests as a decline in physical ability. For example, someone who could walk a mile three months ago might now struggle to walk half that distance before feeling winded. If you notice any changes in your ability to perform regular physical activities, that could be a sign of underlying heart issues.”

Asymptomatic Heart Disease

Some individuals may have heart disease without any obvious symptoms. This is especially true for those with a sedentary lifestyle. The heart can adapt over time to a slow blockage, and as long as the individual isn’t very active, they might not feel any discomfort until something more severe, like a heart attack, occurs.

Even active individuals, like mountain bikers or athletes, can have heart disease without noticeable symptoms. They might suddenly experience a heart attack, despite being in good physical shape. So, while active people often have some warning signs, it’s not guaranteed, and sedentary individuals may not feel any symptoms at all until it’s too late.

Questions To Ask

Dr. Wall says the most important question you should ask your cardiologist is, “What can I do to slow or halt the progression of heart disease?” Unfortunately, there’s no cure for heart disease, and the damage can’t be reversed once it’s done. However, lifestyle changes like a heart-healthy diet, regular exercise, and medications—such as statins—can help slow the progression and manage the condition effectively.

It’s also important to ask about your treatment options and how to monitor your health moving forward. Understanding how lifestyle adjustments and medications can work together will help you feel more in control of your condition.

If you’re ever unsure about your symptoms or whether they’re related to heart disease, Dr. Wall says to call your healthcare provider right away. If you’re questioning whether what you’re experiencing is related to heart disease, it’s always better to make the call.

Find a cardiologist near you.