Patient guide
Common Heart Tests Explained: ECG, Troponin, Exercise Test and Angiography
Your cardiologist may recommend one or more tests to understand your symptoms and your heart’s health. Here is what the most common tests involve and what they show.
Written for patients of Dr. Azhar ul Hassan Qureshi, Consultant Interventional Cardiologist. Content prepared from current international guidelines · Updated October 2026.
Medical review pending
Key points
- Different tests answer different questions. Not everyone needs every test.
- An ECG records the heart’s electrical activity in a few minutes.
- Troponin is a blood test used to diagnose heart attacks.
- Coronary angiography is the most direct way to see the heart arteries.
Electrocardiogram (ECG)
Small sticky electrodes on the chest, arms and legs record the heart’s electrical activity. An ECG is quick and painless. It can show rhythm problems, signs of a previous or current heart attack, and strain on the heart. A normal ECG does not rule out all heart problems.
Troponin blood test
Troponin is a protein released when heart muscle is damaged. It is central to diagnosing a heart attack and is often repeated a few hours apart. Troponin can also rise in other conditions, so results are interpreted together with symptoms and the ECG.
Exercise tolerance test (ETT)
Also called a treadmill test, this records your ECG, heart rate and blood pressure while you walk on a treadmill at increasing speed and incline. It shows how your heart responds to exertion and can help assess chest pain.
Dr. Qureshi explains · YouTube
What is ETT? Exercise Tolerance Test. (Urdu)
Video · 3:59 · Watch on YouTube
More from the channel
Echocardiogram
An ultrasound scan of the heart that shows its size, how well it pumps and how the valves work. It is painless and commonly used to assess breathlessness, heart failure and valve disease.
Coronary angiography
An X-ray test in which a thin tube is passed through the wrist or groin to the heart and contrast dye shows the coronary arteries. It is used when significant narrowing is suspected or after a heart attack. See coronary angiography.
Other blood tests
A lipid profile (cholesterol), HbA1c (long-term blood sugar), kidney function and other blood tests help assess your cardiovascular risk. See understanding your cardiovascular risk.
References
- Vrints C, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024;45:3415–3537. doi.org/10.1093/eurheartj/ehae177 (opens in a new tab)
- Byrne RA, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J 2023;44:3720–3826. doi.org/10.1093/eurheartj/ehad191 (opens in a new tab)
This guide is general health information, not personal medical advice. If you are worried about your symptoms, speak to a doctor. In an emergency call 1122. Medical disclaimer.
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Book a consultation with Dr. Qureshi
Clinic at Rawalpindi Institute of Cardiology (RIC), Room 8. Monday to Friday, 3:00 PM to 8:00 PM. Call or WhatsApp +92 307 5793387.