How is coronary artery disease diagnosed?
The gold standard for diagnosis of coronary artery disease is coronary angiography, also known as cardiac catheterization, which is described below. Although cardiac cath is the gold standard, it is an invasive test and not appropriate for all patients. For this reason, noninvasive stress testing has been developed for the diagnosis of coronary disease.
To diagnose coronary artery disease, doctors start by doing a physical exam and asking questions about your past health and your risk factors. Risk factors are things that increase the chance that you will have coronary artery disease. Some common risk factors are being older than 65; smoking; having high cholesterol, high blood pressure, or diabetes; and having heart disease in your family. The more risk factors you have, the more likely it is that you have coronary artery disease. If your doctor thinks that you have coronary artery disease, you may have tests, such as: Electrocardiogram (EKG or ECG), which checks for problems with the electrical activity of your heart. An EKG can also show signs of an old or new heart attack. Chest X-ray. Blood tests. Exercise electrocardiogram, commonly called a “stress test.” This test checks for changes in your heart while you exercise. Your doctor may order other tests to look at blood flow to your heart. You may have a coronary angiogram if your
doc It is not possible to diagnose coronary artery disease through genetic testing. Genetic testing can look for variants that increase the risk of developing coronary artery disease but can not diagnose the condition. Coronary artery disease must be diagnosed by a physician based on a patient’s medical history, family history, risk factors, and results of medical tests.
Your doctor diagnoses coronary artery disease by talking to you about your symptoms, medical history and risk factors, and performing a physical exam. Diagnostic tests, including blood tests, an electrocardiogram (ECG or EKG), exercise stress tests, cardiac catheterization and others. These tests help your doctor evaluate the extent of your coronary heart disease, its effect on the function of your heart, and the best form of treatment for you. Research into new testing procedures, such as coronary computed tomography angiogram (CTA), may change the way coronary artery disease is diagnosed in the future. Tests used to predict increased risk for coronary artery disease include: C-reactive protein (CRP), complete lipid profile and calcium score screening heart scan.
In addition to a complete medical history and physical examination, diagnostic procedures for coronary artery disease may include any, or a combination of, the following: • electrocardiogram (ECG or EKG) – a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage. • stress test (also called treadmill or exercise ECG) – a test that is given while a patient walks on a treadmill to monitor the heart during exercise. Respiratory rate and blood pressure are also monitored. A stress test may be used to detect coronary artery disease, and/or to determine safe levels of exercise following a heart attack or heart surgery. • coronary arteriogram (or angiogram) – with this procedure, x-rays are taken after a contrast agent is injected into an artery – to locate the narrowing, occlusions, and other abnormalities of specific arteries. • nuclear scanning – radioactive material is injected into a vein and then is ob
