Ask an Expert


Learn more about medical tests: how they work, what the results mean, and how heart conditions are diagnosed.

  • Will policy changes come about soon in the healthcare industry to improve patient-provider communication?
  • The idea of shifting healthcare policies from “fee-for-service” to “pay-for-performance” has been in the works for years. This means that healthcare organizations would provide incentives for physicians to spend more time with patients, providing higher quality care to the individual, rather than just seeing the highest number of patients possible. The implementation of these changes will take time, but as more and more patients, providers, and leaders recognize the importance of communication and high-quality care for patients, the likelihood of policy changes increases as well.
  • Why is communication not an important skill taught to physicians?

  • With so much for students to learn during medical school, patient-provider communication is addressed, but can be overshadowed by the wealth of information that students must learn throughout their education. Later, when students move onto residency programs, few programs have structured programming in communication, and supervisors do not have the time to observe residents’ patient interactions for evaluation and feedback. During this cycle, patient-provider communication often takes a backseat to the many other responsibilities that physicians hold.
  • Why is FDG-PET good at finding inflammation?

  • The “G” in FDG stands for glucose, which is a type of sugar. Inflamed tissues burn through a lot of energy. They take up the glucose to use as fuel. Normal tissues don’t burn through as much energy, so they take up less glucose.

    When doctors are looking for inflamed or cancerous tissue, they use FDG that has been labeled with a small amount of radioactivity. The FDG is injected into a vein and is taken up by inflamed tissues as it circulates through the body. The PET camera can see how much glucose the inflamed tissue is using by measuring the radioactive particles the FDG releases.

  • What is the difference between unstable angina, ST Segment Elevation Myocardial Infarction (STEMI) and Non-ST Segment Elevation Myocardial Infarction (NSTEMI)?
  • STEMI and NSTEMI are two classifications for a heart attack. Although both result from the interruption of blood supply to a part of the heart, STEMI results in ST-elevation (elevation of a cardiac enzyme) while NSTEMI does not. Unstable angina, on the other hand, is a condition characterized by chest pain or discomfort that is unexpected and usually occurs at rest. Unstable angina is often accompanied by shortness of breath, indigestion and/or dizziness. Unlike STEMI and NSTEMI, which cause muscle damage in the heart, unstable angina is not associated with muscle damage. However, unstable angina is very dangerous, may progress to a heart attack, and needs emergency treatment.

    Unstable angina and NSTEMI often appear identical at first presentation. The difference can be ascertained only after an ECG and blood tests to look for markers that indicate heart muscle damage.

    Call 9-1-1 immediately if you have the following symptoms:

    • Chest pain, pressure, tightness, or heaviness.  This discomfort may radiate to the neck, jaw, shoulders, back, or one or both arms.
    • Weakness, dizziness, lightheadedness, loss of consciousness.
    • Indigestion or “heartburn”; nausea and/or vomiting associated with chest discomfort
    • Shortness of breath that does not go away
  • What should I do if I have red, inflamed gums?

  • Even if you’re not worried about heart disease—but especially if you are—you should see your dentist or periodontal specialist. It’s important to follow their recommendations for treating your gum disease. Good care of your teeth and gums requires some effort every day, but it will keep you healthier. Remember, it’s not just your smile that’s at stake—it could be your heart.
  • What types of medical tests emit radiation?

  • There are a number of medical tests that emit radiation, including X-rays, CT scans and cardiac imaging. However, each test can emit different doses of radiation.
  • How can doctors assess the hostility of a patient?

  • Doctors often use an Expanded Structural Interview (ESI) to assess whether a patient is considered “hostile” or not. The ESI is a 12-minute interview designed to assess how individuals respond to stressful situations. During the ESI, the interviewer rates the degree to which the participant expresses hostility, either through hostile statements, vocal hostility or a combination of both.
  • How are white blood cell counts tested?

  • White blood cell counts can be measured using a simple blood test, which is most commonly used to determine the presence of infections.
  • How can doctors test inflammation of adipose tissue?

  • To test for fat inflammation, doctors must obtain a fat sample to biopsy for certain substances known as macrophage crown-like structures, which are indicative of inflammation.
  • How do home blood pressure monitors work?

  • There are two main types of home blood pressure monitors that patients can use to track their blood pressure on their own—manual and automatic. Manual blood pressure monitors are similar to those that doctors might use to take your blood pressure, while automatic monitors are electronic monitors that can report your numbers digitally and even integrate with other digital health tools. Both can be very easy to use and useful in helping monitor blood pressure in between doctor visits.

  • How do I know if I have peripheral artery disease (PAD)?

  • The most common symptoms for PAD include painful cramps in the hips and legs when walking, exercising or climbing the stairs, which goes away after stopping. Those with severe PAD may have foot or toe wounds that take a long time to heal and may experience leg pain that does not go away after physical activity. The good news is that PAD is easily diagnosed and doesn’t require any tests or needles, just a quick examination to check for weak pulses in the legs.
  • How can I reduce my sleep-time blood pressure?
  • Patients can decrease their sleep-time blood pressure the same way that they reduce their awake blood pressure: maintaining a healthy diet and weight, exercising regularly and avoiding smoking. There are also a number of medications that doctors can prescribe to help lower blood pressure, which can be useful, particularly in combination with positive lifestyle changes.
  • Can children improve their HRR?

