Heart disease may develop silently, without apparent symptoms, until a severe health event such as a heart attack or cardiac arrest arises. Regular checkups are important for your healthcare provider to assess your risk factors and suggest healthy lifestyle changes to prevent heart disease.

While routine screenings may begin around 20 years of age, it is advisable to consult with a healthcare provider to determine the most suitable course of action based on your individual risk factors and medical history. Children with factors like obesity, low levels of physical activity, or a family history of heart problems can also find screening beneficial.

Common symptoms of coronary heart disease include chest discomfort and occasional difficulty breathing, particularly during physical activity. Many individuals with this condition may not show any noticeable signs, which can lead to a lack of awareness regarding their heart issue. Consequently, they might unintentionally overlook taking prescribed medications that can help prevent heart attacks, strokes, or even death. For those without apparent symptoms, undergoing testing for coronary heart disease offers valuable insights.

How Do You Test For Coronary Heart Disease?

Coronary heart disease occurs when plaque (a mixture of cholesterol, calcium, and other substances) builds up in the coronary arteries, which are responsible for supplying blood to the heart.

Diagnosing coronary heart disease (CHD) as the cause of chest discomfort or similar anginal symptoms typically begins with a thorough clinical history and a resting electrocardiogram (ECG). Other non-invasive tests like stress tests or echocardiograms might also be used initially depending on the patient's situation. While invasive coronary angiography remains the gold standard for diagnosing significant blockages in major coronary arteries, its invasive nature and limitations in assessing smaller blood vessels make it less suitable as a routine initial test. Doctors may consider angiography for high-risk patients, situations requiring immediate intervention alongside diagnosis, or when non-invasive tests are inconclusive.

Doctor's Diagnosis: The First Step

If you experience symptoms or have a family history of coronary heart disease (CHD), your healthcare provider may recommend certain blood tests. These tests evaluate various factors that can contribute to CHD risk. Doctors may measure cholesterol levels, including LDL ("bad") and HDL ("good") cholesterol, triglycerides, different types of lipoproteins, blood sugar (glucose), and protein levels. High blood sugar can increase CHD risk, while abnormal protein levels might indicate inflammation or other health issues that indirectly affect heart health.

Cholesterol Levels: High LDL (bad) cholesterol and low HDL (good) cholesterol lead to plaque formation.

Triglyceride Levels: Higher triglyceride levels, another kind of fat in the bloodstream, elevate the risk of CHD.

Blood Sugar Levels: High blood sugar levels can damage blood vessels and increase the risk of CHD, especially in diabetics.

Your healthcare provider may also suggest the following heart tests and procedures to further assist in diagnosing coronary heart disease:

Electrocardiogram (ECG or EKG)

An electrocardiogram records the heart's electrical signals to assess its rhythm and strength, identifying any irregularities.

Coronary Calcium Scan

A coronary calcium scan, a form of cardiac computed tomography (CT) scan, measures calcium levels in the coronary artery walls, helping evaluate the risk of coronary heart disease, particularly for smokers or asymptomatic individuals.

Stress Tests

Stress tests evaluate heart function during physical exertion or under medication-induced stress. These tests typically involve treadmill walking, stationary biking, or pharmacological stressors, coupled with ECG monitoring or other imaging techniques to detect reduced blood flow to the heart muscle.

Cardiac Magnetic Resonance Imaging (MRI)

Cardiac MRI detects heart tissue damage or blood flow issues in the heart or coronary arteries. It's useful for diagnosing conditions like coronary microvascular disease and both nonobstructive and obstructive coronary artery disease, often complementing other imaging findings.

Cardiac Positron Emission Tomography (PET) Scan

Cardiac PET scans assess coronary blood flow and can diagnose coronary microvascular disease using nuclear imaging techniques.

Invasive Coronary Angiography

Invasive coronary angiography, performed via cardiac catheterization with contrast dye, identifies coronary artery blockages. It's typically recommended when other tests suggest coronary artery disease.

Coronary CT Angiography

Coronary CT angiography is a non-invasive imaging procedure that examines blood flow through the coronary arteries using specialized X-ray technology, providing detailed images of the heart's blood vessels.

Choosing the Right Test

The recommended test will depend on your individual risks and symptoms. Your doctor will carefully consider the pros and cons of each test to find the best option for you.

Remember, early detection is important for managing CHD. By working with your doctor and getting the right tests, you can take steps to keep your heart healthy and improve your overall well-being.