Heart check-up: which tests you may actually need
Published 15 September 2026 · Updated 21 October 2026 · Grand Medical, Riga
The heart does not always give clear signals when risk factors appear or when the first changes begin. At the same time, going through every available test without a reason is usually unnecessary. The right plan depends on your symptoms, blood pressure, age, cholesterol, chronic conditions, family history and the treatment you are already on.
At Grand Medical a doctor can choose the tests that fit your situation: from a standard ECG to echocardiography, Holter monitoring or 24-hour blood pressure monitoring.
Where to start
If you are troubled by your blood pressure, skipped beats, a racing heartbeat, shortness of breath or less tolerance for exertion, or if you have cardiovascular risk factors, start with a cardiologist consultation.
At the appointment the doctor will go through your symptoms, measure your blood pressure and pulse, review your history and your medicines, and decide whether further testing is needed. That way you avoid unnecessary tests and get the ones that actually answer the clinical question.
Which tests you may need
ECG: the rhythm at the moment of the recording
An ECG records the electrical activity of the heart at the moment it is taken. It may be ordered for a sense of skipped beats, a racing heartbeat, chest pain or discomfort, shortness of breath, high blood pressure, or as part of the work-up before treatment or surgery.
A normal ECG does not always rule out occasional rhythm disturbances: if symptoms come and go, the doctor may need a longer recording.
Holter monitoring: when the symptom is not constant
Holter ECG monitoring records the heart over 24 hours or longer. It helps pick up certain rhythm and conduction disturbances that a standard ECG may miss.
It is often considered for episodes of palpitations, skipped beats, dizziness, brief weakness or fainting, or to check how treatment is working — on the doctor’s recommendation.
ABPM: how blood pressure behaves across a full day
24-hour blood pressure monitoring (ABPM) measures your blood pressure in ordinary life, day and night. It is particularly useful when readings are unstable, when they differ at home and at the clinic, when night-time rises are suspected, or when the effect of treatment needs assessing.
ABPM does not replace regular measurements at home, but it gives the doctor a fuller picture.
Echocardiography: an ultrasound look at the heart
Echocardiography — echo is an ultrasound scan that assesses the size of the heart chambers, how the valves work, how well the heart muscle contracts, and some signs of strain on the heart.
An echo may be ordered for high blood pressure, shortness of breath, a heart murmur, previous cardiovascular disease, suspected structural changes, or to monitor a known condition.
Important: an echo is not a way to prevent a heart attack on its own, and it does not replace assessment of the coronary arteries, blood pressure, cholesterol, an ECG or a doctor’s consultation.
What is worth keeping under control
Cardiovascular risk is raised by high blood pressure, high LDL cholesterol, diabetes, smoking, low physical activity, excess weight, sleep problems, family predisposition and previous vascular events.
Keeping track of these regularly and sticking to the treatment you have been prescribed often matters more than occasional tests with no clear purpose. Do not stop taking blood pressure, cholesterol or rhythm medicines on your own — discuss any change with your doctor.
When to discuss testing soon
Plan a consultation if:
- your blood pressure rises regularly or has become unstable;
- you have noticed skipped beats, a racing heartbeat, shortness of breath or fatigue with ordinary exertion;
- you have high cholesterol or diabetes, or you smoke;
- close relatives had early heart disease;
- you have previously had a heart attack, a stroke, heart failure or a rhythm disorder;
- you need to know whether your current treatment is enough.
If broader preventive testing is appropriate, the doctor may suggest a comprehensive health check-up.
Frequently asked questions
Does everyone need an echocardiogram every year?
No. How often an echo is needed depends on your symptoms, risk factors, any known conditions and your doctor’s advice.
How does Holter monitoring differ from a standard ECG?
An ECG shows the heart during a short recording. A Holter records the rhythm over a long period and can capture occasional disturbances.
Do I need ABPM if my blood pressure only rises occasionally?
That is worth discussing with your doctor. ABPM helps show how your blood pressure changes through the day and night.
Can a single test rule out a heart attack?
No. Diagnosis depends on the situation, your symptoms, the examination, an ECG, lab tests and other data. Acute symptoms need urgent medical care.
Would you like your heart checked and the right tests chosen?
Start with a cardiologist consultation — the doctor will help you put together a clear, well-founded testing plan.
You can also book through Piearsta.lv or eVeselībasPunkts.lv. If the portals have no suitable time, get in touch with the clinic.
Book an appointment
The quickest way is through a booking portal, where you can see the doctors’ free slots. If you are not sure which specialist you need, leave a request or call us — we will help you decide and book the visit.
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Free appointment slots are listed on the booking portals. If you cannot find a time that suits you, get in touch and we will help you find a solution.
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