COPD and Heart Issues: Common Heart Tests

Health Professional

Last month we talked about how your heart works in partnership with your lungs. Today we're going to talk about common cardiac (heart) medical tests. Next time your doctor wants to do a test on your heart, you'll have a better idea what to expect and what your doctor is looking for.

Invasive and Non-invasive
Before we start, let's talk about two main methods of medical testing: Invasive and non-invasive. A medical test or procedure is considered invasive when something is put into your body - a needle or a tube to gather or give blood, fluid, or tissue. In a non-invasive test, nothing is placed into your body.

Here are some commonly done Cardiac tests; Names, how the tests are done, what your doctor is looking for, and what are good - and not so good - results.

Electrocardiogram - EKG
A quick, simple test to show the electrical activity in your heart.

How is it done?
Ten small sticky tabs are placed on your upper chest or arms, your legs, and chest. These stickies are then hooked up to thin wires connected to a machine that picks up the electrical impulses coming from your heart. The EKG machine shows these impulses on a paper that comes out of the machine. Don't worry. An EKG does not put any electricity into you

What is your doctor looking for?
A complete, 12-lead EKG shows your doctor 12 different views of the electrical impulses of your heart, how fast your heart is beating, and if the electrical impulses are taking the right pathway to make your heart beat effectively. Each heartbeat on the page has five parts. These peaks and valleys pictured on the EKG should show an organized and effective heartbeat.

What's good? What's not?
Your heart rate should be between 60 and100 beats per minute. However, some people (usually highly conditioned athletic types) can do just fine with a heart rate below 60 without getting dizzy or fainting. Your doctor can advise you what's normal and acceptable for you. Each "wave" in the heartbeat tracing should be within a certain range of time, shape, and strength. If the waves are outside the normal range, you may need further testing.

An echocardiogram is an ultrasound of your heart.

How is it done?
The technician puts a clear gel onto your chest over the location of your heart, and moves a hand-held device over the gel. Images - live, moving pictures of your heart's motion, appear on a computer screen. During the test you may hear the sound of the blood rushing through the chambers of your heart. This "movie" of your heart is then saved and viewed later on by your doctor.

What is the doc looking for?

The echocardiogram results include many readings, but one main reading is the Ejection Fraction or EF. This shows the strength and effectiveness of your heart muscle. The EF is the fraction of the total amount of blood being ejected by your heart muscle with each beat. An "echo" also shows how your heart valves are working, for example, if any of the blood is sneaking back into the chamber it is supposed to be going out of.

What's good - what's not?
A good EF is 50 to 75 percent. A lower number may indicate a lack of strength and effectiveness of your heart.

Stress test - Graded exercise stress test

How is it done?
A simple graded exercise cardiac stress test is when you are hooked up to sticky patches and wires (something like the EKG) and the you walk on a treadmill or ride a stationary bike. The speed and uphill grade are gradually increased as your heart rate and rhythm is being monitored.

What is the doc looking for?
The doctor is looking for your heart to reach a desired rate, and to see if this level of exercise causes dangerous changes in your EKG.

What's good - what's not?
It is good for your heart to be able to tolerate vigorous exercise safely without showing significant changes. It's not good if your heart shows dangerous changes due to exertion.

Stress test - Chemical stress test  ** Invasive How is it done?**
In this test, you don't get on a treadmill or bike. You lay still as a chemical goes through an IV and that chemical stresses your heart. This test takes longer and uses x-rays.

What is the doc looking for?
The doctor is looking to see that your heart is able to safely tolerate this level of stress.

What's good - what's not?
It is good for your heart to be able to tolerate this stress safely without significant changes. It's not good if your heart shows dangerous changes.

Heart Catheterization Invasive** How is it done?**
In this test, a catheter, a long tube, is inserted in the large artery in your groin, the uppermost part of your leg. A dye is placed into the tubing and that dye travels to your heart. X-rays show how your heart is being supplied with fresh oxygenated blood.

What is your doc looking for?
The cardiologist doing the test is looking for blockages in the arteries of your heart, and if they are serious enough to cause a lack of oxygen, thus damage to your heart muscle, and a possible future heart attack.

What's good - what's not?
Your cardiologist determines how many arteries are blocked, and to what extent. This indicates - in your individual situation - if you need surgery or a procedure to open them up.

Watch for the final part of our series when we'll talk about blood tests for your heart and heart medicines that may interfere with your breathing.

Jane M. Martin is a licensed respiratory therapist, teacher and the founder and director of and the author of Live Your Life With COPD: 52 Weeks of Health, Happiness and Hope and Breathe Better, Live in Wellness: Winning Your Battle Over Shortness of Breath.