August 01, 2019

Diagnosing heart trouble

The right test for you

A diagnosis of heart attack or similar heart problems might seem obvious. However, you might not know you're having heart trouble, or symptoms that seem like heart trouble might be something else. Suspected or discovered heart disease sets in motion a process of testing to clearly diagnose the problem and identify it's scope.

Coronary artery disease

On television and in the movies, the process of diagnosing a heart attack is typically a fast-tempo process that takes place in the emergency department. This certainly can occur, but diagnosing the most common cause of a heart attack — coronary artery disease — can also occur in urgent but non-life-threatening settings, or even in a relaxed clinic environment when you don't think that your symptoms are due to your heart.

The history

As the name suggests, coronary artery disease occurs in the arteries that supply the heart with blood. It's a process in which the inner layers of arteries are damaged, and over time deposits (plaques) made of fats, cholesterol, calcium and other substances tend to accumulate at specific sites in the coronary arteries. This process is called atherosclerosis. It narrows heart arteries and reduces — or sometimes eventually blocks — blood flow to heart muscle. In addition, plaques can tear and rupture, triggering blood clot development that can suddenly block blood flow.

If blood flow to part of the heart is reduced sufficiently, you may notice symptoms when you exert yourself, after eating or when you are under emotional stress. These symptoms generally stop with rest — such as stopping an activity — or with relaxation. This is called angina (an-JIE-nuh or AN-juh-nuh), and it can be a warning sign of coronary artery disease with symptoms and possibly a warning sign of a total or neartotal artery blockage and heart attack. It is very...