How is Coronary Heart Disease Diagnosed?

Your doctor will diagnose coronary heart disease (CHD) based on your medical and family history, CHD risk factors, physical examination, and test results and procedures. As a first step in diagnosis, doctors will usually ask about symptoms, lifestyle, family health history, and check your cholesterol levels. Indeed there is no single test that can diagnose CHD. If your doctor suspects you have CHD, your doctor will usually recommend the following tests.

- ECG ( Electrocardiogram )

An ECG is a simple painless test that detects and records the electrical activity of the heart. The test shows how fast the heart beats and rhythms (steady or irregular). The ECG also records the strength and timing of electrical signals as they pass through the heart. The ECG can show signs of heart damage due to CHD and signs of a previous heart attack or during the examination.

- Stress Test ( Stress Testing )

During stress testing, you exercise to make your heart work hard and beat fast when a heart test is performed. If you can't exercise, you may be given a medication to increase your heart rate. If your heart is working hard and beating fast, more blood and oxygen is needed. The narrowed arteries due to plaque cannot supply enough oxygen-rich blood to meet your heart's needs.

Stress tests can indicate possible signs and symptoms of CHD, such as:
Abnormal changes in heart rate or blood pressureShort breath or chest painAbnormal changes in heart rhythm or cardiac electrical activity.If you can't exercise as long as what is considered normal for someone your age, your heart may not get enough oxygen-rich blood. However, other factors can also prevent you from exercising for a long time (such as lung disease, anemia, or poor general health).
As part of several stress tests, images are taken from your heart when you exercise and while resting.Images on this stress test can show how well blood is flowing in the heart and how well your heart is pumping blood as it pulsates.

- Echocardiography ( Echocardiography )

Echocardiography uses sound waves to make moving heart images. The picture shows the size and shape of your heart and how well your heart's chambers and valves work. Echocardiography can also show areas of poor blood flow to the heart, areas of the heart muscle that do not contract normally, and previous injuries to the heart muscle caused by poor blood flow.

- Thoracic X ( X ray ) examination

Chest X-ray takes pictures of organs and structures in your chest, such as your heart, lungs and blood vessels. Chest X-rays can show signs of heart failure, as well as lung disorders and other causes of symptoms that are not associated with coronary heart disease.

- Blood test

Blood tests check the levels of fat, cholesterol, sugar and certain proteins in your blood. Abnormal levels may be a sign that you are at risk for CHD.

Your doctor may recommend coronary angiography if tests or other factors indicate that you tend to experience CHD. This test uses special dyes and x-rays to show the inside of your coronary arteries. The purpose of this coronary angiography procedure is to examine the presence and severity of narrowing in the heart's blood vessels and to check the pressure in the heart chamber.

To get dye into your coronary artery, your doctor will use a procedure called cardiac catheterization. A thin and flexible tube called a catheter is inserted into a vein in your arm, groin (upper thigh), or neck. The tube is looped into your coronary artery, and the dye is released into your bloodstream. Special x-rays are taken when the dye flows through your coronary arteries. These dyes allow your doctor to study blood flow through your heart and blood vessels.

Cardiac catheterization is usually done in a hospital.You are awake during the procedure. Usually causes little or no pain in the blood vessels where the doctor inserts a catheter.
Thus a series of tests or examinations to answer how coronary  heart disease is diagnosed. 

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