If<unk>  is suspected, a series of tests will be undertaken for confirmation. The most common tests used are an electrocardiogram, an exercise stress test, and a coronary angiography. A medical history will be taken, including queries about past incidences of chest pain or shortness of breath. The duration and frequency of symptoms will be noted as will any measures taken to relieve the symptoms. Electrocardiogram A resting electrocardiogram (EKG) is an early step in the diagnostic process. An electrocardiogram (EKG) involves the use of electrodes that are placed on the arms, chest, and legs. These sensors detect any abnormal rhythms that the heart may be producing. This test is painless and it helps detect insufficient blood flow to the heart. An EKG can also detect damage that has been done in the past to the heart. This test can also detect any thickening in the walls of the left ventricles as well as any defects in the electrical impulses of the heart. It is quick and provides the Physician with the P/PR, Heart Rate, QRS, QT/QTcF, P/QRS/T, and axis results. Exercise stress electrocardiogram A cardiac stress test, puts stress on the heart through exercise. A series of exercises to measure the tolerance for stress on the heart will be carried out. This test uses an EKG to detect the electrical impulses of the heart during physical exertion. A treadmill or exercise bike will be used. The incline or resistance of the bike are steadily increased until the target heart rate for the person's age and weight is reached. However, an exercise stress test is not always accurate in determining the presence of a blockage in the arteries. Women and those who are young may show abnormalities on their test even though no signs of<unk>  or CAD are present. Harmless arrhythmias present at baseline may distort the results. Diagnosis of coronary artery disease is missed in 37% of men and 18% of women with a negative test. However, those patients who are able to complete the test are at lower risk of future cardiac events. Stress echocardiography Stress echocardiography is very commonly used in assessing for<unk>  resulting from coronary artery disease. It can be performed exercising, preferably with a bicycle that allows the patient to exercise while lying flat, which allows for imaging throughout the entire testing period. While the patient is exercising, images of the heart in motion are generated.<unk>  can be detected by visualizing abnormalities in the movement of the heart and the thickness of the heart wall during exercise. Some people may be unable to exercise in order to achieve a sufficient heart rate for a useful test. In these cases, high-dose dobutamine may be used to chemically increase heart rate. If dobutamine is insufficient for this purpose, atropine be added to reach goal heart rate. Dipyridamole is an alternative to dobutamine but it is less effective in detecting abnormalities. While exercise echocardiograms are more effective in detecting coronary artery disease, all forms of stress echocardiograms are more effective than exercise EKG in detecting<unk>  secondary to coronary artery disease. If stress echocardiography is normal, risk of future adverse cardiac events is low enough that invasive coronary angiography is not needed. Coronary angiography A coronary angiography is performed after a stress test or EKG shows abnormal results. This test is very important in finding where the blockages are in the arteries. This test helps determine if an angioplasty or bypass surgery is needed. Coronary angiography should only be performed if a patient is a willing to undergo a coronary revascularization procedure. During this test the doctor makes a small incision in the patient's groin or arm and inserts a catheter. The catheter has a very small video camera on the end of it so that the doctor can find the arteries. Once he/she has found the arteries, he/she injects a dye in them so that he/she can detect any blockages in the arteries. The dye is able to be seen on a special x-ray machine.
Coronary ischemia
Coronary occlusion
Coronary vasospasm
Coronary thrombosis
Proarrhythmia
Myocardial stunning
Ischemia
Myocardial infarction