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Diagnosis of Coronary Artery Disease (CAD)

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The doctor may suspect CAD based on your health history and symptoms. A physical exam will be done to look for other signs of CAD. The doctor will use other tests to confirm the presence of CAD. The tests will also help to rule out other issues that have similar symptoms.

The most accurate way to diagnose CAD is with coronary angiography. A device will create real time images of the heart. A thin tube is threaded to the arteries of the heart. A dye is passed through the tube and released in the area. The dye will highlight local blood flow and blockages on images.

Other tests that may detect changes in blood flow include:

  • Echocardiogram —shows abnormalities in the heart muscle. Highlights areas of poor blood flow.
  • MRI scan —can show blood flow to the heart muscle.
  • PET scan —can show blood flow to the heart muscle.

Some tests may detect heart damage or other health conditions. These may include:

  • Cardiac CT scan —can show deposits of calcium in blood vessels. May suggest early atherosclerosis.
  • Exercise stress test —show the heart's electrical activity with increased physical activity. It may be done with other tests that show blood flow through the heart.
    • Physical stress can also be triggered with medication. It may be used for people who cannot exercise.
  • Chest x-ray —can show an enlarged heart or congestion in the lungs. May help show unknown heart failure.
  • ECG —shows the electrical activity of your heart. Can show heart rhythm problems and heart muscle problems. Can also show damage from a previous heart attack.
  • SPECT scan—shows blood flow to the heart muscle. May also be used to look for signs of a heart attack.

Blood tests may also be done to look for risk factors for CAD such as:

  • Cholesterol levels
  • High blood glucose levels (diabetes)

C-reactive protein (CRP) and other biomarkers as cardiac risk factors. EBSCO DynaMed Plus website. Available at: Updated February 25, 2016. Accessed March 5, 2018.

Coronary artery disease (CAD). EBSCO DynaMed Plus website. Available at: Updated February 28, 2018. Accessed March 5, 2018.

Coronary heart disease. National Heart, Lung, and Blood Institute website. Available at: Accessed March 5, 2018.

Single photon emission computed tomography (SPECT). American Heart Association website. Available at: Updated September 19, 2016. Accessed March 5, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC  Last Updated: 7/6/2018