Coronary artery disease usually is diagnosed after a person has chest pain or other symptoms such as shortness of breath with physical activity.
Your doctor will examine you, paying special attention to your chest and heart. During the physical examination, your doctor will press on your chest to see if it is tender. Tenderness in the area where you have chest pain could be a sign of a non-cardiac problem involving chest muscles, ribs or rib joints. Your doctor will use a stethoscope to listen for any abnormal heart sounds. The physical examination will be followed by one or more diagnostic tests to look for coronary artery disease. Possible tests include:
An EKG - An EKG is a record of the heart's electrical impulses. It can identify problems in heart rate and rhythm, and it can provide clues that part of your heart muscle isn't getting enough blood.
Blood test for heart enzymes - When heart muscle is damaged, enzymes leak out of the damaged muscle cells into the bloodstream. Elevated heart enzymes suggest a heart problem.
An exercise stress test on a treadmill - An exercise stress test monitors the effects of treadmill exercise on blood pressure and EKG and can identify heart problems.
An echocardiogram - This test uses ultrasound to produce images of the heart's movement with each beat.
Imaging test with radioactive tracers - In this test, a radioactive material is injected and is taken up by the heart muscle, which helps certain features show up on images taken with special cameras.
A coronary angiogram (a series of X-rays of the coronary arteries) - The coronary angiogram is considered the most accurate way to measure the severity of coronary disease. During an angiogram, a thin, long, flexible tube called a catheter is inserted into an artery in the forearm or groin, and then threaded through the circulatory system into the coronary arteries. Dye is injected to show the blood flow within the coronary arteries and to identify any areas of narrowing or blockage.
Coronary artery disease is a long-term condition, and people can have different patterns of symptoms. Plaque in coronary arteries never will disappear completely. However, with diet, exercise and proper medication, the heart muscle adapts to decreased blood flow, and new, small blood channels can develop to increase the blood flow to the heart muscle.