Materiały źródłowe

• #1 Coronary Heart Disease – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/coronary-heart-disease/diagnosis

  Your healthcare provider will diagnose coronary heart disease based on your symptoms, your medical and family history, your risk factors, and the results of heart tests. […] To help diagnose coronary heart disease, your provider may also order some of the following heart tests: […] An electrocardiogram (ECG) records the strength and timing of electrical signals as they pass through the heart and determines whether the heart’s rhythm is steady or irregular. […] A coronary calcium scan measures the amount of calcium in the walls of your coronary arteries. […] Stress tests check your heart while it is working hard and beating quickly. […] Cardiac magnetic resonance imaging (MRI) detects tissue damage or problems with blood flow in the heart or coronary arteries. […] A cardiac positron emission tomography (PET) scan assesses blood flow through the coronary blood vessels and into the heart muscle. […] Coronary CT angiography is an imaging test that looks at blood flow through the coronary arteries using a special X-ray machine that takes multiple pictures of the heart. […] Invasive coronary angiography uses contrast dye to detect blockages in the coronary arteries.

• #2 Coronary Artery Disease (CAD): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease

  Coronary artery disease (CAD) is a narrowing or blockage of your coronary arteries, which supply oxygen-rich blood to your heart. […] Healthcare providers diagnose coronary artery disease through a physical exam and testing. […] Your provider may also recommend one or more tests to assess your heart function and diagnose CAD. These include: Blood tests, Cardiac catheterization, Computed tomography (CT) coronary angiogram, Heart MRI (magnetic resonance imaging), Coronary calcium scan, Echocardiogram (echo), Electrocardiogram (EKG/ECG), Exercise stress test, Chest X-ray. […] Coronary artery disease treatment often includes lifestyle changes, risk factor management and medications. Some people may also need a procedure or surgery. […] Your healthcare provider will talk with you about the best treatment plan for you. Its important to follow your treatment plan so you can lower your risk of serious complications from CAD.

• #3 Coronary Artery Disease | CAD | MedlinePlus

  https://medlineplus.gov/coronaryarterydisease.html

  Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women. […] CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This buildup is called atherosclerosis. As it grows, less blood can flow through the arteries. As a result, the heart muscle can’t get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts’ blood supply, causing permanent heart damage. […] Over time, CAD can also weaken the heart muscle and contribute to heart failure and arrhythmias. Heart failure means the heart can’t pump blood well to the rest of the body. Arrhythmias are changes in the normal beating rhythm of the heart.

• #4 Diagnosing Coronary Artery Disease | NYU Langone Health

  https://nyulangone.org/conditions/coronary-artery-disease/diagnosis

  At NYU Langone, specialists diagnose and manage coronary artery disease, which is estimated to affect more than 13 million Americans. […] Your NYU Langone cardiologist takes a family and medical history to determine your risk for coronary artery disease. Next, he or she performs a physical exam, asks whether you smoke and how much you exercise, asks about your diet, and determines if you have diabetes, high blood pressure, or unhealthy cholesterol levels. Your doctor also orders tests to help diagnose coronary artery disease. […] Your doctor may take a sample of blood to check the levels of different substances, including cholesterol; triglycerides, or fat in the blood, which can increase the risk of coronary artery disease; proteins that can indicate inflammation in the arteries; and glucose, or sugar, which can help determine if you have diabetes. Elevated levels of these substances can increase your risk for atherosclerosis.

• #5 Coronary Artery Disease (CAD) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/coronary-artery-disease

  How is coronary artery disease diagnosed? […] Doctors screen for heart disease during routine exams, asking questions about your personal and family history, taking blood samples to test cholesterol levels, and measuring your weight and blood pressure. […] If a doctor has a reason to suspect you have heart disease, he or she may order additional tests. These can include an electrocardiogram, which measures electrical activity in the heart, or a stress test, which measures how well the heart works when stressed by physical activity. […] How is coronary artery disease treated? […] Most people with coronary artery disease can be helped by one or several of three types of treatment. These are: […] Medication: Prescription drugs can counter the effects of heart disease, helping to keep risk factors including hypertension and cholesterol under control.

• #6 Early diagnosis of coronary artery disease | Total Health

  https://www.totalhealth.co.uk/clinical-experts/professor-avijit-lahiri/early-diagnosis-coronary-artery-disease

  Heart Disease Early detection of Coronary Heart Disease and Coronary Artery Disease is crucial in preventing death from these conditions. This article describes the various tests undertaken to diagnose heart disease and will be of help to anyone who has experienced chest pains and is unsure of the next step to take. […] It is important to obtain an accurate and rapid diagnosis of coronary artery disease at the outset as there may be serious consequences with a missed diagnosis; this is also important to exclude chest pain that is not related to the heart. […] A normal electrocardiogram (ECG) does not always exclude a heart attack or angina. […] The key features which make a diagnosis of angina likely are when: Pain is localised to chest and/or radiating to neck, jaw, left arm and shoulder; Chest pain is worse on exercise and during stress; Chest pain is relieved by rest and/or by nitroglycerine tablet or spray.

• #7 Coronary Artery Disease in Women – Ashchi Heart & Vascular Center

  https://drashchiheart.com/coronary-artery-disease-in-women/

  Ischemic heart disease (IHD) is the leading cause of death in women as in men, although presentation in women is on average 7-10 years later. […] Recently a decrease in IHD incidents and resulting mortality among men has been noticed but not so among women due to lack of early diagnosis, prevention, and treatment. Mortality among women remains higher than in men. […] In women, the issue of Coronary Artery Disease (CAD) is underestimated, which results in underdiagnosis and undertreatment. […] Diagnosing angina pectoris is based on medical interviews. […] Unfortunately, clinical practice shows that there are significant differences in symptoms between men and women. […] The symptoms of angina pectoris as the first manifestation of coronary artery disease differ among men and women.

• #8 Coronary Artery Disease in Women – Ashchi Heart & Vascular Center

  https://drashchiheart.com/coronary-artery-disease-in-women/

  Women more often report atypical anginal symptoms or uncharacteristic chest pain accompanied by increased sweating, dyspnea, nausea, and vomiting, which, in most cases, does not lead to further non-invasive CAD diagnostics. […] Diabetes mellitus (DM) is another significant risk factor for CAD. Type 2 DM is associated with higher CAD risk in women than in men. […] Coronary artery disease statistics have shown that mortality due to myocardial infarction is substantially higher in women with type 2 DM than in men with type 2 DM and women without this condition. […] Non-invasive CAD diagnostics in women are less sensitive and specific than in men; this pertains to electrocardiographic stress testing. […] Women are more likely than men to exhibit non-specific changes in resting ECG, lower voltage of QRS complexes, high resting heart rate, which, combined with the smaller diameters of coronary vessels and lower fitness, reduces the specificity of stress testing.

• #9 Coronary artery disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/diagnosis-treatment/drc-20350619

  To diagnose coronary artery disease, a healthcare professional examines you. You are usually asked questions about your medical history and any symptoms. If you have symptoms of coronary artery disease such as chest pain or shortness of breath, tests may be done to check your overall health. […] Tests to help diagnose or watch coronary artery disease include: […] Blood tests can check blood sugar and cholesterol levels. A high-sensitivity C-reactive protein (CRP) test checks for a protein linked to inflammation of the arteries. […] This quick test checks the electrical activity of the heart. It shows how the heart is beating. […] This test uses sound waves to show blood flow through the heart. […] If your symptoms usually occur during exercise, your healthcare professional may recommend this test.

