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arteries. Your blood pressure can also indicate the general state of the circulation, as well as the force of contraction in your heart itself. The veins along side your neck also are indicators of cardiac function. Normally little pulse waves are seen, but unusual distention usually means that the right side of the heart is unable to keep up with the demand. Examine the jugular veins particularly when a patient is sitting upright.
Finally, your heart itself is evaluated by first looking at the chest to see if there are unusual pulsations, then feeling with the hand to detect unusual vibrations or heaves, and finally listening with a stethoscope. The presence of turbulence as the blood flows through the valves is reflected in sounds called murmurs. These can occur during either phase of the heart cycle. Considerable practice is needed to hear these specific sounds and understand their meaning. Diagnostic tests are frequently performed to evaluate the efficiency of the heart. A chest x-ray can determine enlargement of one or more chambers. The electrocardiogram provides an excellent look at your electrical activity during each cardiac contraction. During exercise your heart rate should increase. An evaluation of the pulse and blood pressure during mild exercise on a motorized treadmill or bicycle (called a stress test) can be extremely helpful in assessing the dynamic function of this marvelous organ. More specialized tests are done in hospitals today, using x-rays, flow studies involving radioactive isotopes, Thallium scanning procedures, and the coronary angiogram which x-rays the heart in rapid sequence while a radiopaque dye is simultaneously injected into a coronary artery or blood