How is heart block diagnosed?

If your primary care physician suspects that you have heart block, he or she probably will refer you to a cardiologist for a complete cardiac evaluation. At the Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute, our cardiologists will start by obtaining your medical records from your primary care physician, including records of any heart tests you have had done.

Your cardiologist will review your complete medical history with you and ask you questions about your overall health, your diet and activity level, and your family medical history. The cardiologist also will want to know about any medications you are taking (prescription or over the counter) and whether you smoke or use drugs.

You will undergo a complete physical exam during which the doctor will listen to your heart and check your pulse to measure your heart rhythm and heart rate. He or she will check you for signs of heart failure, such as fluid retention in the legs and feet.

An ECG is a useful test to diagnose heart block. An ECG records the heart’s electrical activity. The test produces a graph that shows the heart rate and rhythm and the timing of the electrical signals as they move through the heart.

Cardiologists can look at the graph created during an ECG and determine whether a patient has heart block and how severe it is, based on the patterns of the heartbeat, rhythm and signal timing.

Your cardiologist may want to record your heart’s electrical signals over a longer period of time. If so, you will be asked to wear a portable ECG. A Holter monitor is a type of portable ECG that is worn for 24 to 48 hours. The Holter monitor continuously records the heart’s electrical activity. An event monitor is another type of portable ECG that is worn for a longer period of time and records the heart’s electrical activity at specified times, rather than continuously.

An electrophysiology study is another useful tool to help diagnose heart block. This minimally invasive test uses thin, flexible wires (catheters) that are placed onto the heart’s surface to record the heart’s electrical activity. The Miller Family Heart, Vascular & Thoracic Institute includes some of the world’s leading experts in electrophysiology who are highly skilled at creating “maps” of the heart’s electrical activity using electrophysiology studies for the most accurate diagnosis and treatment.

Last reviewed by a Cleveland Clinic medical professional on 07/18/2019.

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