• #10 What Blood Tests Detect Heart Problems?

  https://my.clevelandclinic.org/health/diagnostics/16792-blood-tests-to-determine-risk-of-coronary-artery-disease

  Certain elements in your blood, like your cholesterol, triglycerides, or fibrinogen, are like a window to your heart health. Using blood tests to understand your risk of coronary artery disease is a proactive approach to a healthier heart. Your healthcare provider may order blood and urine lab tests to determine your risk of heart and blood vessel disease. Certain results, like high levels of low-density lipoprotein (LDL), indicate a higher risk of heart disease. The test results and your health history help your healthcare team create the best care plan for you. Your healthcare provider may recommend blood tests to determine your risk of heart disease such as coronary artery disease (CAD) if you have other comorbidities or conditions such as diabetes, high blood pressure, prior heart attack or stroke.

• #11 What Blood Tests Detect Heart Problems?

  https://my.clevelandclinic.org/health/diagnostics/16792-blood-tests-to-determine-risk-of-coronary-artery-disease

  When detecting heart disease risk, healthcare providers pay close attention to: Total cholesterol (TC): Your total cholesterol is directly linked to your heart and blood vessel disease risk. High-density lipoprotein (HDL): This test identifies your good cholesterol. High levels reduce your risk of heart and blood vessel disease. Low-density lipoprotein (LDL): LDL is bad cholesterol. High levels are linked to a greater risk of heart and blood vessel disease. Lipoprotein (a), or Lp(a): High levels of Lp(a) increase your risk of heart attack, stroke, blood clots, fatty buildup in veins after coronary artery bypass surgery and narrowing of coronary arteries after angioplasty. […] High levels of Lp(a) tend to run in families. Your provider may order this test if you have a family history of heart disease at an early age. Homocysteine (Hcy): Hcy is an amino acid. High levels increase your risk of heart and blood vessel disease. Hemoglobin A1c (HbA1c): This blood test helps diagnose diabetes, which increases the risk of CAD. It reflects your average blood sugar levels over two to three months. […] While blood tests help your healthcare provider better understand your heart disease risk, they’re not a definitive diagnosis. If your blood test results show you have an increased risk, your provider may recommend further testing.

• #12 Diagnosing Coronary Artery Disease | NYU Langone Health

  https://nyulangone.org/conditions/coronary-artery-disease/diagnosis

  At NYU Langone, specialists diagnose and manage coronary artery disease, which is estimated to affect more than 13 million Americans. […] Your NYU Langone cardiologist takes a family and medical history to determine your risk for coronary artery disease. Next, he or she performs a physical exam, asks whether you smoke and how much you exercise, asks about your diet, and determines if you have diabetes, high blood pressure, or unhealthy cholesterol levels. Your doctor also orders tests to help diagnose coronary artery disease. […] Your doctor may take a sample of blood to check the levels of different substances, including cholesterol; triglycerides, or fat in the blood, which can increase the risk of coronary artery disease; proteins that can indicate inflammation in the arteries; and glucose, or sugar, which can help determine if you have diabetes. Elevated levels of these substances can increase your risk for atherosclerosis.

• #13 Diagnosing Heart Disease | Patient Education | UCSF Health

  https://www.ucsfhealth.org/education/diagnosing-heart-disease

  Various tests are used to diagnose heart disease. Your doctor will start by taking your personal and family medical history, recording your current and past symptoms, doing laboratory tests and sending you for an electrocardiogram. Based on the results, they may order further tests. […] The main lab tests used to evaluate you for heart disease are run on blood samples drawn from a vein in your arm. […] Your doctor may request some or all the following blood tests to check for heart disease. […] A lipid profile measures your low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and total cholesterol. Abnormal levels can elevate the risk of heart disease. […] A high level of one particular type, called lipoprotein (a), is considered a risk factor for heart disease.

• #14 Coronary Heart Disease – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/coronary-heart-disease/diagnosis

  Your healthcare provider will diagnose coronary heart disease based on your symptoms, your medical and family history, your risk factors, and the results of heart tests. […] To help diagnose coronary heart disease, your provider may also order some of the following heart tests: […] An electrocardiogram (ECG) records the strength and timing of electrical signals as they pass through the heart and determines whether the heart’s rhythm is steady or irregular. […] A coronary calcium scan measures the amount of calcium in the walls of your coronary arteries. […] Stress tests check your heart while it is working hard and beating quickly. […] Cardiac magnetic resonance imaging (MRI) detects tissue damage or problems with blood flow in the heart or coronary arteries. […] A cardiac positron emission tomography (PET) scan assesses blood flow through the coronary blood vessels and into the heart muscle. […] Coronary CT angiography is an imaging test that looks at blood flow through the coronary arteries using a special X-ray machine that takes multiple pictures of the heart. […] Invasive coronary angiography uses contrast dye to detect blockages in the coronary arteries.

• #15 Coronary artery disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/coronary-artery-disease/

  Stable CAD can be diagnosed using cardiac stress testing, nonstress cardiac imaging, and/or coronary catheterization. […] The following recommendations are consistent with the 2012 and 2013 American Heart Association (AHA) guidelines for the management of stable ischemic heart disease (IHD) and the 2021 AHA chest pain guidelines. They focus on patients with chronic stable angina and no history of CAD. For patients with acute symptoms, see Diagnostics in Acute coronary syndrome. […] New onset chest pain, pain at rest, and increasing frequency or severity of pain are symptoms of unstable angina. […] Resting ECG: indicated for all patients. […] Resting ECG results are usually normal in patients with stable CAD. […] Either cardiac stress testing or CCTA can be used to risk stratify patients with intermediate to high PTP of obstructive CAD.

• #16 Coronary artery disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/diagnosis-treatment/drc-20350619

  To diagnose coronary artery disease, a healthcare professional examines you. You are usually asked questions about your medical history and any symptoms. If you have symptoms of coronary artery disease such as chest pain or shortness of breath, tests may be done to check your overall health. […] Tests to help diagnose or watch coronary artery disease include: […] Blood tests can check blood sugar and cholesterol levels. A high-sensitivity C-reactive protein (CRP) test checks for a protein linked to inflammation of the arteries. […] This quick test checks the electrical activity of the heart. It shows how the heart is beating. […] This test uses sound waves to show blood flow through the heart. […] If your symptoms usually occur during exercise, your healthcare professional may recommend this test.

• #17 Find Out The Most Popular Diagnostic Methods for Coronary Heart Disease – Diag

  https://diag.vn/en/thongtinyte/diagnostic-methods-for-coronary-heart-disease/

  The simplest and least expensive way to diagnose coronary artery disease is through the results of the electrocardiogram. […] Electrocardiogram (ECG) is a highly regarded method of detecting cardiovascular disease, painless, and non-invasive. […] However, the method of the electrocardiogram to check cardiovascular is not always 100% accurate, there are cases where the patient has coronary artery disease but the ECG measurement does not detect any abnormal signs. […] The exercise ECG method is often used in patients with suspected coronary artery disease, hypertension, heart failure, valvular disease, and monitoring of the progression of coronary heart failure. […] Echocardiography in coronary artery disease often helps to detect coronary artery disease when it has progressed in a late-stage, in the presence of a movement disorder in the heart chamber.

• #18 Coronary Heart Disease – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/coronary-heart-disease/diagnosis

  Your healthcare provider will diagnose coronary heart disease based on your symptoms, your medical and family history, your risk factors, and the results of heart tests. […] To help diagnose coronary heart disease, your provider may also order some of the following heart tests: […] An electrocardiogram (ECG) records the strength and timing of electrical signals as they pass through the heart and determines whether the heart’s rhythm is steady or irregular. […] A coronary calcium scan measures the amount of calcium in the walls of your coronary arteries. […] Stress tests check your heart while it is working hard and beating quickly. […] Cardiac magnetic resonance imaging (MRI) detects tissue damage or problems with blood flow in the heart or coronary arteries. […] A cardiac positron emission tomography (PET) scan assesses blood flow through the coronary blood vessels and into the heart muscle. […] Coronary CT angiography is an imaging test that looks at blood flow through the coronary arteries using a special X-ray machine that takes multiple pictures of the heart. […] Invasive coronary angiography uses contrast dye to detect blockages in the coronary arteries.

