Conduction Disorders - Diagnosis - Diagnosis

Your doctor may ask questions about your personal medical history using questions such as the following:

• Do you experience heart palpitations?
• Do you experience unusual shortness of breath or fatigue with exercise?
• Do you have high blood pressure?
• Do you have symptoms of sleep apnea?
• Have you ever fainted or almost fainted without a known reason?
• Have you experienced chest pain or discomfort with exertion or exercise?
• What medicines are you taking?

Your doctor may ask about your family’s medical history, including:

• Complications from heart disease in a close relative
• Premature death of a relative, either sudden or unexpected
• Specific knowledge of heart conditions in family members

As part of your physical exam, your doctor may listen to your heart, record your heart rate, and measure your blood pressure.

To diagnose a conduction disorder, your doctor may order an EKG, which records your heart’s electrical activity. Each conduction disorder has a specific pattern that can be seen on an EKG.

If the diagnosis is unclear from the EKG or your doctor would like more information, your doctor may order additional tests, such as one or more of the following:

• Blood tests to look for potentially reversible causes, including high or low blood electrolyte levels or endocrine disorders such as hypothyroidism, or to check medicine levels.
• Holter or event monitor to record your heart’s electrical activity over long periods of time while you do your normal activities.
• Implantable loop recorder to look at the heart’s electrical activity over a longer period of time or to find a diagnosis if earlier tests do not rule out a conduction disorder. The recorder can transmit data to the doctor’s office to help with monitoring. An implantable loop recorder helps doctors figure out why a person may be having palpitations or fainting spells, especially if these symptoms do not happen very often.
• Stress test to look at changes in your heart’s activity that occur with an increase in heart rate and during recovery after exercise.
• Cardiac magnetic resonance imaging (MRI) or other types of imaging to look at the heart’s structure.
• Echocardiography to look at the heart’s structure and how well it is working.
• Electrophysiology study (EPS) to look at the electrical activity of the heart and to find the source of an abnormal heartbeat. The study uses a wire to stimulate your heart electrically. The information from an EPS may help guide treatment.
• Genetic testing to confirm a genetic diagnosis, as in some ion channel disorders. If you have certain genes known to be risk factors for a conduction disorder, your doctor may also recommend testing other family members.

If a conduction disorder is diagnosed while you are asleep, your doctor may also request a test to find out if you have sleep apnea, which is a common complication.

• Return to Risk Factors to review family history, medicines, or other medical conditions that increase your risk of developing a conduction disorder.
• Return to Signs, Symptoms, and Complications to review common signs and symptoms of conduction disorders.
• Return to Screening and Prevention to review how to screen for conduction disorders.