<unk>  angiogram of a man<unk>  angiogram of a woman For symptomatic people, stress echocardiography can be used to make a diagnosis for obstructive<unk> . The use of echocardiography, stress cardiac imaging, and/or advanced non-invasive imaging is not recommended on individuals who are exhibiting no symptoms and are otherwise at low risk for developing<unk><unk> . The diagnosis of "Cardiac Syndrome X" – the rare<unk>  that is more common in women, as mentioned, is a diagnosis of exclusion. Therefore, usually, the same tests are used as in any person with the suspected of having<unk> : * Baseline electrocardiography (ECG) * Exercise ECG – Stress test * Exercise radioisotope test (nuclear stress test, myocardial scintigraphy) * Echocardiography (including stress echocardiography) *<unk>  angiography * Intravascular ultrasound * Magnetic resonance imaging (MRI) The diagnosis of<unk><unk>  underlying particular symptoms depends largely on the nature of the symptoms. The first investigation is an electrocardiogram (ECG/EKG), both for "stable" angina and acute<unk>  syndrome. An X-ray of the chest and blood tests may be performed. Stable angina In "stable" angina, chest pain with typical features occurring at predictable levels of exertion, various forms of cardiac stress tests may be used to induce both symptoms and detect changes by way of electrocardiography (using an ECG), echocardiography (using ultrasound of the heart) or scintigraphy (using uptake of radionuclide by the heart muscle). If part of the heart seems to receive an insufficient blood supply,<unk>  angiography may be used to identify stenosis of the<unk> <unk> es and suitability for angioplasty or bypass surgery. Stable<unk>  (SCAD) is also often called stable ischemic heart<unk>  (SIHD). A 2015 monograph explains that "Regardless of the nomenclature, stable angina is the chief manifestation of SIHD or SCAD." There are U.S. and European clinical practice guidelines for SIHD/SCAD. Acute<unk>  syndrome Diagnosis of acute<unk>  syndrome generally takes place in the emergency department, where ECGs may be performed sequentially to identify "evolving changes" (indicating ongoing damage to the heart muscle). Diagnosis is clear-cut if ECGs show elevation of the "ST segment", which in the context of severe typical chest pain is strongly indicative of an acute myocardial infarction (MI); this is termed a STEMI (ST-elevation MI) and is treated as an emergency with either urgent<unk>  angiography and percutaneous<unk>  intervention (angioplasty with or without stent insertion) or with thrombolysis ("clot buster" medication), whichever is available. In the absence of ST-segment elevation, heart damage is detected by cardiac markers (blood tests that identify heart muscle damage). If there is evidence of damage (infarction), the chest pain is attributed to a "non-ST elevation MI" (NSTEMI). If there is no evidence of damage, the term "unstable angina" is used. This process usually necessitates hospital admission and close observation on a<unk>  care unit for possible complications (such as cardiac arrhythmias – irregularities in the heart rate). Depending on the risk assessment, stress testing or angiography may be used to identify and treat<unk>  in patients who have had an NSTEMI or unstable angina. Risk assessment There are various risk assessment systems for determining the risk of<unk> , with various emphasis on different variables above. A notable example is Framingham Score, used in the Framingham Heart Study. It is mainly based on age, gender, diabetes, total cholesterol, HDL cholesterol, tobacco smoking, and systolic blood pressure. When it comes to predicting risk in younger adults (18–39 years old), Framingham Risk Score remains below 10-12% for all deciles of baseline-predicted risk. Polygenic score is another way of risk assessment. In one study the relative risk of incident<unk>  events was 91% higher among participants at high genetic risk than among those at low genetic risk.
Coronary artery disease
Dilated cardiomyopathy
Peripheral artery disease
Peptic ulcer disease
Cerebrovascular disease
Diabetes
Hypertensive heart disease
Heart cancer