Cholesterol And Cardiac Testing

What is a heart screening test?

Heart screening tests are typically used to evaluate a person's heart health and function and/or their personal risk factors for developing heart disease. Goals of screening may be to identify risk factors that can be addressed for reduced risk, detect heart disease in its earliest, most treatable stages, or to monitor the effectiveness of medical treatments and/or cardiac risk-reduction strategies. Examples of cardiac tests used for these purposes include:

• Cholesterol blood test – These blood tests measure a person's total cholesterol level. High total cholesterol indicates heart disease risk.
• Lipids panel – Also a blood test, a lipid panel or profile also tests cholesterol levels, but in greater detail, measuring total cholesterol levels, as well as levels of high density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides. High levels of LDL-C and triglycerides and/or low levels of HDL-C are risk factors for heart disease.
• Lipoprotein(a) test – This blood test measures levels of Lipoprotein (a) in the blood, a particle in the blood that carries proteins, fats and cholesterol. High levels indicate increased cardiac risk.
• C-reactive protein test – This blood test measures the amount of C-reactive protein in the blood, a substance related to inflammation. High levels of this protein can indicate the presence of atherosclerosis.
• Homocysteine test – This test measures levels of an amino acid called homocysteine in the blood. High levels have been associated with elevated risk of cardiovascular disease.
• Apolipoprotein B (Apo-B) test – Measures levels of Apo-B in the blood. High levels of this protein are a factor in the development of atherosclerosis.

Other screening tools used to evaluate a person's level of risk, heart health and other cardiovascular health factors include blood pressure checks, body weight and waist circumference measurement, blood glucose testing, evaluation of lifestyle factors and an examination of any family history of heart disease.

How do you test for heart failure?

Heart failure is a condition in which the heart becomes weakened and is unable to pump blood through the body efficiently. This most often occurs as a side-effect of diseases that damage the heart, such as coronary heart disease, high blood pressure, diabetes, kidney disease or thyroid disease.

Tests for heart failure may include any or all of the cardiac tests and screening measures listed above, as well as screening tests for prediabetes, diabetes, kidney disease or thyroid disease to evaluate whether a person suffers from diseases that can cause heart failure. Diagnostic tests that look for signs of the condition are also commonly used in diagnosing heart failure, including:

• Stress tests to evaluate heart function
• Diagnostic imaging tests, such as cardiac MRI, coronary angiography, echocardiography or cardiac catheterization, among others to look for signs of heart failure
• B-type natriuretic peptide (BNP) blood test. This test checks the level of a hormone called BNP in the blood, which rises with heart failure

How long do I fast for cholesterol test?

Eating before your blood is drawn for a cholesterol test can lead to inaccurate test results. For this reason, you can expect to be asked to consume nothing but water for 12 to 14 hours before the testing appointment.

What do the results of a cholesterol test mean?

Cholesterol blood test results present you with your personal cholesterol levels, which help determine your risk for heart disease. Your cholesterol numbers, expressed as milligrams of cholesterol per deciliter of blood (mg/dL) will fall into one of three categories used to classify that risk. For adults these are:

• Healthy cholesterol levels – Total cholesterol is below 170 mg/dL
• Borderline high – Total cholesterol is between 200 and 239 mg/dL
• High risk – Total cholesterol is at or above 240 mg/dL

Levels in children and teens are classified as follows:

• Healthy levels – Total cholesterol below 170 mg/dL
• Borderline high – Total cholesterol between 170 and 199 mg/dL
• High risk – Total cholesterol is at or above 200 mg/dL

Further testing to determine the causes of elevated cholesterol levels is generally the next step for those who have a borderline high or high cholesterol levels. Treatment is also typically recommended, with the goal of bringing blood cholesterol levels down in order to reduce cardiac risk. Treatment often includes cholesterol lowering drugs and lifestyle changes, including dietary changes, exercise, weight maintenance and, when applicable, addressing lifestyle factors that can contribute to high cholesterol levels, such as smoking or excessive alcohol use.