How to Diagnose Coronary Heart Disease Through Medical Tests

Coronary heart disease (CHD) requires a comprehensive diagnostic approach tailored to the patient's symptoms and medical history. A variety of tests are commonly used to assess heart function and identify potential blockages or abnormalities. These diagnostic tools help doctors make accurate evaluations and develop effective treatment plans.

Essential Diagnostic Tests for Coronary Heart Disease

1. Laboratory Blood Tests

One of the first steps in diagnosing CHD involves blood tests to assess various biomarkers. These include complete blood count (CBC), coagulation profile, liver and kidney function, lipid panel, blood glucose, HbA1c (glycated hemoglobin), cardiac enzymes, electrolytes, thyroid function, and uric acid levels. These tests provide valuable insights into overall health and potential risk factors associated with heart disease.

2. Electrocardiogram (ECG or EKG)

An electrocardiogram is a standard test for nearly all patients with suspected heart conditions. It records the electrical activity of the heart and can detect abnormalities that may indicate reduced blood flow to the heart muscle. Comparing ECG results during episodes of chest discomfort with baseline readings can help doctors determine if ischemic changes are occurring.

3. Echocardiogram (Cardiac Ultrasound)

This non-invasive imaging test allows physicians to visualize the heart's structure and function. In patients with coronary artery disease, echocardiography often reveals segmental wall motion abnormalities—areas of the heart muscle that don't contract normally due to reduced blood supply. This is a key indicator of possible coronary artery disease.

4. 24-Hour Holter Monitoring

A Holter monitor is a portable ECG device worn for 24 hours to record heart activity continuously. It not only detects arrhythmias but also analyzes ST-segment changes throughout the day. This helps identify episodes of myocardial ischemia, especially during periods of increased heart rate or physical activity.

5. Exercise Stress Test (Treadmill Test)

During a stress test, patients walk on a treadmill while their heart rate, blood pressure, and ECG readings are monitored. The test increases the heart's workload, which can reveal whether the heart receives enough blood flow during physical exertion. It is particularly useful for identifying ischemia that may not be evident at rest.

6. Coronary CT Angiography

This advanced imaging test uses contrast dye and computed tomography (CT) to visualize the coronary arteries. It can detect plaque buildup, narrowing of the arteries, and other structural issues. Coronary CT angiography is often used as a non-invasive screening tool for patients with suspected coronary artery disease.

7. Coronary Angiography (Cardiac Catheterization)

Considered the gold standard for diagnosing coronary heart disease, coronary angiography is an invasive procedure that involves inserting a catheter into a blood vessel and guiding it to the heart. Contrast dye is injected to highlight the coronary arteries on X-ray imaging, allowing doctors to precisely identify blockages, assess the severity of the disease, and determine whether interventions such as stenting or bypass surgery are necessary.