Many people think heart disease always comes with obvious symptoms like chest pain or breathlessness. However, some forms of cardiovascular disease can develop quietly over many years, showing little or no outward signs until they become more advanced. Heart screening offers a structured way to assess cardiovascular health and may help identify early signs and risk factors before noticeable symptoms occur.

What Is Heart Screening and Who May Benefit

Heart screening refers to a collection of medical tests and evaluations that help assess the condition of the heart and a person’s risk for cardiovascular disease. The specific tests used in screening are selected based on clinical judgement, an individual’s age, family history, existing health conditions, and other risk factors. Basic components often include measurement of blood pressure and cholesterol levels, along with a clinical assessment. More detailed testing such as electrocardiograms (ECG) or imaging may be considered for people with moderate to high risk profiles.

In Singapore’s clinical context, heart screening is generally recommended for people with risk factors such as high blood pressure, high cholesterol, diabetes, smoking, or a strong family history of heart disease, as well as for those reaching mid-life or older ages. Screening is not uniform for everyone; the choice and frequency of tests are tailored to individual needs.

How Screening May Identify Cardiovascular Issues Before Symptoms Appear

The purpose of heart screening is to identify risk factors or subtle evidence of cardiovascular changes that may not yet have caused symptoms. Many serious heart conditions — such as coronary artery disease, rhythm abnormalities, or high blood pressure — can be present for years without significant complaints. Detecting these issues early allows healthcare providers to discuss appropriate next steps with patients.

Screening typically begins with a detailed medical history and physical examination. Based on clinical assessment, selected tests may be used, such as:

• Blood pressure and cholesterol checks to reveal modifiable cardiovascular risk factors.

• Electrocardiogram (ECG) to assess electrical activity of the heart and detect rhythm abnormalities or signs of past injury.

• Imaging tests such as echocardiography, which visualise heart structure and function.

• Other assessments tailored to individual risk, such as coronary artery calcium scoring or stress testing in certain clinical scenarios.

These tests provide pieces of information that, when interpreted together, can help clinicians form a clearer picture of cardiovascular health.

The Role of Diagnostic Tests in Early Detection

ECG and Related Assessments

An electrocardiogram (ECG) records the heart’s electrical signals and can identify irregular rhythms or indirect indications of reduced blood flow or prior injury. In selected asymptomatic individuals with risk factors, an ECG may be part of the screening process.

Echocardiography and Imaging

An echocardiogram uses ultrasound to produce real-time images of the heart’s chambers and valves, helping to detect structural changes that may not yet produce symptoms. Depending on risk factors and clinical findings, other imaging tests such as CT coronary calcium scoring may be used to further evaluate risk.

Stress and Functional Tests

In selected individuals, functional tests like stress testing (exercise or pharmacologic) are used to assess heart function under exertion. The use of such tests is determined on a case-by-case basis and is not routine for all asymptomatic people.

Combining information from multiple tests can support clinical judgement about heart health in a given individual, though no single test identifies every possible condition.

Benefits of Detecting Early Changes Through Screening

Heart screening is a tool that can support informed discussions between patients and clinicians about cardiovascular health. Some potential benefits include:

• Identification of risk factors such as high blood pressure or high cholesterol that may not be evident without testing.

• Risk stratification to help determine whether further evaluation or tailored monitoring is appropriate.

• Early clinical discussions about lifestyle adjustments and, where relevant, evidence-based treatments tailored to an individual’s risk profile.

While screening can help identify indicators that inform care planning, it is important to understand that it is one part of a broader process of cardiovascular risk assessment and management.

When to Discuss Heart Screening With a Healthcare Professional

Determining the appropriate timing and frequency of heart screening depends on a person’s risk factors and overall health context. In Singapore, clinical practice generally considers age, family history, lifestyle factors, and other health conditions when recommending screening. For example, routine risk factor assessments such as blood pressure and cholesterol checks are commonly suggested from young adulthood, with more tailored screening approaches considered as risk increases with age or health history.

Individuals should discuss their personal risk profile with a qualified healthcare provider to determine the most suitable screening strategy for their circumstances.

Conclusion

Heart screening refers to a set of clinical assessments and tests that help evaluate cardiovascular health and may reveal risk factors or subtle changes before symptoms are apparent. By integrating clinical evaluation with selected diagnostic testing, screening can provide useful information to support conversations between patients and cardiologist about cardiovascular risk and possible next steps. In Singapore’s clinical context, tailoring screening to an individual’s risk profile allows for more personalised and context-appropriate care planning.