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Diagnosis of Coronary Artery Disease (CAD)
Suspicion of CAD may be based on your medical history and symptoms, such as chest pain with exertion. A complete physical exam will be done to look for other signs of CAD. Diagnosis is often made by assessing the results of several tests. Tests can also eliminate other health conditions with symptoms similar to CAD. In some people, CAD is found accidentally during a regular physical exam.
The most accurate way to diagnose CAD is with coronary angiography and coronary catheterization. During this procedure, a thin tube is threaded to the coronary artery where a dye is released. The dye shows the location of blockages in the coronary arteries.
Other tests that may detect changes in blood flow include:
- Echocardiogram —Ultrasound that detects abnormalities in the heart muscle by highlighting areas of poor blood flow.
- MRI scan —Evaluates blood flow to the heart muscle.
- PET scan —Evaluates blood flow to the heart muscle.
Some tests may detect heart damage or other health conditions. These may include:
- Cardiac CT scan —Detects calcium deposits that may indicate early atherosclerosis .
- Exercise stress test —Records the heart's electrical activity during increased physical activity. It may be coupled with other tests that detect blood flow through the heart. People who cannot exercise may be given IV medication that simulates the effects of physical exertion.
- Chest x-ray —Detects heart enlargement or congestion in the lungs. This test can help diagnose heart failure or an unrelated lung condition.
- Electrocardiogram (EKG)—The EKG records the electrical activity of your heart through electrodes attached to the skin. This test will help diagnose heart rhythm problems, muscle abnormalities, and damage to the heart from a previous heart attack .
- SPECT scan—Evaluates blood flow to the heart muscle or looks for signs of a heart attack.
Blood tests may also be done to look for risk factors for CAD such as:
- Elevated C-reactive protein levels
- Cholesterol levels
- High blood glucose levels (diabetes)
Blood tests may also be done to look for related conditions such as kidney or liver disease.
C-reactive protein (CRP) as a cardiac risk factor. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 25, 2016. Accessed March 2, 2016.
Coronary artery disease (CAD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 4, 2015. Accessed March 2, 2016.
How is coronary heart disease diagnosed? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/cad/diagnosis.html. Updated August 23, 2012. Accessed January 27, 2014.
Single photon emission computed tomography (SPECT). American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Single-Photon-Emission-Computed-Tomography-SPECT%5FUCM%5F446358%5FArticle.jsp. Updated September 11, 2015. Accessed March 2, 2016.
- Reviewer: Michael J. Fucci, DO, FACC
- Review Date: 03/2016
- Update Date: 03/15/2015