• #19 Coronary artery disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/diagnosis-treatment/drc-20350619

  To diagnose coronary artery disease, a healthcare professional examines you. You are usually asked questions about your medical history and any symptoms. If you have symptoms of coronary artery disease such as chest pain or shortness of breath, tests may be done to check your overall health. […] Tests to help diagnose or watch coronary artery disease include: […] Blood tests can check blood sugar and cholesterol levels. A high-sensitivity C-reactive protein (CRP) test checks for a protein linked to inflammation of the arteries. […] This quick test checks the electrical activity of the heart. It shows how the heart is beating. […] This test uses sound waves to show blood flow through the heart. […] If your symptoms usually occur during exercise, your healthcare professional may recommend this test.

• #20 Coronary Artery Disease: Causes, Symptoms, and Treatments

  https://www.healthline.com/health/coronary-artery-disease

  Coronary artery disease diagnosis requires a review of your medical history, a physical examination, and other medical testing. […] These tests include: Electrocardiogram: This test monitors electrical signals that travel through your heart. It may help your doctor determine whether you’ve had a heart attack. […] Echocardiogram: This imaging test uses ultrasound waves to create a picture of your heart. The results of this test reveal whether certain things in your heart are functioning properly. […] Stress test: This particular test measures the stress on your heart during physical activity and while at rest. The test monitors your heart’s electrical activity while you walk on a treadmill or ride a stationary bike. Nuclear imaging or echocardiographic imaging may also be performed for a portion of this test. For those unable to perform physical exercise, certain medications can be used instead for stress testing.

• #21 Coronary Artery Disease: Causes, Symptoms, and Treatments

  https://www.healthline.com/health/coronary-artery-disease

  Coronary artery disease diagnosis requires a review of your medical history, a physical examination, and other medical testing. […] These tests include: Electrocardiogram: This test monitors electrical signals that travel through your heart. It may help your doctor determine whether you’ve had a heart attack. […] Echocardiogram: This imaging test uses ultrasound waves to create a picture of your heart. The results of this test reveal whether certain things in your heart are functioning properly. […] Stress test: This particular test measures the stress on your heart during physical activity and while at rest. The test monitors your heart’s electrical activity while you walk on a treadmill or ride a stationary bike. Nuclear imaging or echocardiographic imaging may also be performed for a portion of this test. For those unable to perform physical exercise, certain medications can be used instead for stress testing.

• #22 Diagnosing Coronary Artery Disease | NYU Langone Health

  https://nyulangone.org/conditions/coronary-artery-disease/diagnosis

  For people who are able to exercise, an exercise stress test helps your doctor determine whether your heart receives enough blood and oxygen during activity. […] If you are unable to complete the exercise stress test, your doctor may prescribe a pharmacologic stress test. […] In this test, which can be part of an exercise or pharmacologic stress test, a small amount of radioactive tracer is injected into a vein in the arm. […] In this ultrasound test, also known as an echocardiogram, sound waves are used to create images of the heart. It can reveal how well the heart is pumping blood. Your doctor can identify any areas where blood isn’t flowing properly.

• #23 Noninvasive Testing for Diagnosis of Stable Coronary Artery Disease in the Elderly

  https://www.mdpi.com/1422-0067/21/17/6263

  Prevalence of asymptomatic CAD can reach 40% among the elderly with no clinical history of the disease and 50% in patients with documented history of CAD. […] Among elderly patients, up to 50% present with resting ECG abnormalities, including nonspecific ST–T changes. […] High prevalence of arrhythmia and conduction defects as well as nonspecific ST–T changes hinder ECG exercise testing for stable CAD diagnostic. […] Elderly patients are less fit in terms of physical exercise due to age-related changes and deconditioning, as well as musculoskeletal system, peripheral artery, pulmonary and neurological diseases. […] The positive predictive value (PPV) in CAD diagnostics tends to be higher in elderly patients. […] A positive treadmill test result increased the likelihood of having CAD from 57% to 80%, while a negative result reduced it to 28%.

• #24 Coronary Artery Disease in Women – Ashchi Heart & Vascular Center

  https://drashchiheart.com/coronary-artery-disease-in-women/

  Women more often report atypical anginal symptoms or uncharacteristic chest pain accompanied by increased sweating, dyspnea, nausea, and vomiting, which, in most cases, does not lead to further non-invasive CAD diagnostics. […] Diabetes mellitus (DM) is another significant risk factor for CAD. Type 2 DM is associated with higher CAD risk in women than in men. […] Coronary artery disease statistics have shown that mortality due to myocardial infarction is substantially higher in women with type 2 DM than in men with type 2 DM and women without this condition. […] Non-invasive CAD diagnostics in women are less sensitive and specific than in men; this pertains to electrocardiographic stress testing. […] Women are more likely than men to exhibit non-specific changes in resting ECG, lower voltage of QRS complexes, high resting heart rate, which, combined with the smaller diameters of coronary vessels and lower fitness, reduces the specificity of stress testing.

• #25 Coronary Artery Disease (CAD): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease

  Coronary artery disease (CAD) is a narrowing or blockage of your coronary arteries, which supply oxygen-rich blood to your heart. […] Healthcare providers diagnose coronary artery disease through a physical exam and testing. […] Your provider may also recommend one or more tests to assess your heart function and diagnose CAD. These include: Blood tests, Cardiac catheterization, Computed tomography (CT) coronary angiogram, Heart MRI (magnetic resonance imaging), Coronary calcium scan, Echocardiogram (echo), Electrocardiogram (EKG/ECG), Exercise stress test, Chest X-ray. […] Coronary artery disease treatment often includes lifestyle changes, risk factor management and medications. Some people may also need a procedure or surgery. […] Your healthcare provider will talk with you about the best treatment plan for you. Its important to follow your treatment plan so you can lower your risk of serious complications from CAD.

• #26 Coronary Artery Disease | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/coronary-artery-disease

  Diagnosis of coronary artery disease is assessed by looking for atherosclerosis, which can be detected using various tests, including: […] Coronary angiography. This minimally invasive study is considered the gold standard for diagnosing CAD. […] Computed tomography (CT) scan. This can show calcium deposits and blockages that are narrowing the arteries. […] Echocardiogram (ECHO). Sometimes referred to as a heart ultrasound, this noninvasive test uses sound waves to create pictures of your heart. […] Electrocardiogram (ECG or EKG). An ECG records the heart’s electrical activity using small electrodes that are placed with patches on your chest, arms and legs. […] Exercise stress test. Also called a stress echocardiogram, this test shows how your heart performs when physically challenged. […] Nuclear stress test. Also known as a stress thallium test, this has two components, a treadmill stress test and a heart scan.

• #27 Diagnosing Heart Disease | Patient Education | UCSF Health

  https://www.ucsfhealth.org/education/diagnosing-heart-disease

  A CRP test can reveal inflammation in your body, but it cannot pinpoint the exact location or reason. Inflammation plays a central role in the process of atherosclerosis, in which fatty deposits clog your arteries. […] This test may be ordered if you have heart disease or are at high risk for developing it, or if you have a family history of heart disease but no other known risk factors. […] In addition to blood tests, your doctor may recommend several non-invasive tests to check for heart disease. […] An electrocardiogram (EKG or ECG) is a short, painless test that records the electrical activity of your heart. […] An echocardiogram (also called an echo) is an ultrasound of the heart. […] Exercise stress tests are used to see how your heart performs under physical stress. […] Nuclear stress tests have two components: an exercise (or chemical) stress test and a heart scan combined with an injection of a radioactive substance.