  • Absolutely. Higher levels of HRR are associated with risk factors for heart disease, such as high cholesterol, high body mass index (BMI), and a lack of physical activity. Through diet, exercise, and lifestyle changes, children can improve their HRR, thus improving their cardiovascular health.
  • Am I at risk for obstructive sleep apnea (OSA)?

  • Obstructive sleep apnea is more likely to occur in men than in women. It is also becomes more common as you get older. Certain anatomical features also put you at risk for the condition such as having overly large tonsils or tongue, or naturally smaller air passages. Allergies that cause nasal congestion can also contribute to your risk. Half of the 12 million American adults who have OSA are overweight, but body fat appears to be less of a factor in people with heart failure.
  • How are liprotein-a levels tested?

  • Lipoprotein-a can be measured with a simple blood test, similar to blood tests for other types of cholesterol.
  • Do radiation risks associated with medical tests often outweigh the benefits?

  • Risks and benefits of medical tests vary between the type of test and the health and history of each patient. Therefore, the risks and benefits for tests are unique to each patient and should be discussed with a health care provider.
  • Is it worth the radiation risk to have angioplasty and stenting?

  • In a word, yes. Skilled interventional cardiologists perform coronary procedures only when the benefits outweigh the overall risks, including any risks from radiation exposure. Keep in mind, we’re all exposed to radiation from the atmosphere as we go about our everyday lives. Background radiation comes to about 3 to 4 “milliSieverts” (mSv) a year. By comparison, the radiation dose from cardiology procedures such as cardiac catheterization and angioplasty is about 1 to 10 mSv. Still, it is important to talk with your doctor about plans for minimizing radiation dose as much as possible.

  • Should I be worried about developing redness or other signs of a radiation burn on my skin after angioplasty?
  • Radiation burns are extremely rare. When they do happen, they are usually related to very long x-ray times or repeat procedures. However, if you notice skin redness on your back that looks like rash, even months after your angioplasty, tell your doctor. You may need to be referred to a skin specialist for treatment.
  • How important is immediate medical attention after a heart attack or stroke?

  • Seeking medical attention at the first signs of a heart attack or stroke is crucial to survival and avoiding permanent damage. If you are experiencing any symptoms of a cardiac event, call 911 immediately and wait for help to come.
  • How is a heart attack diagnosed?

  • The diagnosis of a heart attack is based on symptoms, an electrocardiogram and results from a blood test used to identify markers of heart attack.
  • How does telemedicine work?

  • Telemedicine is a modern way that patients and providers can communicate through the use of telecommunications and information technology. Although the use of telemedicine is relatively new, it can greatly improve the lines of communication between patients and their doctors and create a more effective and efficient way for patients to receive health care.
  • How is heart failure diagnosed?

  • There are many tests that doctors can use to diagnose heart failure, ranging from a physical examination to an x-ray, echocardiogram, stress test, MRI or blood test. If you think that you may have heart failure, make an appointment to see your healthcare provider as soon as possible. It is important to identify heart failure early in order to help manage symptoms and slow their progression.
  • How is Heart Rate Recovery measured?

  • To determine HRR, the pulse must be measured before, during, and after exercise (typically following a short exercise test). By comparing the heart rate a few minutes after exercise with the heart rate right after stopping, the rate at which the heart slows down or recovers can be measured.
  • How is pre-diabetes diagnosed?

  • Pre-diabetes can be diagnosed through two types of testing: oral glucose tolerance testing and/or fasting glucose testing. Both can help identify if a patient has an impaired fasting glucose or impaired glucose tolerance.
  • How is Peripheral Arterial Disease diagnosed?

  • PAD is diagnosed based on general medical and family history, history of leg or heart problems, personal risk factors, a physical exam, and test results. An accurate diagnosis is critical, because people with PAD face a six to seven times higher risk of heart disease or stroke than the rest of the population. PAD is often diagnosed after symptoms are reported with a simple test called an Ankle-brachial index (ABI)  If you have PAD, your doctor also may want to look for signs of coronary artery disease (CAD).

    A simple test called an ankle-brachial index (ABI) can be used to diagnose PAD. The ABI compares blood pressure in the ankle with blood pressure in the arm to see how well blood is flowing. A normal ABI is 1.0 or greater (with a range of 0.90 to 1.30). The test takes about 10–15 minutes to measure both arms and both ankles. It can help the doctor find out if PAD is affecting the legs, but it will not identify which blood vessels are blocked. The ABI can be performed yearly if necessary to see if the disease is getting worse.

Ask an Expert

Please note that every question submitted will not receive a direct response from a Cardiologist. However, we will follow-up with suggested ways to find appropriate information related to your question. Please do not use your last name or any other confidential information in your question.

Meet our Expert

Your questions are answered by more than two dozen members of the American College of Cardiology who volunteer their time with CardioSmart.

Learn more about our volunteers