Tests and Diagnosis of Coronary Artery Disease

Complex measures aimed at diagnosing of coronary heart disease include:

• Initial medical examination involving:
  • Patient interview – to determine the risk group (the causes of CAD);
  • Systematization of patient complaints, identification of the CAD symptoms – pains, irregular heartbeat, palpitation, shortness of breath, dizziness, weakness, etc. – as well as their nature, peculiarities and duration;
  • Physical examination - including listening to internal sounds with the help of stethoscope, palpation, tapping of certain body areas – for heart murmurs, edemas, etc.
• Electrocardiography (ECG) – heart muscle function assessment, to help detect and evaluate any deviations and confirm the CAD diagnosis;
  
  
• Echocardiography of the heart – helps fully evaluate the cardiac muscle soft tissues (the thickness of the heart, volume of the cavities, condition of the tissues as well as heart valves, myocardial activity) and all the changes happening in the cardiac muscle;
  
  
• Exercise ECG testing (treadmill test, bicycle ergometry) – to identify heart pathologies at early stages, while performing physical activity, when no external changes can be observed while at rest. Physical exercises are selected individually. In some cases, drugs intensifying cardiac performance are used instead of exercise equipment;
  
  
• Complete biochemical blood analysis – to evaluate the indices relevant to heart muscle disorders:
  • Concentration of specific proteins in blood;
  • Level of triglycerides;
  • Level of cholesterol;
  • Increased erythrocyte sedimentation rate;
  • High level of neutrophils in blood;
  • Levels of alanine transaminase (ALT), aspartate transaminase (AST), etc.
• Holter monitoring – employs a special device called Holter monitor. During the test, patient performs daily routine and makes notes of all activities and emotions. This procedure evaluates the cardiac muscle performance over time, to help understand the causes of heart muscle irregularities, and consider all the factors associated with the cardiac muscle problems;
  
  
• Angiography and CT angiography of the coronary arteries – observes the state of the arteries supplying the heart. A catheter is introduced into the aorta, and a special contrast agent is injected into the arteries by means of this catheter. The contrast agent helps identify the location of the narrowing artery on the X-ray picture;
  
  
• Magnetic resonance angiography (MRA) – this procedure uses MRI technology often in combination with the injection of contrast agents. This test helps identify the narrowing and blockage of the coronary arteries.

Next chapter: Treatment and prevention