Aging & Health A to Z
Coronary Artery Disease, Angina
Diagnosis & Tests
Tests used to diagnose coronary artery disease are typically conducted by a specially trained technician or a heart specialist (cardiologist).
Below are some common cardiac tests.
Cardiac Catheterization (Angiogram)
The heart specialist threads a tiny tube (catheter) through an artery in your arm or leg into the arteries of your heart. He or she injects a dye into the tube that can be seen on an x-ray as the dye travels through your heart chambers and arteries. This shows the pumping action and circulation of blood through your heart, and any blockages you might have in your coronary arteries. Your heart specialist will tell you if you need to change your diet or medications before or after the test.
A large machine containing a strong magnet and radio waves creates a picture of the inside of your heart. This test can provide more detailed information about how your heart valves and other parts of your heart are working.
A chest x-ray can show whether parts of your heart are enlarged, or if there’s fluid buildup in your lungs. These can be signs of heart failure, a heart valve problem, or thickening of the heart muscle.
Coronary Calcium Scan
In coronary artery disease (CAD), calcium builds up in “plaques” in the walls of arteries, narrowing the blood vessels and raising your risk of a heart attack. Healthcare professionals can estimate your heart attack risk by checking your coronary calcium “score”—even when you have no symptoms. During the scan, you will lie on a table for a few minutes. You may have electrodes attached to your chest and be injected with a dye. Coronary calcium scans use electron beam computerized tomography (EBCT or “ultra-fast CT”), an advanced type of x-ray technique that exposes you to the same amount of radiation as 33 chest x-rays. Repeated scans may raise your cancer risk. This procedure is not recommended if you are either at low or high risk for a heart attack, in which case you should already be taking medications and making lifestyle changes. It is recommended for persons at “moderate” risk who have a 10–20 percent chance of having a heart attack within the next 10 years.
Electrocardiogram (ECG or EKG) and ECG Stress Test
This simple, painless test measures the electrical activity of your heart using electrodes (wires) placed on the chest and other parts of your body. You might have the test lying down, or while you’re exercising on a treadmill or bicycle to monitor how your heart responds to increasing levels of physical activity. If you can’t exercise, your health care professional might give you a drug that makes your heart pump harder.
To test your heart activity over a period of time, your cardiac specialist might give you a portable monitor to use at home. While you wear the monitor on your shoulder (much like a shoulder bag), you can perform all your normal activities, except for showering. You usually wear the monitor for a day or two and then return it to your healthcare professional’s office for analysis.
Nuclear Stress Test
If you have symptoms like chest pain or shortness of breath, your healthcare professional may order a nuclear stress test. You will receive an injection of radioactive dye and images will be taken of your heart while you are at rest. Afterwards, you may be asked to exercise on a treadmill or stationary bicycle, or you may receive an injection to speed up your heart. Another dose of radioactive dye may be given during the test through a small intravenous (IV) tube, and your blood pressure and heartbeat (ECG) will be monitored during the test. Another set of images will be taken at that time. After resting for a prescribed time you might have another set of images taken. The nuclear stress test shows the specialist who is interpreting your images if there are any damaged areas in your heart. The images may also show whether the arteries that bring blood to your heart muscle are blocked or narrowed, or if your heart is enlarged. It also measures how well your heart is pumping blood (called the ejection fraction).
Updated: March 2012
Posted: March 2012