Clogged arteries, referred to clinically as coronary artery disease (CAD), is the result of plaque buildup along the interior walls of arteries. Over time, these arteries become narrowed and lose their elasticity. Left untreated, blockages may form, leaving the patient vulnerable to a heart attack or stroke. Early detection of CAD reduces the risk significantly. A complete medical evaluation for CAD begins with simple non-invasive tests and graduates to more comprehensive diagnostics as the results warrant.
As a first step, most doctors order a simple blood test called a lipid panel to access your susceptibility for CAD. High cholesterol is usually the first indicator that CAD may be developing. Your doctor will focus on your overall cholesterol total---your HDL and LDL levels---in addition to your triglycerides.
If your cholesterol is high or you have symptoms, your doctor will order an electrocardiogram (EKG). This non-invasive test measures the electrical activity of the heart. It can detect abnormalities in the beat and rhythm, which may be an early sign of clogged arteries.
During a stress test, you will be required to walk on a treadmill while connected to diagnostic equipment that monitors your heart rate and blood pressure. As the speed on the treadmill gradually increases, the equipment tracks how well your heart tolerates the stress. The doctor will follow up the treadmill test with either an EKG or echocardiogram. A stress test may or may not include the injection of a nuclear contrast dye into the bloodstream.
An echocardiogram is a non-invasive test that allows your doctor to monitor how efficiently your heart valves and chambers are working. It can also detect weak areas of the heart muscle that may be contracting abnormally, which helps identify areas of poor blood flow.
Angiography with cardiac catheterization is viewed as the most definitive test for the diagnosis of coronary artery disease. This invasive procedure requires the insertion of a thin flexible tube into an artery in your leg or arm. The tube is carefully guided through your artery up into the heart, where dye is injected to reveal the severity of possible blockages. This procedure is usually performed in a hospital without anesthesia.
High Speed Scan
The most advanced non-invasive diagnostic test for CAD is the 64-CT high speed scan. The 64 slice CT is the latest generation of computerized tomography scanners, originally developed at Johns Hopkins in 2005. During the procedure, the CT scanner rotates around the patient, utilizing 64 detectors to create a three dimensional view of the heart. A study performed at Johns Hopkins and published in the New England Journal of Medicine online November 26, 2008, reports that continued scan studies can display the precise location of a blocked artery with 91 percent accuracy.