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How is coronary artery disease diagnosed?

The diagnosis of coronary artery disease requires a careful history, physical examination, and an electrocardiogram (ECG). Once the initial evaluation is performed, imaging and laboratory studies, stress testing, and cardiac catheterization may be necessary to obtain further information. The American College of Cardiology (ACC), the American Heart Association (AHA),

and the American College of Physicians-American Society of Internal Medicine (ACP-ASIM) have published a position paper on the diagnosis and risk stratification of patients with chronic stable angina pectoris.

To determine if you have coronary artery disease, your physician may obtain your medical history, listen to your heart, take your pulse and check your blood pressure. An electrocardiogram, or ECG, may be run. With this test, electrodes connected to a recording machine are attached to the chest, wrist and ankles to measure changes in electrical activity of the heart with every beat. If the ECG reading is abnormal, other tests may be ordered such as stress testing, cardiac ultrasound, cardiac catheterization, or nuclear imaging.

In addition to evaluating your risk factors, there are also noninvasive imaging techniques available to detect coronary artery disease at its earliest stage. Young or old, it is extremely important to be aware of coronary artery disease. It is a progressive disease that can lead to death or heart failure. There are many treatment options which can slow the progression or in some cases reverse the effects of the disease.

The non-invasive and catheterization technique available to detect coronary artery disease are listed below:

  • An EKG - An EKG is a record of the heart's electrical impulses. It can identify abnormalities in heart rate and rhythm, and it can provide clues that part of your heart muscle isn't getting enough blood.
  • Blood test for heart enzymes - When heart muscle is damaged, even a little, enzymes leak out of the damaged muscle cells into the bloodstream. Elevated heart enzymes suggest a heart problem.
  • An exercise stress test on a treadmill - An exercise stress test monitors the effects of treadmill exercise on blood pressure and EKG and can identify heart problems.
  • An echocardiogram - This test uses ultrasound to produce images of the heart's movement with each beat.
  • Imaging test with radioactive tracers - In this test, a radioactive material is injected and is taken up by the heart muscle, which helps certain features show up on images taken with special cameras.
  • A coronary angiogram (a series of X-rays of the coronary arteries) - The coronary angiogram is considered the most accurate way to measure the severity of coronary disease. During an angiogram, a thin, long, flexible tube called a catheter is inserted into an artery in the forearm or groin, and then threaded through the circulatory system into the coronary arteries. Dye is injected to show the blood flow within the coronary arteries and to identify any areas of narrowing or blockage.
  • More information on coronary artery disease

    What is coronary artery disease? - Coronary artery disease is a heart disease condition that results when the coronary arteries are narrowed or occluded, caused by atherosclerotic deposits of fibrous and fatty tissue.
    What're the symptoms of coronary artery disease? - In most patients, the most common symptom of coronary artery disease is the type of chest pain called angina, or angina pectoris.
    What're the risk factors for coronary artery disease? - Risk factors of coronary artery disease include advancing age, male sex, and a family history of early coronary artery disease.
    How is coronary artery disease diagnosed? - The diagnosis of coronary artery disease requires a careful history, physical examination, and an electrocardiogram (ECG).
    What're the treatments for coronary artery disease? - Medical treatment for coronary artery disease generally includes medications, risk factor reduction, along with close follow-up with your health care team.
    How is coronary artery disease prevented? - Prevention of coronary artery disease centers on the modifiable risk factors: blood sugar, lipoprotein transport systems, obesity, homocysteine, hypertension.
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