Exams and Tests

Your health care team will take a medical history, ask about your symptoms and listen to your heart with a stethoscope.

Your care team also may order tests to determine whether you have coronary artery disease and to what extent.

The results of these tests can also help guide treatment decisions.

Tests may include:

• Routine blood tests to check the level of fats, cholesterol, sugar and proteins in your blood. These are risk factors for heart disease that can be modified with lifestyle changes and, if needed, medication.
• Electrocardiogram (ECG), which records your heart's electrical activity and shows how fast or evenly the heart is beating. It can also show whether there is enough blood supply to the heart or if it is already damaged.
• Echocardiogram to look at the structure and overall function of your heart.
• Stress testing, which involves exercising, usually on a treadmill or stationary bike (or taking medicine to simulate exercise if you are unable to be active), to non-invasively evaluate blocked arteries in the heart.
• Chest X-ray to look at the heart and lungs and to see if there are abnormalities that might explain your symptoms.
• Computed tomography (CT) angiography scan of the heart that shows pictures of the heart's arteries and whether there is a buildup of plaque, even in the early stages before the plaque hardens.
• Coronary angiogram is done in the cardiac catheterization laboratory. It involves threading a thin tube or catheter into an artery, usually in the wrist or leg, and up to the heart. Dye is injected into the artery to evaluate it for any blockage. This test usually is recommended when a non-invasive one is abnormal, or a patient's symptoms strongly suggest CAD, or after a heart attack.

What Do the Results Mean?

Your care team might tell you that you have "less than 70% blockage in an artery." That means that you have non-obstructive CAD. In other words, blood flow to the heart muscle is not reduced at rest but may be limited during intense exercise or exertion. In this case, risk reduction through lifestyle and medication is the best treatment.

Or your care team might say you have "over 70% blockage in one artery." This means that you have a severe blockage in a coronary artery. Blood flow to a portion (or portions) of the heart muscle is greatly reduced and would likely explain any chest pain or shortness of breath you may have been feeling. In this case, your care team might recommend stepped up medical treatment, and possibly a procedure or surgery.