health

For some people, a heart attack is the first symptom of CAD. They will
be taken to a hospital emergency room, where they will be asked to
describe their symptoms. In addition to taking the patient’s personal and
family history of risk factors for CAD, the doctor will also take the
patient’s temperature, blood pressure, and pulse. Listening to the patient’s
lungs and heartbeat through a stethoscope can help to rule out pneumonia
or other diseases that might cause chest pain or difficulty breathing.

The next step is diagnostic tests to rule out a heart attack, which
include:

• Electrocardiogram (ECG or EKG). An ECG or EKG measures the
  heart’s electrical activity. Injured heart muscle makes unusual patterns
  or tracings on the paper printout produced by the ECG
  machine. If only a small amount of the heart muscle has
  been affected, however, the ECG may not show any abnormal
  patterns.
  
• Blood tests. These are done to confirm the diagnosis of a heart
  attack or to make sure that the electrocardiogram did not miss a
  small heart attack. Injured heart muscle leaks small amounts of
  special enzymes into the bloodstream.
  
• Chest x ray. A chest x ray may be done to see whether the patient’s
  lungs are normal.
  
• Coronary angiography. Coronary angiography is a type of x-ray
  study in which the doctor threads a long thin tube called a
  catheter into the heart through an artery in the arm or upper
  thigh. A dye that will show up on x ray is injected into the bloodstream
  through the catheter. This test allows the doctor to find
  the location of the blockage in the coronary artery. It is also the
  only test that allows a heart specialist to determine the best treatment
  for the blockage.

If the patient is having angina but does not appear to be having a
heart attack, he or she will be asked to take a stress test. In a stress test,
the patient walks on a treadmill or pedals a stationary bicycle while
hooked up to an ECG machine, which measures the electrical tracings
of the heart before, during, and after exercise. Another type of stress test
is a radionuclide stress test, in which a radioactive tracer element is
injected into a vein while a special camera records the amount of the
trace element that reaches various parts of the heart.