Your health care professional will ask you questions about your symptoms and family history. To know if your symptoms are normal or not, it's important to consider what sports and exercises you do, how long you've been doing them, and your exercise intensity.
You should find out if anyone in your family died suddenly, especially at a young age. It's important to know if you or any of your relatives had episodes of passing out for no reason, drowning, car accidents, or seizures. These all may have been due to a heart condition.
Typically, your physician will obtain a thorough personal and family medical history and perform a physical exam. Long-term endurance athletes may have a slow pulse. Your health care professional also may listen closely to your heart for any murmurs.
Depending on your history and exam findings, she may recommend other diagnostic tests. The goal of these tests is to identify and treat the problems that might increase your risk of sudden cardiac arrest. Common tests include:
- Electrocardiogram (ECG). Your ECG should be interpreted with the knowledge that you are an athlete. People who exercise a lot, especially when young, may have an ECG that would look abnormal if you were a non-athlete.
- Echocardiogram (echo). An echocardiogram, or ultrasound of the heart . This test doesn't hurt and shows the size and function of the heart. It can also look at the heart valves. For a more detailed look at your heart, your doctor may order a cardiac MRI (magnetic resonance imaging).
- Home ECG Monitor. If your heartbeat has been fast or irregular or if you have passed out, your doctor may want you to wear an ECG monitor at home. This may be for only one day or up to 30 days, depending on how often you have your symptoms. Some of these monitors are called Holter monitors and some are called event monitors.
- Stress Test. If symptoms occur during exercise, you may undergo a stress test when you run on a treadmill attached to an ECG. This can mimic the exercise that triggers your symptoms. Sometimes your doctor may also want to do this test using an echocardiogram or a nuclear medicine image. Another test may be a coronary calcium score. Interestingly, higher levels of exercise increase the amount of calcium and plaques in the arteries of the heart, but people in this situation are less likely to have a heart attack.
Genetic Testing may be recommended in specific cases. This requires either a cheek swab or blood work.
In rare cases, your doctor may do an electrophysiology study (EPS) to find out whether you have an issue with your heartbeat.