Diagnosis
Cardiovascular disease can be diagnosed based on a medical and family history, a complete physical examination, and diagnostic tests. Tests that may be performed include the following:
- Coronary angiography, also called cardiac catheterization
- Echocardiogram
- Electrocardiogram (ECG or EKG)
- Heart scan
- Stress test
- Nuclear scan (e.g., cardiac positron emission tomography [PET])
Coronary angiography (cardiac catheterization) allows the physician to identify the location of arterial blockages and evaluate the severity of the condition. This procedure involves inserting a catheter (thin, hollow tube) into an artery in the groin or arm and advancing it to the coronary arteries (arteries that supply blood to the heart). Then, a small amount of radioactive material (contrast solution) is injected into the arteries and x-rays are taken (called angiograms).
The procedure usually is performed under local anesthesia and intravenous sedation and takes about 30 minutes. Following coronary angiography, the catheter is removed and the artery in the groin or arm is closed using sutures (stitches), special sealant, or compression.
Complications are rare and include the following:
- Adverse reaction to the contrast agent
- Damage to an artery
- Excessive bleeding (hemorrhage)
- Heart attack or stroke
- Irregular heart rate (arrhythmia)
- Low blood pressure
Echocardiogram (also called cardiac echo) is an ultrasound examination of the heart that produces detailed images of the organ. It uses a microphone-like device (transducer) to transmit and receive sound waves that travel through the chest wall to the heart, and then are reflected back. The reflected sound waves are translated into images of the heart, which can be used to detect heart disease.
Echocardiogram does not require special preparations or anesthesia and takes about 45 minutes to perform.
Electrocardiogram (EKG or ECG) is a noninvasive test used to measure electrical activity in the heart. In this test, electrical sensors called leads are attached to predetermined positions on the arms, legs, and chest to record electrical activity and help assess heart function. An EKG can be used to detect impaired blood flow to the heart.
A heart scan is an ultra-fast CT scan that detects calcified deposits (plaques) in coronary arteries. This noninvasive test takes about 10 minutes to perform and can be used to help diagnose advanced atherosclerosis in patients who are at increased risk for heart disease, even before symptoms develop.
Stress tests, also called exercise cardiac stress tests, may be used to diagnose heart disease. There are several types of stress tests. The test may simply involve having the patient walk on a treadmill while connected to an electrocardiogram (EKG or ECG). In other cases, a drug is infused into the bloodstream to increase the heart rate or to affect the flow of blood within the heart and an echocardiogram is used to obtain images of the heart.
Nuclear stress test involves injecting a radioactive substance into a vein and using a special camera to obtain images of the heart during rest and immediately following exercise on a treadmill. If the results of this test suggest coronary artery disease, cardiac catheterization may be performed.
Physician-developed and -monitored.
Original Date of Publication: 10 Feb 2006
Reviewed by: Karen Larson, M.D., Stanley J. Swierzewski, III, M.D.
Last Reviewed: 10 Feb 2006
Heart Disease, Diagnosis reprinted with permission from healthinfo.healthcommunities.com
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