Tests used to accurately diagnosis heart disease

Have you ever wondered how do doctors detect if a person has heart disease? It’s one thing to use their stethoscope to listen to your heart, but that is only the beginning. To really put your heart to the test, there are several different types of tests designed to detect the extent of any coronary artery disease you may have.

Coronary artery disease (CAD) begins early in life and continues over the years as fatty deposits called plaque accumulate within artery walls, narrowing passageways and restricting blood supply to the heart. Plaque buildup over the years puts you at a precariously dangerous situation in that if the plaque ruptures, it can trigger a blood clot which can cut off oxygen to the heart causing a heart attack or oxygen to the brain, causing a stroke. Many years ago, very few tests were available to detect and prevent this type of situation. Today, these tests can be literal lifesavers as they can reveal where significant plaque buildup has occurred and from there, treatment to prevent a worst case scenario.

Depending on your coronary risk factors and symptoms, if any, will determine which tests your doctor may order.  Each of these tests has their strengths and weaknesses as to their ability to discovering CAD.  Here are several tests routinely used to find coronary artery disease and what they show:

·      Electrocardiogram (ECG or EKG)

While the U.S. Preventative Task Force recently reaffirmed its position that ECGs should not be part of a routine exam, the test may be done if you have coronary artery disease risk factors such as family history of heart disease or high blood pressure. Though it can detect irregular heart rhythms, some cases of cardiac damage, and other problems, it is not a particularly good test for symptomless CAD.  People with CAD may have normal resting ECGs. When done using a treadmill or stationary bike, an ECG is called a stress test.

·      Echocardiogram

In this painless and safe imaging test, a machine beams high-frequency sound waves (ultrasound) at the heart, and the returning echoes are used to create a picture of the heart. It is not particularly useful for evaluating symptomless CAD.

·      Coronary calcium scan

This imaging technique – also called multi-detector computed tomography – detects calcium deposits in coronary arteries which may signal the presence of CAD. Its value as a screen test – that is, for people without symptoms, signs, or a history of cardiovascular disease – has been debated for well over a decade.  The best evidence suggests that this testing may be useful for people who are at intermediate coronary risk and thus may be on the fence about treatment.

·      Nuclear imaging

The goal in this test is to capture an image of your heart and coronary arteries. During an exercise stress test, for example, you may be injected with small amounts of a radioisotope, which a special camera detects as it passes through your heart. Another technique is single photon emission computed tomography.  This three dimensional imaging is done with a rotating camera and a computer. Nuclear imaging is not particularly useful for evaluating symptomless CAD.

·      Computed tomography angiography (CT angiography)

Also referred to as multislice or multidetector scanning, this produces high-resolution, three-dimensional computerized pictures of the moving heart and some blood vessels that can show plaque formation or calcium in the larger coronary arteries.

·      Magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA)

These technologies use magnetic fields and computers to show images of the heart and arteries.