Coronary Heart Disease Diagnostic Methods
There are various methods available for diagnosing coronary heart disease (CHD), but only a few are considered essential for accurate diagnosis. These key diagnostic tools help physicians evaluate the presence and severity of CHD, guiding appropriate treatment strategies. Below are the most commonly used and reliable diagnostic techniques.
Coronary Angiography – The Gold Standard
Coronary angiography is widely regarded as the most accurate and definitive diagnostic method for detecting coronary artery disease. This procedure is typically performed using a minimally invasive approach, where a catheter is inserted via the radial artery in the right hand and guided into the coronary arteries. A contrast dye is then injected, allowing physicians to visualize the coronary arteries using X-ray imaging. This technique enables precise assessment of arterial narrowing and blockages.
In addition to standard imaging, advanced tools such as intravascular ultrasound (IVUS), optical coherence tomography (OCT), and fractional flow reserve (FFR) can be used during the procedure. These technologies provide detailed insights into plaque composition, vessel wall structure, and blood flow dynamics, enhancing the diagnostic value of coronary angiography.
Coronary CT Angiography (CTA) – A Non-Invasive Alternative
For patients who require a less invasive diagnostic option, coronary CT angiography (CTA) offers a valuable alternative. This method involves intravenous injection of a contrast agent followed by a CT scan. Sophisticated software then reconstructs detailed images of the coronary arteries, allowing doctors to assess their structure and detect any narrowing or blockage.
While coronary CTA is more convenient and carries fewer risks than traditional angiography, it is generally less accurate, especially in complex cases or patients with heavy calcification. However, it serves as an excellent initial screening tool for individuals with suspected CHD and low to intermediate risk.
Additional Diagnostic Tools
Electrocardiogram (ECG) and Exercise Stress Testing
Other supportive diagnostic methods include the resting electrocardiogram (ECG) and the exercise stress test. An ECG can reveal signs of myocardial ischemia, such as ST-T segment changes, which may indicate reduced blood flow to the heart muscle.
The exercise stress test monitors the heart's electrical activity during physical exertion. If significant dynamic ischemic changes occur during the test, it strongly suggests the presence of coronary artery disease. While these tests are useful for initial assessment, they are not definitive and are often followed by more advanced imaging such as coronary CTA or invasive angiography for confirmation.