If you’ve been referred to a cardiologist, it’s natural to wonder what’s coming next. Many patients I speak to are unsure what kind of tests we might do and why. Whether you’re experiencing symptoms like chest pain or shortness of breath, or you’re simply being checked due to family history, cardiologists' tests play a key role in understanding your heart health.
I’ll walk you through the most common tests used in cardiology clinics, what they involve, and when you might need them.
Why Are Heart Tests Needed?
The heart is a complex organ, and symptoms like fatigue, dizziness, palpitations or chest pain can point to a wide range of possible causes. Testing helps us:
Diagnose specific heart conditions
Assess the risk of future problems
Monitor ongoing treatment
Identify heart issues before they cause symptoms
Sometimes, these tests are routine. Other times, they’re urgent. Either way, the right test at the right time can make all the difference.
1. ECG (Electrocardiogram)
An ECG is often the first test we perform. It’s quick, painless, and gives an immediate picture of your heart’s rhythm and electrical activity.
What it shows:
Heart rate and rhythm
Signs of previous heart attacks
Abnormalities such as atrial fibrillation or heart block
What to expect:Small electrodes are placed on your chest, arms and legs. The test takes about 5–10 minutes and can be done in a clinic or GP surgery.
2. Echocardiogram (Heart Ultrasound)
An echocardiogram is an ultrasound scan of the heart. It shows the heart's structure and how well it’s pumping.
What it shows:
Heart valve function
Heart muscle strength (ejection fraction)
Signs of heart failure or cardiomyopathy
Fluid around the heart
What to expect:You lie on your side while a probe with gel is moved across your chest. It’s non-invasive, safe, and usually takes around 20–40 minutes.
There are also other types like transoesophageal echo and stress echo, which give more detailed information in certain cases.
3. Blood Tests
Cardiologists often request blood tests to look at key markers related to your heart.
Common ones include:
Troponin – to check for heart muscle damage (especially after chest pain)
Cholesterol – high cholesterol increases risk of heart disease
BNP – can indicate heart failure
Thyroid and kidney function – as these can affect the heart
These tests help us identify risk factors and underlying causes.
4. Stress Test (Exercise Tolerance Test)
Also called an exercise ECG, this test looks at how your heart copes under physical stress.
What it shows:
Signs of reduced blood flow to the heart (ischaemia)
How your heart responds to exercise
Potential issues with rhythm that only appear under stress
What to expect:You walk on a treadmill or use a stationary bike while being monitored. If you can't exercise, there are alternatives like stress echocardiography or pharmacological tests.
5. 24-Hour ECG or Holter Monitor
Some irregular heart rhythms don’t show up during a short test like a resting ECG. That’s where Holter monitors come in.
What it shows:
Heart rhythm over 24 hours or more
Palpitations or skipped beats that happen at random
What to expect: Small electrodes are attached to your chest and connected to a portable device worn under your clothes. You go about your day as normal, then return the device to the clinic.
6. Blood Pressure Monitoring (Ambulatory)
For patients with suspected high blood pressure or “white coat syndrome”, we use ambulatory blood pressure monitors.
What it shows:
Blood pressure patterns over 24 hours
Whether medication is working effectively
You’ll wear a cuff and monitor for a full day, which takes regular readings automatically. It gives a more accurate picture than a one-off reading in a clinic.
7. Cardiac MRI
A cardiac MRI offers a detailed picture of the heart’s structure, tissue, and function using magnetic imaging.
What it shows:
Heart muscle damage
Inflammation (e.g. myocarditis)
Congenital heart problems
Cardiomyopathies
What to expect:You lie in an MRI scanner for around 30–60 minutes. It’s painless but can be noisy and requires you to keep still. Some scans involve contrast dye to get clearer results.
8. CT Coronary Angiogram
A CT coronary angiogram uses X-rays to check for narrowing in the coronary arteries.
What it shows:
Early signs of coronary artery disease
Calcium build-up or plaques in arteries
What to expect:You lie on a table while a contrast dye is injected into a vein. The scanner then takes detailed images of your heart arteries. It’s non-invasive and helpful in assessing risk of heart attack.
9. Invasive Tests (When Needed)
Some patients need more detailed investigation. These include:
Coronary angiography – a catheter is passed into the arteries to view blockages
Electrophysiology study (EPS) – used to investigate abnormal rhythms in detail
These are done in hospital settings and usually follow other, less invasive tests.
When Do I Need These Tests?
You might need one or more of these tests if you:
Have symptoms like chest pain, palpitations, dizziness or breathlessness
Have a family history of heart disease
Are starting new treatment for blood pressure or cholesterol
Have conditions like diabetes, which increase heart risk
Need to monitor an existing heart condition
Sometimes, we also use these tests proactively, especially if you’re over 40 or have known risk factors.
NHS vs Private: What’s the Difference?
Many of these cardiologists' tests are available on the NHS, but you may face longer waiting times depending on where you live. If your symptoms are urgent, your GP will refer you directly.
Going private gives you faster access to testing, often within days. At Heartsure, for example, we can arrange ECGs, blood tests, echocardiograms and monitoring during your first appointment with results explained immediately. For some people, this speed offers peace of mind and flexibility.
Are These Tests Safe?
Yes, the vast majority of heart tests are safe and non-invasive. A few (like CT or angiography) involve a small amount of radiation or contrast dye, but these risks are low and always weighed against the benefits.
We follow strict UK and NHS safety guidelines for all testing, whether you’re seen privately or publicly.
Conclusion
Heart testing doesn’t need to be overwhelming. Each test has a specific role, and most are simple, safe, and quick. If your GP or cardiologist recommends a test, it’s because they’re trying to better understand what’s going on and help prevent future problems.
If you’ve been wondering whether your symptoms need checking, or if you’d like faster access to heart tests, we’re here to help. At Heartsure, we offer a full range of diagnostic tests with expert support throughout the process.
Knowing your heart is healthy, or catching an issue early, can make all the difference, trust me.
