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Diagnostic Methods

Your physician will make a diagnosis of Coronary Artery Disease based on presented symptoms, risk factors, and a series of tests.

Before deciding on a treatment plan, your physician may recommend a series of diagnostic tests to determine the extent of your CAD. You will undergo a typical physical examination with blood tests and chest X-rays as well as additional assessments that include:

Exercise Stress Test

The Exercise Stress Test is conducted on a treadmill or stationary bike to gauge how your heart responds to increasing levels of activity. During the test, electrodes are placed on your chest and a blood pressure cuff placed on your arm. The workout on the treadmill or bike is gradually increased while your physician watches for symptoms and monitors your heart rate, blood pressure, and electrocardiogram recordings (ECGs or EKGs). The Exercise Stress Test takes approximately thirty minutes.

Electrocardiogram (ECG or EKG)

The ECG or EKG records the electrical activity in your heart. Electrodes are attached to the surface of your body. The electrical pulses of your heart are then recorded and represented as waves on a television monitor or graph paper. From these waves your physician can detect rhythm disorders, indications of a previous or recent heart attack, and other cardiac problems.

The ECG procedure typically uses 6 or 12 electrodes attached to the skin of your head, limbs, and trunk while you relax motionless. The recording process takes only a few minutes.

Coronary Angiogram

The Coronary Angiogram is one of the most common tests used for diagnosing the presence and extent of Coronary Artery Disease. An angiogram (also called cardiac catheterisation) is a special X-ray study of your heart. Angiograms are used to examine the location and amount of arterial blockage in CAD. They are also used to study the function of your heart valves and to observe the shape and function of the chambers of your heart.

Coronary angiograms are performed in a cardiac catheterisation laboratory (often called a cath lab). This is a room specially designed for this procedure.

During an angiogram, a flexible narrow tube called a catheter is inserted into an artery in the arm or upper leg. The catheter is then passed through the aorta and into a coronary artery. Special X-ray dye, called contrast, is injected to allow your physician to see the coronary arteries of the heart on an X-ray monitor. The test takes between 20 and 40 minutes.

Intravascular Ultrasound

Intravascular ultrasound (IVUS) can be used in addition to coronary angiograms. The IVUS gives an "inside out" view of the coronary artery. This view is created using ultrasound technology. Ultrasound uses sound waves to produce images of the inside of the body. A small device called a transducer produces and receives high-frequency sound waves that pass through body tissue and are then transformed into a live image on a video screen. This can determine if a blockage is severe enough to deprive the heart muscle of sufficient blood flow.

In IVUS, the sound wave transducer is mounted at the end of a catheter and threaded to the blocked artery as in the coronary angiogram. IVUS can also determine the severity of a narrowed artery as well as the composition of the blocking plaque. This information can be valuable to your physician when determining what treatment would be best to treat the blockage.

Last update: 31.07.2005

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