Diagnosis of Heart Rhythm Disorders

Identifying Heart Rhythm Disorders (HRD) encompasses many aspects including a careful study of medical and family history. Often, people with HRD may not experience any indications at all or they may exhibit symptoms that can appear unconnected to the heart such as giddiness, fainting or shortness of breath.

Heart Rhythm Disorder specialists at Narayana Health take these factors into account and conduct relevant examinations, together with the ones listed below to discover the exact reason behind a disorder.

Physical examination and first level tests:

  • Heart and lung sounds are checked for abnormal or unusual heart sounds called murmurs
  • Checking the pulse
  • Checking the legs and feet for swelling
  • Checks in general for other diseases such as thyroid swelling
  • Blood tests to check for electrolytes, blood sugar or thyroid hormones
  • Chest X-Ray to test for fluid in lungs or lung diseases
  • Echocardiography (ECHO) test
  • Stress Test: An ECG recording and blood pressure monitoring will be performed while the patient runs on a treadmill. The test examines heart behaviour under stress; it is often followed up with ECHO and nuclear heart scans.

Diagnostic Tests

The following tests may be chosen depending on the symptoms:

Electrocardiogram (ECG/EKG)

This test is conducted using a machine that is attached to the legs, arms and chest with 10 electrodes to record the heart's electric signals that generate heart beats. The test can help doctors notice irregular heartbeats, previous heart attacks, and difficulty in the conduction of impulses in the heart.

Holter Monitoring

When Heart Rhythm Disorders cannot be detected by the ECG tests, the patient is given a small phone-sized device which is slung around the patient’s neck, kept in the pocket or attached to their chest by five adhesive electrode patches. This device records irregular heart rhythms every 24-48 hours. It may be worn for up to a month.

Tilt Table Test

The Tilt Table test evaluates blood pressure-related reasons for fainting (syncope). The heart rhythm and blood pressure are continuously observed while a patient rests on a special table. The table can tilt the patient upright at a 70-80 degree angle for about 30-45 minutes. A fainting incident can point out that the patient experienced vasovagal or neurocardiogenic fainting, which is not life threatening.


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