How Doctors Diagnose Arrhythmias

What is an arrhythmia and why is my doctor ordering all of these tests? According to the American Heart Association, arrhythmias are disorders of the regular rhythmic beating of the heart. Arrhythmia is almost as difficult to spell as it is to properly detect. Your doctor conducts a battery of tests to identify the arrhythmia and treat accordingly.

The possible causes of arrhythmias include, but are not limited to, a congenital abnormality, a myocardial infarction (heart attack), inadequate blood flow to the heart, heart disease, and drug toxicity.

The signs and symptoms of arrhythmia include light headedness, dizziness, palpitations, heart fluttering, bradycardia (slow heartbeat), tachycardia (rapid heartbeat), presyncope (feeling faint), syncope (actual fainting), and sometimes no apparent symptoms are felt by the patient.

Arrhythmias have the potential to be dangerous and fatal if left untreated. If you feel the signs and symptoms of an arrhythmia, you should notify your physician. Left untreated, an arrhythmia can cause irreversible damage and even death.

If your doctor suspects an arrhythmia, he will order a battery of diagnostic tests to diagnose or cancel out arrhythmias as the cause of your condition. Some tests that the doctor will likely order includes blood tests, drugs tests, ECG, Holter Monitoring, Stress Tests, and electrophysiological tests.

Certain blood tests the physician will likely order include measuring the level of serum electrolytes such as potassium. He may also measure the serum amount of certain medications you are on, specifically quinidine or digoxin.

Your physician may also order certain drug tests to test for illicit and street drugs in your system. Illegal drug use, whether it is from street drugs or prescription drug abuse, can cause drug toxicity in your body and potentially be the underlying cause of your arrhythmia.

An ECG, electrocardiography, may be ordered to help identify an arrhythmia or other possible cardiac issue. The test will last approximately 10 to 15 minutes and will be under the supervision of the physician or technician. The technician will cleanse and possible shave the sites of your body where the electrodes will be placed. The test is harmless and requires you to lie perfectly still while the test is being performed. Movement by you will distort the ECG results and lengthen the recording test time.

A Holter Monitor may also be ordered by the physician to record the possible causes of your arrhythmia. This monitor, a small box connected to electrodes will be worn by the patient for at least 24 hours. This is a type of ambulatory monitoring. The patient will keep a log of the activities performed throughout the day and at what time the activities occurred. These activities include walking, chores, sleeping, eating, and any emotional upset that may have occurred while wearing the Holter Monitor. You will also log any specific time you feel the symptoms of a cardiac issue including arrhythmia. Much like the ECG, the technician will cleanse and possible shave the areas of your body where the electrodes will be placed. The technician will also teach you to not tamper with the electrodes or the monitor as well as teach you how to determine if the device has been compromised. This is usually obvious by blinking lights on the device to signal a loose electrode. Your physician will prompt you as to what to do in this case.

An Exercise ECG, also known as a 'stress test' is used to determine arrhythmias that occur due to physical exertion. These tests are performed using a treadmill or stationary bike. The technician will apply the electrodes of an ECG to your body and the test will record your heart rhythms while you use the treadmill or stationary bike. The speed of the treadmill or resistance of the stationary bike will begin low and increase as the test progresses. The doctor will be present throughout this test. Be sure to wear comfortable loose fitting clothes and comfortable shoes during this test. Notify your doctor if you experience any pain or difficulty during this test. You should not eat, drink, or smoke 3 hours prior to this test or per doctors orders. You will likely be instructed by your physician to continue taking any prescribed medications before the test.

The above tests are essentially painless and do not pose a risk to your well being. Your doctor will educate you more about each test. Remember to be as educated as possible about the tests and other diagnostic procedures your doctor will be performing. The more educated you are the more likely you are to understand your condition and know what types of questions to ask your health care provider.

Sources:
Springhouse, Patient Teaching made Incredibly Easy.