• #28 Noninvasive Testing for Diagnosis of Stable Coronary Artery Disease in the Elderly

  https://www.mdpi.com/1422-0067/21/17/6263

  Exercise stress echocardiography (SE) is the most attractive CAD diagnostic method in the elderly. […] According to US recommendations for the diagnosis and management of patients with stable CAD, exercise SE is indicated for patients with intermediate PTP that are capable of physical exercise and show ECG abnormalities that hinder interpretation during exercise. […] Few studies assessed the accuracy of exercise SE for detecting stable CAD in the elderly. […] A meta-analysis of studies including patients from all age groups reported s sensitivity of exercise SE of 79–85% and s specificity of 77–89%. […] According to the US recommendations, CTA is indicated for patients that are capable of physical exercise and have intermediate PTP. […] The authors revealed reduced efficacy of coronary CTA for the diagnosis of obstructive coronary atherosclerosis in patients aged >75 years compared to other age groups.

• #29 Appropriate use of non-invasive testing for diagnosis of stable coronary artery disease

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Appropriate-use-of-non-invasive-testing-for-diagnosis-of-stable-coronary-artery

  The sensitivity and specificity of stress echocardiography are 80-85% and 80-88%, respectively. […] The sensitivity and specificity of exercise stress SPECT are 73-92% and 63-87%, respectively. […] Although less well studied than SPECT, PET has better diagnostic accuracy for detection of CAD, including in women. […] The imaging endpoint of CMR for diagnosis of SCAD depends on the stress agent: CMR may detect either ischemia-induced wall motion abnormalities (dobutamine stress CMR) or myocardial perfusion (vasodilator stress CMR). […] Coronary CTA has a sensitivity of 95-99% and specificity of 64-83% for detection of obstructive CAD. […] Non-invasive testing to establish diagnosis of SCAD is appropriate for patient with an intermediate pre-test probability of disease.

• #30 Diagnosing Coronary Artery Disease | NYU Langone Health

  https://nyulangone.org/conditions/coronary-artery-disease/diagnosis

  For people who are able to exercise, an exercise stress test helps your doctor determine whether your heart receives enough blood and oxygen during activity. […] If you are unable to complete the exercise stress test, your doctor may prescribe a pharmacologic stress test. […] In this test, which can be part of an exercise or pharmacologic stress test, a small amount of radioactive tracer is injected into a vein in the arm. […] In this ultrasound test, also known as an echocardiogram, sound waves are used to create images of the heart. It can reveal how well the heart is pumping blood. Your doctor can identify any areas where blood isn’t flowing properly.

• #31 Evolving Diagnostic and Management Advances in Coronary Heart Disease

  https://www.mdpi.com/2075-1729/13/4/951

  CAD may be assessed via anatomical or functional methods. […] The key to anatomical methods is coronary angiography, which delineates coronary anatomy using contrast media and radiation. […] In addition to luminal evaluation, CCT offers insights into vascular structures beyond the degree of obstruction and allows the evaluation of the coronary artery calcium (CAC) score, an important prognostic tool with the capacity to reclassify patients during primary prevention. […] Coronary angiography is inaccurate for assessing the function of coronary lesions; often, stenosis that is deemed severe on angiographic assessment does not restrict coronary blood flow at rest or with maximal dilatation. […] The physiological assessment of CAD allows complementing the findings of the anatomical evaluation. […] Imaging methods, such as stress echocardiography, single-photon emission computed tomography (SPECT), cardiac magnetic resonance (CMR), or positron emission tomography (PET), have emerged as more accurate means of evaluating ischemia.

• #32 Coronary Heart Disease – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/coronary-heart-disease/diagnosis

  Your healthcare provider will diagnose coronary heart disease based on your symptoms, your medical and family history, your risk factors, and the results of heart tests. […] To help diagnose coronary heart disease, your provider may also order some of the following heart tests: […] An electrocardiogram (ECG) records the strength and timing of electrical signals as they pass through the heart and determines whether the heart’s rhythm is steady or irregular. […] A coronary calcium scan measures the amount of calcium in the walls of your coronary arteries. […] Stress tests check your heart while it is working hard and beating quickly. […] Cardiac magnetic resonance imaging (MRI) detects tissue damage or problems with blood flow in the heart or coronary arteries. […] A cardiac positron emission tomography (PET) scan assesses blood flow through the coronary blood vessels and into the heart muscle. […] Coronary CT angiography is an imaging test that looks at blood flow through the coronary arteries using a special X-ray machine that takes multiple pictures of the heart. […] Invasive coronary angiography uses contrast dye to detect blockages in the coronary arteries.

• #33 Appropriate use of non-invasive testing for diagnosis of stable coronary artery disease

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Appropriate-use-of-non-invasive-testing-for-diagnosis-of-stable-coronary-artery

  The sensitivity and specificity of stress echocardiography are 80-85% and 80-88%, respectively. […] The sensitivity and specificity of exercise stress SPECT are 73-92% and 63-87%, respectively. […] Although less well studied than SPECT, PET has better diagnostic accuracy for detection of CAD, including in women. […] The imaging endpoint of CMR for diagnosis of SCAD depends on the stress agent: CMR may detect either ischemia-induced wall motion abnormalities (dobutamine stress CMR) or myocardial perfusion (vasodilator stress CMR). […] Coronary CTA has a sensitivity of 95-99% and specificity of 64-83% for detection of obstructive CAD. […] Non-invasive testing to establish diagnosis of SCAD is appropriate for patient with an intermediate pre-test probability of disease.

• #34 Appropriate use of non-invasive testing for diagnosis of stable coronary artery disease

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Appropriate-use-of-non-invasive-testing-for-diagnosis-of-stable-coronary-artery

  The sensitivity and specificity of stress echocardiography are 80-85% and 80-88%, respectively. […] The sensitivity and specificity of exercise stress SPECT are 73-92% and 63-87%, respectively. […] Although less well studied than SPECT, PET has better diagnostic accuracy for detection of CAD, including in women. […] The imaging endpoint of CMR for diagnosis of SCAD depends on the stress agent: CMR may detect either ischemia-induced wall motion abnormalities (dobutamine stress CMR) or myocardial perfusion (vasodilator stress CMR). […] Coronary CTA has a sensitivity of 95-99% and specificity of 64-83% for detection of obstructive CAD. […] Non-invasive testing to establish diagnosis of SCAD is appropriate for patient with an intermediate pre-test probability of disease.

• #35 Coronary Heart Disease – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/coronary-heart-disease/diagnosis

  Your healthcare provider will diagnose coronary heart disease based on your symptoms, your medical and family history, your risk factors, and the results of heart tests. […] To help diagnose coronary heart disease, your provider may also order some of the following heart tests: […] An electrocardiogram (ECG) records the strength and timing of electrical signals as they pass through the heart and determines whether the heart’s rhythm is steady or irregular. […] A coronary calcium scan measures the amount of calcium in the walls of your coronary arteries. […] Stress tests check your heart while it is working hard and beating quickly. […] Cardiac magnetic resonance imaging (MRI) detects tissue damage or problems with blood flow in the heart or coronary arteries. […] A cardiac positron emission tomography (PET) scan assesses blood flow through the coronary blood vessels and into the heart muscle. […] Coronary CT angiography is an imaging test that looks at blood flow through the coronary arteries using a special X-ray machine that takes multiple pictures of the heart. […] Invasive coronary angiography uses contrast dye to detect blockages in the coronary arteries.

• #36 Coronary Artery Disease: Causes, Symptoms, and Treatments

  https://www.healthline.com/health/coronary-artery-disease

  Cardiac catheterization (left heart catheterization): During this procedure, your doctor injects a special dye into your coronary arteries through a catheter inserted through an artery in your groin or wrist. The dye helps enhance the radiographic image of your coronary arteries to identify any blockages. […] Heart CT scan: Your doctor may use this imaging test to check for calcium deposits in your arteries.

