Diagnosing Coronary Heart Disease
If your doctor thinks you have coronary artery disease, there are a number of tests that can confirm the diagnosis.
Coronary artery disease is the number one killer of both men and women in the U.S. It often has no symptoms early on. Sometimes, the first sign of heart disease is a heart attack or sudden death. That is why it is so important to check your risk factors, find out if you have heart disease and get treatment if you do. Your doctor will base the diagnosis on a number of findings, including your symptoms, risk factors and the results of several tests.
While no single exam can diagnose coronary artery disease, there are a variety of exams and tests that, taken together, can help your doctor make the diagnosis. First, you will be asked questions about your medical history, symptoms and family history. Your level of physical activity and whether or not you smoke are also very important. Then you will have a thorough physical exam, including weight and blood pressure readings. Depending on these findings, your doctor may suggest some or all of the following:
Laboratory tests. By checking some simple blood tests, your doctor can judge your risk for heart disease. Some things your doctor may look for include high cholesterol and diabetes. Both of these raise your risk for coronary artery disease.
Electrocardiogram (EKG). Ten pads are applied to your chest, arms and legs to detect and record your heart's electrical pattern. An EKG shows how fast your heart beats and whether it beats regularly. It can show if the electrical pattern is normal. It can also show if there has been a heart attack or some strain on the heart.
To get a baseline reading, the test is done as you quietly rest. Your doctor may want to compare those results with readings taken during exercise, when your heart is working harder. An exercise EKG, or stress test, can show whether your heart muscle is getting enough oxygen-rich blood to work properly. Low blood flow to the heart muscle may be caused by coronary artery disease.
Echocardiograph. This test is a type of ultrasound. It uses high-frequency sound waves to make a moving picture of your heart. Among other things, it can show how well blood flows through the heart, how strong it can pump and whether any areas of the heart muscle have been injured by poor blood flow.
Coronary angiography. This is a procedure that is usually done in a hospital. Before the test, you will be given medicine to help you relax.
A long, thin tube called a catheter is inserted into a blood vessel in your arm, groin or neck. From there, the doctor guides it into the arteries that supply blood to the heart.
Once it is in the correct position, dye is released. As the dye moves through the arteries, special x-rays are taken so doctors can see and evaluate any blockages. Doctors can also treat some blockages using this technique.
What's next? If your doctor determines that you have coronary artery disease, there are a number of ways to treat it. These include lifestyle changes, medicine and surgery.
For example, a nutritious diet and proper exercise are two good ways to help control high blood pressure and high cholesterol, and to maintain a healthy weight. Ask your doctor about a safe activity level before you get started. If you smoke, it's very important to quit. Your doctor can help you reach these goals.
If lifestyle changes aren't enough, you may need medicine to relieve symptoms, control cholesterol and blood pressure, and ease the strain on your heart. Other options include medical procedures or surgery.
If you're diagnosed with heart disease, talk with your doctor. He or she can help you decide which treatment is right for you.