Diagnosis of ischemia

For diagnosing ischaemic heart disease the doctors perform a series of tests depending whether the disease is with angina (symptomatic) or without-silent ischemia.

Angina attacks associated with risk factors for heart disease influence the doctor to diagnose a blockage in the coronary arteries very quickly. On the contradiction, the diagnosis of silent ischemia is more difficult to establish. For people with silent ischemia who do not show any obvious symptoms, if they are men with age over 40 years or women over 50, or if they have jobs related to public safety it is recommended they should start an adequate exercise program.

The following tests are done by specialists in order to establish the diagnosis of ischemia:

~ echocardiogram is a test that measures the hearts response to physical exertion.

~ exercise stress is a test used to detect silent ischemia.

~ pharmacological stress test is performed on patients unable to do physical activity. The patient is given a medicine called dobutamine or adenosine which make the heart to react as if the patient were doing exercise.

~ electrocardiogram (EKG) is a test that records the electrical activity of the heart as a series of lines on a moving shit of paper. This test is quick, painless, safe and cheap. The bad part is that EKG detects ischemia only if cardiac ischemia manifests while the test is being performed.

~ the tests bellow can be combined with a nuclear stress test that produces clear images of the heart that show a contrast between dark and light spots. This contrast show wheather exist scarring or reductions of thje blood flow during or after exertion.

~ holter monitor is a test that entails a continuous EKG attached to a moving patient the entire day. The test can detect arrhythmias (abnormal heartbeats), an episode of cardiac ischemia. The tests results are recorded by the monitor in order to be verified by a specialist. ~ computed tomography arteriography is a new technique that generates pictures of the carotid arteries using a scanner.

~ angiogram is a test that provides images of the coronary arteries (coronary angiogram) or of the brain arteries (cerebral angiogram).

~ ICD-implantable cardioverter defibrillator is a device placed in the chest compound of a generator and leads that help the defributor to send electrical signals in order to correct the heart rhythm. The patients with an implantable defribillator should not walk near metal detectors or devices that emit strong magnetic fields.