• #37 Coronary Heart Disease – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/coronary-heart-disease/diagnosis

  Your healthcare provider will diagnose coronary heart disease based on your symptoms, your medical and family history, your risk factors, and the results of heart tests. […] To help diagnose coronary heart disease, your provider may also order some of the following heart tests: […] An electrocardiogram (ECG) records the strength and timing of electrical signals as they pass through the heart and determines whether the heart’s rhythm is steady or irregular. […] A coronary calcium scan measures the amount of calcium in the walls of your coronary arteries. […] Stress tests check your heart while it is working hard and beating quickly. […] Cardiac magnetic resonance imaging (MRI) detects tissue damage or problems with blood flow in the heart or coronary arteries. […] A cardiac positron emission tomography (PET) scan assesses blood flow through the coronary blood vessels and into the heart muscle. […] Coronary CT angiography is an imaging test that looks at blood flow through the coronary arteries using a special X-ray machine that takes multiple pictures of the heart. […] Invasive coronary angiography uses contrast dye to detect blockages in the coronary arteries.

• #38 Diagnosing Coronary Artery Disease | NYU Langone Health

  https://nyulangone.org/conditions/coronary-artery-disease/diagnosis

  An electrocardiogram, or EKG, records electrical signals from your heart. It can show whether you have had or are having a heart attack. […] Also called cardiac calcium scoring, this type of CT scan enables a doctor to check the walls of the arteries for calcium buildup, a sign of coronary artery disease. […] A CT coronary angiogram can reveal plaque buildup and identify blockages in the arteries, which can lead to a heart attack. […] Cardiac catheterization, also known as a cardiac cath or an angiogram, uses X-rays taken in real time to create images of the coronary arteries. […] Your doctor may order a stress test to check the function of your heart and arteries. […] An abnormal result can indicate a reduction in blood flow to the heart during exertion called ischemia that’s typically caused by a blockage in the heart arteries.

• #39 Appropriate use of non-invasive testing for diagnosis of stable coronary artery disease

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Appropriate-use-of-non-invasive-testing-for-diagnosis-of-stable-coronary-artery

  The sensitivity and specificity of stress echocardiography are 80-85% and 80-88%, respectively. […] The sensitivity and specificity of exercise stress SPECT are 73-92% and 63-87%, respectively. […] Although less well studied than SPECT, PET has better diagnostic accuracy for detection of CAD, including in women. […] The imaging endpoint of CMR for diagnosis of SCAD depends on the stress agent: CMR may detect either ischemia-induced wall motion abnormalities (dobutamine stress CMR) or myocardial perfusion (vasodilator stress CMR). […] Coronary CTA has a sensitivity of 95-99% and specificity of 64-83% for detection of obstructive CAD. […] Non-invasive testing to establish diagnosis of SCAD is appropriate for patient with an intermediate pre-test probability of disease.

• #40 Noninvasive Testing for Diagnosis of Stable Coronary Artery Disease in the Elderly

  https://www.mdpi.com/1422-0067/21/17/6263

  There are no currently published studies showing that coronary CTA is more or less suitable than exercise SE for CAD diagnosis in the elderly. […] In such situations, a decision is made regarding whether to use coronary CTA to assess the necessity of invasive CAG or to use invasive CAG immediately. […] Coronary CTA in elderly patients is often hindered by a pronounced calcification of coronary arteries.

• #41 Evolving Diagnostic and Management Advances in Coronary Heart Disease

  https://www.mdpi.com/2075-1729/13/4/951

  Computed tomography angiography (CCTA) is a noninvasive method that has been increasingly used in patients with chest pain, providing acceptable anatomical, but limited functional, evaluation. […] CCTA-based FFR (CCTA-FFR) has emerged as an alternative to merge anatomical and functional evaluation through a noninvasive test. […] In conclusion, CCTA-FFR apparently has a high accuracy when FFR is used as the gold standard, adding discriminative power to CT alone and reducing false-positive findings by associating a functional evaluation with this anatomical method.

• #42 A safer way to diagnose coronary artery disease? – Harvard Health

  https://www.health.harvard.edu/heart-health/a-safer-way-to-diagnose-coronary-artery-disease

  A safer way to diagnose coronary artery disease? Cardiac CT angiography a noninvasive test to check for clogged heart arteries is now considered a first-line option for people with suspected heart disease. Angiography, a technique that allows doctors to „see” the heart’s arteries, can be done two ways. The first, called invasive coronary angiography (ICA), has been used for more than half a century. The second, cardiac CT angiography (CCTA), was developed nearly 25 years ago. In the United States, CCTA isn’t as widely used as it is in many European countries, which have led the way in adopting this newer test. Last year, expert guidelines from the American Heart Association and American College of Cardiology recommended CCTA as a first test for certain people without known coronary artery disease who have stable angina. „CCTA is helpful for assessing people with chest pain who have an intermediate risk of coronary artery disease, meaning their chance of having or not having the disease is roughly equal,” says cardiologist Dr. Joseph Loscalzo. A recent study suggests that CCTA is less risky but just as effective as ICA. CCTA is a promising alternative, but it’s not perfect. Just as technologies to diagnose heart disease have evolved, so has the typical heart attack. „What we really need is a test that can tell whether you have one of these so-called vulnerable plaques. That’s been the holy grail in cardiology for many years,” says Dr. Loscalzo. In the meantime, if you have stable angina and your doctor recommends ICA, ask if CCTA might be an alternative.

• #43 Coronary Heart Disease – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/coronary-heart-disease/diagnosis

  Your healthcare provider will diagnose coronary heart disease based on your symptoms, your medical and family history, your risk factors, and the results of heart tests. […] To help diagnose coronary heart disease, your provider may also order some of the following heart tests: […] An electrocardiogram (ECG) records the strength and timing of electrical signals as they pass through the heart and determines whether the heart’s rhythm is steady or irregular. […] A coronary calcium scan measures the amount of calcium in the walls of your coronary arteries. […] Stress tests check your heart while it is working hard and beating quickly. […] Cardiac magnetic resonance imaging (MRI) detects tissue damage or problems with blood flow in the heart or coronary arteries. […] A cardiac positron emission tomography (PET) scan assesses blood flow through the coronary blood vessels and into the heart muscle. […] Coronary CT angiography is an imaging test that looks at blood flow through the coronary arteries using a special X-ray machine that takes multiple pictures of the heart. […] Invasive coronary angiography uses contrast dye to detect blockages in the coronary arteries.

• #44 Heart disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/heart-disease/diagnosis-treatment/drc-20353124

  To diagnose heart disease, a healthcare professional examines you and listens to your heart. You are usually asked questions about your symptoms and your personal and family medical history. […] Many different tests are used to diagnose heart disease. […] Blood tests can be done to check for these proteins. A high-sensitivity C-reactive protein (CRP) test checks for a protein linked to inflammation of the arteries. Other blood tests may be done to check cholesterol and blood sugar levels. […] A Holter monitor is a portable ECG device that’s worn for a day or more to record the heart’s activity during daily activities. This test can detect irregular heartbeats that aren’t found during a regular ECG exam. […] An echocardiogram can help determine if a valve is narrowed or leaking. […] Exercise tests help reveal how the heart responds to physical activity and whether heart disease symptoms occur during exercise. […] This test can show blockages in the heart arteries. […] A cardiac MRI uses a magnetic field and computer-generated radio waves to create detailed images of the heart.

• #45 Coronary Artery Disease Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/349040-overview

  For chronic stable CAD, the treatment objective is a combination of symptomatic and prognostic improvement. Cardiovascular magnetic resonance (CMR) has emerged as a highly accurate technique for diagnosis and risk stratification in stable CAD and has been incorporated into national and international guidelines. […] MRI has proved capable of imaging the coronary arteries and revealing stenoses without catheterization or injection of contrast material. […] Advances in MRI and CT have markedly improved the speed and resolution of imaging, making these modalities useful in the clinical evaluation of CAD, while improving their safety and convenience. […] Although neither MRI nor CT has replaced coronary angiography (XRA) as the clinical standard for diagnosis of coronary stenosis, their use in determining whether a vessel is open is increasing.

