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Diagnosing Coronary Artery Disease

Your physician may suspect coronary artery disease (CAD) if you experience chest discomfort, shortness of breath, back pain, jaw pain and arm pain. Some patients with coronary artery disease experience little or no symptoms while others have a variety of symptoms. When your physician suspects CAD he may order diagnostic testing to determine the extent of the disease.



Non-Invasive Testing

A Computerized Tomography Angiography utilizes X-rays to generate three dimensional images of the coronary arteries. An X-ray tube and detector rotate around the body to gather information that a computer transforms into a three dimensional image of the coronary arteries. This test is may be used to determine if there is plaque buildup narrowing the arteries.

Also known as an echo, an echocardiogram is an ultrasound procedure that utilizes sound waves to create images of your heart. This test allows your doctor to see the size, shape, heart valve movement, heart chambers, and the pumping action of the heart.

Electrocardiogram also called ECG or EKG is a quick and painless test that shows the electrical activity of the heart. This test records the electrical impulses that trigger the beating of your heart.

Exercise Treadmill Test (non-imaging) is an exercise test that monitors the heart rate and rhythm over a period of time, while you are walking on a treadmill. During exercise treadmill testing your heart rhythm, heart rate, and blood pressure are monitored to identify possible coronary artery disease, abnormal heart rhythms, effectiveness of your heart treatment plan, and/or assist your doctor in developing a safe and adequate exercise plan for you.

A multi-gated acquisition (MUGA) or cardiac blood pool scan is a nuclear medicine scan that measures the flow of blood through the heart. The test shows how much blood is pumped through the ventricles on each heartbeat. The MUGA scan helps show abnormalities in the size and function of the ventricles.

A positron emission tomography (PET) scan shows if there is still viable (living) heart tissue in areas of the heart that may have previously been damaged. This allows your physician to determine if there is a benefit to treatment and what treatments would be best to restore blood flow to these damaged areas.

During stress testing your heart rate, heart rhythm, and blood pressure are monitored. A stress test procedure gives your doctor valuable information about your heart during physical activity that may identify heart issues not identifiable at rest.

Nuclear Stress Test
Also referred to as a myocardial perfusion imaging (MPI) test, this imaging test shows how blood flows into the heart muscle. This can show effects of narrowed arteries and blockages as well as any previous heart attacks or cardiac interventions. Your physician is also able to see how the heart wall moves during MPI. A small amount of radioactive tracer is injected into a vein. A gamma camera then detects the radiation released by the radioactive tracer in order to produce images of the heart. This test is done in conjunction with an exercise treadmill test or chemical stress test for individuals who are unable to handle moderate physical activity.

Stress Echocardiogram
Also known as a stress echo, is a procedure that evaluates the function of your heart and valves with physical activity. This is done by stressing the heart with strenuous exercise over a period of time on a treadmill or by medications to increase the heart workload. Then echocardiogram images are taken in order to compare images taken at rest.


Heart Catheterization

Cardiac or heart catheterization is a medical procedure that cardiologists use to evaluate the heart function and diagnose cardiovascular conditions. During a heart cath procedure, a long narrow plastic tube or catheter is inserted in an artery in either the groin or the wrist. Pictures of the heart arteries are made with the use of x-ray and the injection of x-ray dye into the arteries. If a blockage is found, intervention is needed.

Image of an exercise treadmill test