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How is coronary artery disease (CAD) diagnosed?

Dr. Jeanne Morrison, PhD
Family Practitioner

A risk of coronary artery disease can be diagnosed through routine checkups. A blood test can indicate high levels of cholesterol. A check of blood pressure can reveal unhealthy levels. The presence of common symptoms such as chest pain or shortness of breath can also point to the presence of the condition. If any or all of these risk factors are present, further tests of the heart can confirm the diagnosis.

An EKG can be very useful for a doctor to notice when the blood supply is constricted. Still, an EKG in someone with a history of Coronary Artery Disease and angina often has a "normal" reading.

Because a resting EKG often produces a "normal" reading for someone with angina, doctors may need to perform a stress test to evaluate the presence of Coronary Artery Disease. If characteristic signs occur during stress testing, especially if typical chest pains occur, the test is considered "positive".

A cardiac catheterization test can determine if Coronary Artery Disease is present, how severe it is and if a coronary artery bypass graft is needed. The catheterization test can definitely exclude Coronary Artery Disease if it is not present.

A doctor will perform the test if:

  • angina is being treated by a doctor by the symptoms continue
  • severe blood flow restriction is present on a stress test and symptoms suggest Coronary Artery Disease, yet the doctor is not able to come to a definitive diagnosis with other tests
  • a patient has many hospital admissions for chest pain where a heart attack is ruled out but the presence of Coronary Artery Disease has not been determined

During cardiac catheterization, blockages are treated by a balloon that is blown up inside the coronary arteries, forcing open the passage. This procedure is Percutaneous Transluminal Coronary Angioplasty - or just plain angioplasty.

Dr. John J. Marshall, MD
Cardiologist (Heart Specialist)

To determine whether you have coronary artery disease, and how severe it is, your doctor will talk with you about your health, lifestyle and family history. This information, plus the results of a physical examination and blood tests will help determine whether you have risk factors for heart disease.

Your doctor may also want you to have certain diagnostic tests, including one or more of the following:

  • electrocardiogram, which measures electrical activity in your heart;
  • a stress test, which measures your heart’s ability to tolerate exercise  and may include an imaging test as well; and
  • cardiac catheterization (also known as coronary angiography) or computed tomography, both of which allow your doctor to see images of your arteries and any build up of artery-clogging plaque.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.