• #46 Appropriate use of non-invasive testing for diagnosis of stable coronary artery disease

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Appropriate-use-of-non-invasive-testing-for-diagnosis-of-stable-coronary-artery

  Non-invasive testing can detect myocardial ischemia and also offers visualisation of the coronary anatomy. […] Initial diagnostic assessment of individuals with suspected SCAD has clinical evaluation as cornerstone. […] Sensitivity – the true positive rate – of most modalities is around or below 85% and specificity – the true negative rate – is approximately or below 85%, thus a key message is that specific non-invasive testing to establish diagnosis of SCAD is only recommended for patients with intermediate clinical likelihood of SCAD (15-85%), but not for individuals with higher PTP 85% or lower PTP 15%. […] Non-invasive modalities for diagnosis of SCAD are either functional tests – non-imaging stress tests or stress tests combined with imaging – that detect inducible myocardial ischemia, or modalities that visualise coronary anatomy.

• #47 Coronary Artery Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564304/

  Cardiac catheterization is the gold standard and most accurate modality for evaluating ischemic coronary heart disease. Coronary angiography is used to assess the type and number of affected vessels and the severity of stenosis, which are essential in determining the appropriate approach for coronary intervention. However, this invasive procedure has potentially serious complications, and not everyone is a candidate for it. […] CAD could present either as SIHD or ACS. The management depends on the particular disease type, as discussed below. […] ACS presents as sudden-onset substernal chest pain or pressure, typically radiating to the neck and left arm, and may be accompanied by dyspnea, palpitations, dizziness, syncope, cardiac arrest, or new-onset congestive heart failure. Prompt ECG testing is necessary for all patients with ACS to assess for STEMI. […] Regular visits with cardiologists and family physicians are critical to the long-term management of CAD. Medication adherence and lifestyle modification are also essential.

• #48 Evolving Diagnostic and Management Advances in Coronary Heart Disease

  https://www.mdpi.com/2075-1729/13/4/951

  CAD may be assessed via anatomical or functional methods. […] The key to anatomical methods is coronary angiography, which delineates coronary anatomy using contrast media and radiation. […] In addition to luminal evaluation, CCT offers insights into vascular structures beyond the degree of obstruction and allows the evaluation of the coronary artery calcium (CAC) score, an important prognostic tool with the capacity to reclassify patients during primary prevention. […] Coronary angiography is inaccurate for assessing the function of coronary lesions; often, stenosis that is deemed severe on angiographic assessment does not restrict coronary blood flow at rest or with maximal dilatation. […] The physiological assessment of CAD allows complementing the findings of the anatomical evaluation. […] Imaging methods, such as stress echocardiography, single-photon emission computed tomography (SPECT), cardiac magnetic resonance (CMR), or positron emission tomography (PET), have emerged as more accurate means of evaluating ischemia.

• #49 Coronary Artery Disease Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/349040-overview

  Although invasive coronary angiography has been the gold standard in establishing the diagnosis of CAD, there is a growing shift to more appropriately use the cardiac catheterization laboratory to perform interventional procedures once a diagnosis of CAD has been established by noninvasive imaging modalities, rather than using it primarily as a diagnostic facility to confirm or refute CAD. […] Newer technologies such as CT fractional flow reserve, CT angiography with perfusion, and whole-heart coronary magnetic resonance angiography with perfusion, which can provide both anatomic and functional information in the same test, obviate the need for multiple diagnostic tests to obtain a comprehensive assessment of both plaque burden and downstream ischemia.

• #50 Coronary Artery Disease (CAD) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/coronary-artery-disease

  Coronary stent: This is also called a percutaneous coronary intervention. A catheter is sent to the site of the blockage to open up the artery to restore blood flow. […] Heart surgery: A coronary artery bypass graft can reroute blood flow around a blocked artery. […] Each of these treatments has advantages and disadvantages for patients. Surgery is generally reserved for patients who do not improve with the help of medication or stents or who can’t be effectively treated with those less-invasive methods. […] What surgical procedures does Yale Medicine offer for the treatment of coronary artery disease? […] Yale Medicine offers the full array of modern surgical treatments for all types of coronary artery disease. These include: […] Heart transplants […] Implantation of artificial hearts (called left ventricular assist devices, or LVAD) […] Mitral valve replacement and repair, for diseased heart valves […] Transcatheter Aortic Valve Replacement (called TAVR), an innovative treatment for patients with heart disease who are not strong enough for other types of heart surgery.

• #51 Coronary artery disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/coronary-artery-disease?lang=us

  Coronary artery disease (CAD) is primarily due to the narrowing of the coronary arteries due to atherosclerosis, which results in myocardial ischemia and is the leading cause of mortality globally. […] The diagnosis of coronary artery disease is based on typical imaging criteria either by cardiac CT or invasive coronary angiography. […] There are a variety of techniques to image coronary artery disease including both anatomical and functional modalities. Coronary angiography has been the mainstay for many years, but in certain patient groups, it is being replaced by non-invasive imaging such as coronary CT angiography (cCTA). […] Haemodynamically significant stenoses are those 70% for all coronary arteries, except the left main coronary artery where 50% stenosis is considered significant. […] The proposed SCCT grading scale for stenosis severity assesses the degree of luminal diameter stenosis.

• #52 Diagnosis of patients with angina and non-obstructive coronary disease in the catheter laboratory | Heart

  https://heart.bmj.com/content/105/20/1536

  Around 40% of all patients undergoing angiography are found to have normal coronary arteries or non-obstructive coronary artery disease (NOCAD). […] Despite the high prevalence, this is a group who rarely receive a definitive diagnosis, are frequently labelled and managed inappropriately and by and large, continue to remain symptomatic. […] Half of this group will have coronary microvascular dysfunction (CMD), associated with a higher rate of major adverse cardiovascular events; identifying CMD represents a therapeutic target of unmet need. […] The standard of care for investigating stable angina in patients with an intermediate-high likelihood of coronary artery disease (CAD) is the coronary angiogram. […] In a registry of nearly 400000 patients undergoing invasive coronary angiography, approximately 40% had Non-Obstructive Coronary Artery Disease, a diagnosis often referred to as NOCAD.

• #53 Coronary Microvascular Disease | American Heart Association

  https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/coronary-microvascular-disease-mvd

  Your health care professional can diagnose coronary MVD based on your medical history, a physical exam and test results. […] PET scans and other types of imaging can help diagnose coronary MVD. They measure blood flow through the coronary arteries and can find coronary MVD in tiny blood vessels. Cardiac catheterization and cardiac MRI with perfusion can also be used. […] Standard tests for heart disease may not detect coronary MVD. If you have angina but tests show your coronary arteries are normal, you could still have coronary MVD. Additional testing can confirm the diagnosis.

• #54 Diagnosis of patients with angina and non-obstructive coronary disease in the catheter laboratory | Heart

  https://heart.bmj.com/content/105/20/1536

  The presence of non-obstructive atherosclerotic disease heralds a poorer prognosis among NOCAD and should be managed with secondary preventative therapy. […] In the absence of physiologically flow-limiting epicardial disease, reduced coronary flow reserve (CFR) indicates the presence of CMD. […] Endothelial dysfunction precedes atherosclerosis and often coexists with abnormalities in microvascular smooth muscle dysfunction. […] The reference method for provocative spasm testing involves intracoronary administration of a provocative stimulus during invasive coronary angiography with the monitoring of patient symptoms, ECG and angiographic documentation of coronary artery spasm. […] The wider adoption of anatomical imaging with CT coronary angiography (CTCA) as a first-line diagnostic test for the assessment of stable chest pain may increase the diagnosis of NOCAD.

