Diagnostic Cardiology

The proper diagnosis is essential to recovery from any type of heart disease. Depending on your specific symptoms, the specialists at the Heart and Vascular Institute at UPMC Western Maryland will use one or more of the six diagnostic tests described below. Shortly after receiving a diagnosis, the cardiologist will devise a multi-faceted treatment plan to help you recover as quickly as possible.

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Cardiac Catheterization

The purpose of cardiac catheterization is to provide an X-ray image of your coronary arteries and heart. The cardiologist inserts a catheter, which is a long, thin tube, into a vein or artery in your leg or arm. After securing the catheter in place, the cardiologist guides it up towards the heart. Next, the cardiologist injects a contrast dye directly into the catheter. This helps to illuminate any defects or blockages of the heart or coronary arteries. The high-speed X-ray machine captures pictures from a variety of angles to aid in diagnosis.

The biggest advantage of undergoing cardiac catheterization is that it provides the cardiologist with a highly detailed picture of the current performance of your heart. This procedure is especially useful to detect blockages in the coronary arteries as well as the percentage of the block. It also lets the cardiologist know how efficiently your heart valves work, how strong the heart muscles are, whether there’s been previous damage to the heart muscles and the speed and efficiency at which it pumps blood.

Our cardiology team completes this procedure in the Cardiac Cath Lab under completely sterile conditions. The laboratory is equipped with high-resolution fluoroscopic video (X-ray), as well as equipment for digital imaging. The cardiology staff continually monitors you as you undergo cardiac catheterization with a hemodynamic system. This piece of equipment can simultaneously measure blood pressure, oxygen saturation, and pulse, and will alert the care team immediately to any problems.


An echocardiogram takes a picture of your heart muscle and valves using ultrasound technology, which emits high-frequency sound waves to a computer monitor. When the waves show up on the monitor, it automatically records it. This allows the cardiology team to review your results promptly and form a diagnosis more quickly. Echocardiograms provide valuable information, such as the size of your heart, its valves, and muscles, as well as how well blood flows from inside the heart.


Also known as an EKG, an electrocardiogram measures your heart’s electrical activity. To start the procedure, the cardiologist attaches several electrodes to your chest. This sensitive piece of equipment can diagnose heart conditions ranging from mild to severe. It also detects issues with the size or rhythm of your heart or problems with its muscles. An EKG can also provide a baseline measurement for you if you have no known heart disease.

Holter Monitor

A cardiologist may have you wear a Holter monitor, a recording device about the size of a small Transistor radio that is worn on a belt or as a shoulder harness. It contains electrodes to measure the electrical activity of your heart 24 hours a day. While wearing the Holter monitor, you record all daily activities and any symptoms experienced. This allows the cardiologist to compare activities and symptoms with any changes detected during your EKG. A Holter monitor is most effective for detecting coronary artery disease and an irregular heartbeat.

Stress Tests

If you have heart disease, you often show symptoms of dysfunction while exercising that do not appear while resting. The purpose of a stress test is to see how well your heart functions during moderate exercise. The cardiologist will have you walk on a treadmill or peddle a stationary bicycle to elevate your heart rate. The cardiologist then measures your EKG, blood pressure, and heart rate. The stress test helps determine the capacity of the arterial blood supply, as well as your tolerance for exercise.

If the cardiologist detects increased blood flow to your heart while you exercise that relaxes as you rest, the cardiologist will order a thallium stress test or a myocardial perfusion scan. These tests use a radioactive isotope, also known as a thallium, along with a nuclear camera to provide greater details about potential coronary artery disease. It also indicates the severity of the issue.

Transesophageal Echocardiography

This procedure, commonly abbreviated TEE, uses a special image procedure to provide an exceptionally clear picture of your heart and all of its structures. The cardiologist inserts a small tube into your throat and advances it towards the esophagus. The tube has a transducer attached to the end of it. The TEE produces clearer images than a typical echocardiogram because of the proximity of the esophagus to the heart. It’s useful for detecting problems with blood flow and heart valves, as well as the functioning of your heart’s aorta and muscle.