Diagnosing Coronary Heart Disease: Essential Tests and Procedures

Coronary heart disease (CHD) is typically diagnosed through a combination of risk factors, patient symptoms, physical examination, and various diagnostic tests. Each method plays a crucial role in identifying the presence and severity of the condition. Below is a detailed overview of the most common diagnostic approaches:

1. Electrocardiogram (ECG or EKG)

An electrocardiogram is often the first test used to diagnose coronary heart disease. During an episode of symptoms such as chest pain or shortness of breath, an ECG can detect changes in the heart's electrical activity. These changes may include ST-segment depression or T-wave inversion, which are strong indicators of reduced blood flow to the heart muscle. Comparing the results with a baseline ECG taken when the patient is at rest can help confirm the presence of ischemia.

2. Stress Test (Exercise ECG)

Some patients may have normal ECG results when they are at rest, even if they have significant coronary artery disease. In such cases, a stress test—also known as an exercise ECG—is recommended. This test involves monitoring the heart's response to physical exertion, typically while the patient walks on a treadmill or rides a stationary bike. If the heart muscle isn't receiving enough blood during exercise, the ECG will show characteristic changes that suggest coronary artery blockage.

3. Advanced Imaging and Diagnostic Procedures

Coronary CT Angiography (CTA): This non-invasive imaging test provides detailed images of the coronary arteries and can reveal blockages or narrowing caused by plaque buildup.

Coronary Angiography: Considered the gold standard for diagnosing CHD, this invasive procedure involves injecting a contrast dye into the coronary arteries and using X-ray imaging to visualize any blockages or constrictions.

Myocardial Perfusion Imaging (MPI): Also known as a nuclear stress test, this technique assesses blood flow to the heart muscle at rest and during stress, helping to identify areas with reduced perfusion.

Each of these diagnostic tools provides valuable insight into the condition of the heart and coronary arteries. When used together, they offer a comprehensive picture that guides effective treatment planning for patients with suspected or confirmed coronary heart disease.