• #55 Evolving Diagnostic and Management Advances in Coronary Heart Disease

  https://www.mdpi.com/2075-1729/13/4/951

  Evolving Diagnostic and Management Advances in Coronary Heart Disease […] Despite considerable improvement in diagnostic modalities and therapeutic options over the last few decades, the global burden of ischemic heart disease is steadily rising, remaining a major cause of death worldwide. […] In this article, we summarize the literature on recent advances regarding therapeutic strategies and diagnostic methods for CAD. […] Coronary artery disease (CAD) is the most common type of heart disease, killing approximately 380,000 people in 2020. […] Recently, new technologies have promoted substantial progress in the diagnosis and treatment of CAD. These technologies include the physiological assessment of CAD, which complements the findings of the anatomical evaluation; cardiac biomarkers; and microRNAs, which help in the detection of CAD.

• #56 Technique Improves Coronary Artery Disease Diagnosis

  https://newsroom.uvahealth.com/2024/11/19/technique-improves-coronary-artery-disease-diagnosis/

  Coronary artery disease is the most common form of heart disease, affecting 70% or more of people over 60. […] A new technology which allows doctors to quantify blood flow in the heart can improve their ability to diagnose potentially deadly coronary artery disease (CAD), an international study led by School of Medicine investigators has found. […] The technique represents an advance in cardiac magnetic resonance imaging (CMR) used in conjunction with stress testing to diagnose coronary artery disease, a condition which affects 70% or more of people over 60. […] CMR stress testing is a useful way to spot coronary artery disease, but the new research from Patel and colleagues suggests that quantitative CMR with blood-flow data is even better. […] The researchers found that adding data on blood flow significantly improved CMRs ability to identify obstructive coronary artery disease.

• #57 Evolving Diagnostic and Management Advances in Coronary Heart Disease

  https://www.mdpi.com/2075-1729/13/4/951

  Finally, biomarkers have been investigated to aid with CAD detection. […] Additionally, perivascular fat attenuation has recently been studied and associated with local immune-inflammatory response activation, which is closely related to plaque vulnerability. […] Intravascular ultrasonography (IVUS) has played an important role in recent interventional evolution. […] IVUS technology is based on the acquisition of intravascular images with the aid of a transducer in the tip of a catheter during interventional coronary angiogram (ICA), generating cross-sectional images of the arteries. […] Fractional flow reserve (FFR) is an invasive index of the functional severity of stenosis determined from coronary pressure measurement during cardiac catheterization. […] The pressure distal to the lesion is then compared with a normal reference, such as the aortic root pressure.

• #58 Technique Improves Coronary Artery Disease Diagnosis

  https://newsroom.uvahealth.com/2024/11/19/technique-improves-coronary-artery-disease-diagnosis/

  The enhanced CMR proved more effective at detecting obstructive CAD than both traditional CMR and human physicians reading scans. […] Although this study focused on improving the diagnosis of obstructive coronary artery disease, future studies will be needed to determine how the blood flow measurements will be beneficial for patients with other heart conditions such as heart failure.

• #59 Appropriate use of non-invasive testing for diagnosis of stable coronary artery disease

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Appropriate-use-of-non-invasive-testing-for-diagnosis-of-stable-coronary-artery

  Non-invasive testing can detect myocardial ischemia and also offers visualisation of the coronary anatomy. […] Initial diagnostic assessment of individuals with suspected SCAD has clinical evaluation as cornerstone. […] Sensitivity – the true positive rate – of most modalities is around or below 85% and specificity – the true negative rate – is approximately or below 85%, thus a key message is that specific non-invasive testing to establish diagnosis of SCAD is only recommended for patients with intermediate clinical likelihood of SCAD (15-85%), but not for individuals with higher PTP 85% or lower PTP 15%. […] Non-invasive modalities for diagnosis of SCAD are either functional tests – non-imaging stress tests or stress tests combined with imaging – that detect inducible myocardial ischemia, or modalities that visualise coronary anatomy.

• #60 The Diagnosis of Chronic Coronary Heart Disease (20.10.2017)

  https://swww.aerzteblatt.de/archiv/194090/The-Diagnosis-of-Chronic-Coronary-Heart-Disease

  Chronic coronary heart disease (CHD) and acute myocardial infarction are endemic conditions. In Germany, an estimated 900 000 cardiac catheterizations were performed in the year 2014, and a percutaneous intervention was carried out in 40% of these procedures. It would be desirable to lessen the number of invasive diagnostic procedures while preserving the reliability of diagnosis. In this article, we present the updated recommendations of the German National Care Guideline for Chronic CHD with regard to diagnostic evaluation. […] Updated recommendations for the diagnostic evaluation of chronic CHD were developed on the basis of existing guidelines and a systematic literature review and approved by a formal consensus process. […] General practitioners should estimate the probability of CHD with the Marburg Heart Score. Specialists can use detailed tables for determining the pre-test probability of CHD; if this lies in the range of 15% to 85%, then non-invasive tests should be primarily used for evaluation and treatment planning. If the pre-test probability is less than 15%, other potential causes should be ruled out first. If it is over 85%, the presence of CHD should be presumed and treatment planning should be initiated.

• #61 The Diagnosis of Chronic Coronary Heart Disease (20.10.2017)

  https://swww.aerzteblatt.de/archiv/194090/The-Diagnosis-of-Chronic-Coronary-Heart-Disease

  Chronic coronary heart disease (CHD) and acute myocardial infarction are endemic conditions. In Germany, an estimated 900 000 cardiac catheterizations were performed in the year 2014, and a percutaneous intervention was carried out in 40% of these procedures. It would be desirable to lessen the number of invasive diagnostic procedures while preserving the reliability of diagnosis. In this article, we present the updated recommendations of the German National Care Guideline for Chronic CHD with regard to diagnostic evaluation. […] Updated recommendations for the diagnostic evaluation of chronic CHD were developed on the basis of existing guidelines and a systematic literature review and approved by a formal consensus process. […] General practitioners should estimate the probability of CHD with the Marburg Heart Score. Specialists can use detailed tables for determining the pre-test probability of CHD; if this lies in the range of 15% to 85%, then non-invasive tests should be primarily used for evaluation and treatment planning. If the pre-test probability is less than 15%, other potential causes should be ruled out first. If it is over 85%, the presence of CHD should be presumed and treatment planning should be initiated.

• #62 Appropriate use of non-invasive testing for diagnosis of stable coronary artery disease

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Appropriate-use-of-non-invasive-testing-for-diagnosis-of-stable-coronary-artery

  Non-invasive testing can detect myocardial ischemia and also offers visualisation of the coronary anatomy. […] Initial diagnostic assessment of individuals with suspected SCAD has clinical evaluation as cornerstone. […] Sensitivity – the true positive rate – of most modalities is around or below 85% and specificity – the true negative rate – is approximately or below 85%, thus a key message is that specific non-invasive testing to establish diagnosis of SCAD is only recommended for patients with intermediate clinical likelihood of SCAD (15-85%), but not for individuals with higher PTP 85% or lower PTP 15%. […] Non-invasive modalities for diagnosis of SCAD are either functional tests – non-imaging stress tests or stress tests combined with imaging – that detect inducible myocardial ischemia, or modalities that visualise coronary anatomy.

