Your doctor can diagnose coronary artery disease by first talking to you about your symptoms, medical history and risk factors and then performing a physical exam. In addition, a number of diagnostic tests may be ordered.
If your doctor thinks you have coronary artery disease, he or she will probably do one or more of the following tests.
If you go to the emergency room with chest pain, some of the following tests will be ordered immediately. These tests will determine if you are having angina or a heart attack. If you have a stable pattern of angina, other tests may be done to determine the severity of your disease.
These tests check for levels of certain fats, cholesterol, sugar and proteins called troponins in the blood that help determine if you have risk factors for coronary artery disease or if you are having a heart attack.
Electrocardiogram (EKG or ECG)
This is a painless, noninvasive test in which patches with electrodes are attached to your skin to measure electrical impulses produced by your heart.
These impulses are recorded as waves displayed on a monitor or printed out on graph paper. The test can reveal evidence of a previous heart attack or on that is in progress.
This portable device records all of your heartbeats over an extended period, usually either 24 or 48 hours. You wear small patches with electrodes on your chest that are connected by wires to a small, portable recorder. The recorder can be clipped to a belt, kept in a pocket, or hung around your neck. During the time you're wearing a Holter monitor, you do your usual daily activities.
During a stress test, you exercise to make your heart work hard and beat fast while heart tests are done. The test can reveal abnormal changes to your heart rate or blood pressure, symptoms such as shortness of breath, or abnormal changes to your heart's electrical activity.
Sometimes, the test is given using a radioactive dye, sound waves, or other imaging devices to take pictures of your heart when it's working hard and when it is resting.
This test uses sound waves to create a moving picture of your heart.
- Provides information about the size and shape of your heart and how well your heart chambers and valves are functioning.
- Identifies areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow.
The test is noninvasive and is performed by placing a probe on your chest wall. It is the same technique used in sonograms in pregnant women.
To see the blood flowing to your heart, your doctor may perform a coronary catheterization. This involves injecting a dye into your arteries in what is called an
The dye is delivered through a long, thin, flexible tube called a catheter that is threaded through a leg artery into the coronary arteries. This is called catheterization.
The dye outlines areas of blockages on x-ray images. If a blockage is found and needs treatment, a balloon can be pushed through the catheter and inflated to open the artery or arteries in question. A stent or tiny wire mesh tube can then be inserted to keep the artery open.
This procedure is done in the hospital.
A computerized tomography scan, including ones known as an electron beam computerized tomography (EBCT) scan or a CT coronary angiogram, may also be used so your doctor can look at your arteries. EBCT can detect calcium located inside fatty deposits inside your arteries. The CT coronary angiogram involves the injection of a contrast dye to allow the images to be better seen on x-ray.