$Unique_ID{BRK01255}
$Pretitle{Circulatory System}
$Title{What Tests Are Used for a Diagnosis of Coronary Heart Disease?}
$Subject{coronary artery disease tests}
$Volume{G-4}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


What Tests Are Used for a Diagnosis of Coronary Heart Disease?


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QUESTION:  Could you please explain a bit about the tests that I may be facing
with a diagnosis of coronary heart disease?  Do any of them cause pain, or are
they dangerous?  I am more than a little anxious.

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ANSWER:  Coronary heart disease is the number one cause of death in the United
States.  It is the most common form of heart disease, and since treatment is
based upon knowing the extent of your problem, testing is very important.
     Coronary artery disease (CAD) is a condition in which the muscle tissue
of the heart is not receiving enough oxygen.  The heart can not take any
oxygen from the blood that it pumps.  It gets its own supply through the
coronary arteries, a set of arteries that encircle the heart and resemble a
crown (coronary means crown-like).  When these arteries become clogged,
blocked or narrowed, heart tissue dies from lack of oxygen, and a myocardial
infarction (or heart attack) occurs.  Gradual narrowing or spasm of these
arteries causes the chest pain known as angina.
     Your doctor will decide which tests to use to diagnose coronary heart
disease based on several factors, the most important of which is your
symptoms.  If you feel chest pain on exertion or if you've suffered a heart
attack, your doctor will probably have you undergo several tests.  Tests for
CAD fall into two general categories, noninvasive and invasive.  Noninvasive
testing means that, except for some injections, nothing enters your body.
Invasive testing means that a catheter (a very small tube) is placed into a
vein or artery and used to inject a contrast medium (which shows up on x-ray),
or to measure pressures in the vessel.  Invasive tests are more reliable than
noninvasive tests, but they are more expensive and carry some risk.
     Noninvasive tests include stress or exercise testing, where you walk or
run on a treadmill while an electrocardiogram (ECG) is taken.  Your doctor
will evaluate how your ECG changes as exercise stresses your heart.  This is
an easy, relatively inexpensive test and will probably be the first you
undergo.
     You may need additional tests that can give more information about the
condition of your heart.  Some of these tests require an injection with small
amounts of radioactive materials.  The amount of radioactivity is very low and
passes out of your body quickly.
     In exercise echocardiography, your doctor will look at an ultrasound
picture of your heart as you exercise.  Ultrasound works on the same principle
that sonar does and is quite safe.
     Based on results from noninvasive tests, your physician may ask you to
undergo an invasive test for CAD.  The most common one is cardiac
catherization.  A catheter is placed in a small blood vessel and, under local
anesthesia, is snaked along into your heart, where a great deal of information
about the way your heart pumps blood can be gathered.  This procedure is
considered a minor operation and has some risks, but gives your doctor the
best information about your coronary arteries.
     It may seem like a long and complicated process, and it is.  Expensive
too.  But it provides all the necessary information that helps the physician
help you choose the right therapy to fight your heart disease.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