• #63 The Diagnosis of Chronic Coronary Heart Disease (20.10.2017)

  https://swww.aerzteblatt.de/archiv/194090/The-Diagnosis-of-Chronic-Coronary-Heart-Disease

  Chronic coronary heart disease (CHD) and acute myocardial infarction are endemic conditions. In Germany, an estimated 900 000 cardiac catheterizations were performed in the year 2014, and a percutaneous intervention was carried out in 40% of these procedures. It would be desirable to lessen the number of invasive diagnostic procedures while preserving the reliability of diagnosis. In this article, we present the updated recommendations of the German National Care Guideline for Chronic CHD with regard to diagnostic evaluation. […] Updated recommendations for the diagnostic evaluation of chronic CHD were developed on the basis of existing guidelines and a systematic literature review and approved by a formal consensus process. […] General practitioners should estimate the probability of CHD with the Marburg Heart Score. Specialists can use detailed tables for determining the pre-test probability of CHD; if this lies in the range of 15% to 85%, then non-invasive tests should be primarily used for evaluation and treatment planning. If the pre-test probability is less than 15%, other potential causes should be ruled out first. If it is over 85%, the presence of CHD should be presumed and treatment planning should be initiated.

• #64 Appropriate use of non-invasive testing for diagnosis of stable coronary artery disease

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Appropriate-use-of-non-invasive-testing-for-diagnosis-of-stable-coronary-artery

  The sensitivity and specificity of stress echocardiography are 80-85% and 80-88%, respectively. […] The sensitivity and specificity of exercise stress SPECT are 73-92% and 63-87%, respectively. […] Although less well studied than SPECT, PET has better diagnostic accuracy for detection of CAD, including in women. […] The imaging endpoint of CMR for diagnosis of SCAD depends on the stress agent: CMR may detect either ischemia-induced wall motion abnormalities (dobutamine stress CMR) or myocardial perfusion (vasodilator stress CMR). […] Coronary CTA has a sensitivity of 95-99% and specificity of 64-83% for detection of obstructive CAD. […] Non-invasive testing to establish diagnosis of SCAD is appropriate for patient with an intermediate pre-test probability of disease.

• #65 Evolving Diagnostic and Management Advances in Coronary Heart Disease

  https://www.mdpi.com/2075-1729/13/4/951

  CAD may be assessed via anatomical or functional methods. […] The key to anatomical methods is coronary angiography, which delineates coronary anatomy using contrast media and radiation. […] In addition to luminal evaluation, CCT offers insights into vascular structures beyond the degree of obstruction and allows the evaluation of the coronary artery calcium (CAC) score, an important prognostic tool with the capacity to reclassify patients during primary prevention. […] Coronary angiography is inaccurate for assessing the function of coronary lesions; often, stenosis that is deemed severe on angiographic assessment does not restrict coronary blood flow at rest or with maximal dilatation. […] The physiological assessment of CAD allows complementing the findings of the anatomical evaluation. […] Imaging methods, such as stress echocardiography, single-photon emission computed tomography (SPECT), cardiac magnetic resonance (CMR), or positron emission tomography (PET), have emerged as more accurate means of evaluating ischemia.

• #66 Coronary Artery Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564304/

  Coronary artery disease (CAD) is a prevalent heart condition characterized by the buildup of atherosclerotic plaque within the arterial lumen. Blood flow impairment reduces oxygen delivery to the myocardium. CAD is the most common cause of major morbidity and mortality in the US and worldwide. Prompt diagnosis and treatment improve outcomes. […] The evaluation of CAD typically involves a combination of clinical assessment and diagnostic tests such as electrocardiography, stress testing, and echocardiography. Coronary angiography helps assess the extent of coronary blockages. […] Several modalities are highly useful in evaluating CAD, including ECG, echocardiography, chest radiography, stress testing, cardiac catheterization, and serum markers. Patient presentation dictates how these tests are utilized. Below are details on different diagnostic modalities available for the evaluation of CAD.

• #67 Coronary Artery Disease Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/349040-overview

  Although invasive coronary angiography has been the gold standard in establishing the diagnosis of CAD, there is a growing shift to more appropriately use the cardiac catheterization laboratory to perform interventional procedures once a diagnosis of CAD has been established by noninvasive imaging modalities, rather than using it primarily as a diagnostic facility to confirm or refute CAD. […] Newer technologies such as CT fractional flow reserve, CT angiography with perfusion, and whole-heart coronary magnetic resonance angiography with perfusion, which can provide both anatomic and functional information in the same test, obviate the need for multiple diagnostic tests to obtain a comprehensive assessment of both plaque burden and downstream ischemia.

• #68 A safer way to diagnose coronary artery disease? – Harvard Health

  https://www.health.harvard.edu/heart-health/a-safer-way-to-diagnose-coronary-artery-disease

  A safer way to diagnose coronary artery disease? Cardiac CT angiography a noninvasive test to check for clogged heart arteries is now considered a first-line option for people with suspected heart disease. Angiography, a technique that allows doctors to „see” the heart’s arteries, can be done two ways. The first, called invasive coronary angiography (ICA), has been used for more than half a century. The second, cardiac CT angiography (CCTA), was developed nearly 25 years ago. In the United States, CCTA isn’t as widely used as it is in many European countries, which have led the way in adopting this newer test. Last year, expert guidelines from the American Heart Association and American College of Cardiology recommended CCTA as a first test for certain people without known coronary artery disease who have stable angina. „CCTA is helpful for assessing people with chest pain who have an intermediate risk of coronary artery disease, meaning their chance of having or not having the disease is roughly equal,” says cardiologist Dr. Joseph Loscalzo. A recent study suggests that CCTA is less risky but just as effective as ICA. CCTA is a promising alternative, but it’s not perfect. Just as technologies to diagnose heart disease have evolved, so has the typical heart attack. „What we really need is a test that can tell whether you have one of these so-called vulnerable plaques. That’s been the holy grail in cardiology for many years,” says Dr. Loscalzo. In the meantime, if you have stable angina and your doctor recommends ICA, ask if CCTA might be an alternative.

• #69 Diagnosis of patients with angina and non-obstructive coronary disease in the catheter laboratory | Heart

  https://heart.bmj.com/content/105/20/1536

  NOCAD is associated with worse healthcare outcomes and higher economical costs than previously appreciated. […] Traditional atherosclerotic risk factors and typicality of angina are poor predictors of CMD, necessitating objective tests to establish a clinical diagnosis; however, tests of coronary microvascular function are rarely used in clinical practice. […] The ability to physiologically characterise CAD at the time of angiography by pressure-wire assessment has revolutionised the interventional cardiology field. […] Advances in guidewire technology now also enable the immediate assessment of the coronary microcirculation to provide clarity into the NOCAD diagnosis. […] CMD can be identified during a single cardiac catheterisation procedure, overcoming issues of specificity and sensitivity associated with non-invasive ischaemia tests.

• #70 Coronary Artery Disease in Women – Ashchi Heart & Vascular Center

  https://drashchiheart.com/coronary-artery-disease-in-women/

  Coronary angiography remains the gold standard to diagnose CAD. […] Women are also less likely to undergo coronary angiography and coronary revascularization. […] More than 50% of women undergoing coronary angiography receive the diagnosis of insignificant changes in the coronary vessels or clear coronary vessels. […] Women undergoing percutaneous or surgical coronary revascularization are more likely to suffer from ischemic stroke or hemorrhagic complications. […] The in-hospital mortality rate after CABG is higher among women. […] Therefore the challenge remains in diagnosing and treating coronary artery disease in women.

• #71 Coronary Artery Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564304/

  Coronary artery disease (CAD) is a prevalent heart condition characterized by the buildup of atherosclerotic plaque within the arterial lumen. Blood flow impairment reduces oxygen delivery to the myocardium. CAD is the most common cause of major morbidity and mortality in the US and worldwide. Prompt diagnosis and treatment improve outcomes. […] The evaluation of CAD typically involves a combination of clinical assessment and diagnostic tests such as electrocardiography, stress testing, and echocardiography. Coronary angiography helps assess the extent of coronary blockages. […] Several modalities are highly useful in evaluating CAD, including ECG, echocardiography, chest radiography, stress testing, cardiac catheterization, and serum markers. Patient presentation dictates how these tests are utilized. Below are details on different diagnostic modalities available for the evaluation of CAD.

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