Diagnosing & Treating Coronary Artery Disease
How is coronary artery disease diagnosed?
Coronary artery disease (CAD) is usually diagnosed using any or a combination of the following:
- Electrocardiogram (ECG or EKG) - a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
- Stress test (also called treadmill or exercise ECG) - a test that is given while a patient walks on a treadmill to monitor the heart during exercise. Respiratory rate and blood pressure are also monitored. A stress test may be used to detect coronary artery disease and/or to determine safe levels of exercise following a heart attack or heart surgery.
- Coronary arteriogram (or angiogram) - with this procedure, x-rays are taken after a contrast agent is injected into an artery to locate the narrowing, occlusions, and other abnormalities of specific arteries.
- Nuclear scanning - radioactive material is injected into a vein and is then observed using a camera that moves through the heart. This indicates the healthy and damaged areas of the heart.
How is coronary artery disease treated?
Specific treatment will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference of treatment
Treatment may include:
Making lifestyle changes such as:
- controlling risk factors
- changing to a low-fat diet
- losing weight (if overweight)
- establishing and maintaining an appropriate exercise program
- quitting smoking
- controlling blood sugar if you have diabetes
- reducing blood pressure
- Statin medications reduce cholesterol levels, prevent the progression of coronary artery disease, and reduce the incidence of heart attacks.
- Other medications may be used to prevent angina or treat other complications of coronary artery disease.
With this procedure, a catheter is used to create a bigger opening in the vessel to increase blood flow. Although angioplasty is performed in other blood vessels, Percutaneous Transluminal Coronary Angioplasty (PTCA) refers to angioplasty in the coronary arteries to permit more blood flow into the heart. There are several types of PTCA procedures, including:
- Balloon angioplasty - a small balloon is inflated inside the blocked artery to open the blocked area.
- Atherectomy - the blocked area inside the artery is "shaved" away by a tiny device on the end of a catheter.
- Coronary artery stent - a tiny titanium coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open. Many stents used today are coated with medications that significantly reduce the chance that a new blockage will form at the site.
- Coronary artery bypass - a surgical procedure in which small portions of veins or arteries are taken from one part of the body and transplanted into the heart to bypass clogged coronary arteries in the heart.
Frequently asked questions about coronary artery disease