How to Diagnose Coronary Heart Disease

Coronary heart disease (CHD) is a serious condition that occurs when the coronary arteries become narrowed or blocked, reducing blood flow to the heart. Accurate diagnosis is crucial for effective treatment and long-term management. There are several key diagnostic methods used in clinical settings to identify CHD.

Gold Standard: Coronary Angiography

Coronary angiography remains the most reliable and widely accepted method for diagnosing coronary heart disease. This invasive procedure involves injecting a contrast dye into the coronary arteries and using X-ray imaging to visualize any blockages or narrowing. In addition to its diagnostic value, angiography also allows for immediate intervention, such as stent placement, to restore proper blood flow.

Advanced Imaging Techniques

As medical technology continues to advance, intravascular imaging techniques have become increasingly valuable in diagnosing CHD. Tools like intravascular ultrasound (IVUS) provide detailed images of the inside of blood vessels, helping doctors assess plaque buildup and vessel structure with high accuracy. These imaging modalities complement traditional diagnostic methods and improve the precision of diagnosis.

Supportive Diagnostic Tools

In addition to imaging, a variety of other diagnostic tools play a critical role in confirming CHD. These include:

Electrocardiogram (ECG): Detects abnormal heart rhythms and signs of previous heart attacks.
Cardiac biomarkers: Blood tests that identify specific proteins released during heart damage, such as troponin.
Echocardiogram: Uses sound waves to create images of the heart and evaluate its function.

Understanding the Different Types of CHD

Patients with coronary heart disease may present in various forms, including:

Asymptomatic myocardial ischemia
Ischemic cardiomyopathy
Angina pectoris
Myocardial infarction (heart attack)
Sudden cardiac death

Each type presents with distinct symptoms and clinical features, requiring a comprehensive evaluation by an experienced cardiologist. A thorough review of the patient's symptoms, combined with appropriate diagnostic tests, is essential for accurate diagnosis. In many cases, especially when symptoms are unclear or test results are inconclusive, coronary angiography is necessary to confirm the diagnosis and guide treatment decisions.