Coronary Artery Disease
Diagnosis

Doctors know that some people are at high risk of this kind of heart disease because of certain physical and behavioral characteristics. For example, men generally are at greater risk for heart disease but the risk increases for women after menopause. Other characteristics for arteriosclerosis include:

• Age
• Diabetes
• Family history of heart disease
• High blood cholesterol
• High blood pressure
• Obesity
• Sedentary lifestyle
• Smoking
• Stress

Arteriosclerosis is diagnosed through various tests including:

• Coronary Angiography — Coronary angiography, also called cardiac catheterization, is a minimally invasive study that is considered the gold standard for diagnosing coronary artery disease. This test is performed under local anesthesia and involves injecting X-ray dye or contrast medium into the coronary arteries via tubes called catheters. An X-ray camera films the blood flow to show the location and severity of artery narrowing. This test can show if the blood vessels in your heart have narrowed, your heart is pumping normally and blood is flowing correctly and your heart valves are functioning properly. It also can identify any heart abnormalities you may have been born with or congenital abnormalities.
• Echocardiogram (ECHO) — This non-invasive test translates sound waves from your chest into pictures of your heart. It provides information about how the heart is pumping, how blood flows in the heart and blood vessels, how large the heart is and how the valves are working.
• Electrocardiogram (ECG or EKG) — The electrocardiogram records the heart's electrical activity. Small patches called electrodes are placed on your chest, arms and legs, and are connected by wires to the ECG machine. Your heart's electrical impulses are translated into a wavy line on a strip of paper, enabling doctors to determine the pattern of electrical current flow in the heart and to diagnose arrhythmias and heart damage.
• Stress Echocardiogram — Stress tests are performed to see how the heart performs under physical stress. The heart can be stressed with exercise on a treadmill or in a few instances, a bicycle. If you can't exercise on a treadmill or bicycle, medications can be used to cause the heart rate to increase, simulating normal reactions of the heart to exercise. During the stress test, you will wear ECG electrodes and wires while exercising so that the electrical signals of your heart can be recorded at the same time.
• Stress Thallium Test — Stress thallium tests have two components — a treadmill stress test and heart scan after injection of a radionuclide material, such as thallium, which allows doctors to see the coronary arteries and the shape and function of the heart. It has been used in this manner safely for many years to demonstrate the amount of blood the heart is getting under various conditions — rest and stress.

Reviewed by health care specialists at UCSF Medical Center.

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