Cardiologists today have more Cardiac tests to use in order to diagnose coronary artery disease (CAD). CAD patients are at risk of acute myocardial infarction (MI) or sudden cardiac death. Now an increasing number of cardiac tests help the healthcare providers in clinical decision making.
Cardiac tests encompasses a list of invasive and noninvasive tests.
Exercise stress testing - the test might use a bicycle ergometer or treadmill. By exercising the goal is to raise workload incrementally to induce coronary ischemia. The occurring of acute chest pain during exercises is typical to evaluate coronary ischemia.
Pharmacologic stress testing - is developed after exercise testing for patients who can not exercise. In this procedure, the cardiovascular stress is induced by pharmacologic agents in patients. The most widely available pharmacologic agents for stress testing are
Myocardial perfusion imaging - is a procedure that demonstrates the function of the myocardium. It is the test of choice for patients with active chest pain, an ECG with no ischemic changes, and an initial negative troponin result. Myocardial perfusion imaging is a method to visualize blood flow to the heart by injection of a radioactive cardiac specific tracer.
Stress echocardiography - is a procedure to perform echocardiography while the heart is undergoing exercise or pharmacologically induced stress. This one is usually called as stress echo.
Cardiac computed tomography (CCT) scanning - is to measure the density and extent of calcifications in coronary artery walls to predict future cardiac disease risk. Because high density of calcifications means narrow coronary artery pathway and low flexibility of artery.
- Thallium stress test - is a nuclear imaging test that shows how blood flows into your heart in exercising or at rest. This test is also called a cardiac or nuclear stress test. Thallium is the type of radioactivity that is injected into the body for the test. This one is usually called as stress thallium.
Sometimes patients suspected with coronary blockage have negative results in negative tests. Doctors will then order stress echo or thallium stress test to confirm. Patients might feel unsure about which one to choose, and ask about which one is better. This could be a debate in seminars and conferences of cardiologists. In general they're about the same, very similar level of sensitivity. If you had either one of them, you don't need to run the other.
- Diagnostic coronary angiography - anesthetic is used and the cardiologist passes a thin hollow tube through an artery to move into the heart. The tube is called catheter. Once the catheter is in place, dye is injected into the catheter. X-ray images are taken so the doctors can see the move of the catheter. The catheter keeps moving through the artery, and the dye helps highlight any blockages in the blood flow.