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.
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 catheterization.
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.
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.
