Diagnostic tests generally fall into two categories: non-invasive, and invasive. Non-invasive tests utilize imaging, such as X-rays or CT scans, which take a picture of the heart. Invasive tests might use a catheter inserted inside the body through an artery or vein to pinpoint the source of heart trouble. 

Non-invasive tests

Echocardiograms/electrocardiograms – An echocardiogram uses ultrasound to view the heart’s structure and function, while an electrocardiogram uses electrodes applied to the chest, arms and legs that are connected to a machine, which records the heart’s electrical activity. 

CT coronary angiogram – This newer heart imaging test provides information about the heart previously only available using more invasive testing methods. It can help detect blockages, such as deposits of fat or plaque that have narrowed the coronary arteries and cause coronary artery disease. Coronary CTA is a special type of x-ray exam. Patients undergoing a coronary CTA scan receive an IV injection of iodine-containing contrast material (dye) to help provide the best possible detail of the areas being examined. It provides imaging previously only available using more invasive testing methods. 

Invasive tests/Intervention

Cardiac catheterization – This widely used, minimally-invasive procedure provides a look at the inside of the heart and surrounding structures. A catheter (a long, thin and flexible plastic tube) is inserted into an artery or vein in the arm or groin, and threaded into the heart’s arteries or chambers. Your doctor is then able to measure blood pressure in the heart, the heart’s pumping capability and the amount of oxygen in the blood. Patients who are usually awake during the procedure, feel little or no pain. However, there may be some residual soreness in the blood vessel where the catheter was inserted, after the procedure.

Cardiac catheterization is not only a diagnostic method, but in many cases, a first step in surgical procedures that can help minimize or stop a heart attack. Once the catheter is in place, it can be used to perform interventional procedures such as angioplasty or stent implantation. 

Percutaneous Intervention – This catheter-based procedure is used to restore blood flow to the heart. A catheter with a balloon at its tip is threaded through a blood vessel to the narrowed artery. Once in place, the balloon is inflated to compress built-up plaque against the artery wall; this opens the area and restores blood flow. Angioplasty is frequently used to relieve symptoms of coronary artery disease, such as chest pain (angina), and it can reduce heart muscle damage when performed early during a heart attack. Sometimes the cardiologist will place a stent (a metal support structure) inside the artery that has been opened with a balloon to help the artery remain open.

If you’re experiencing symptoms of a heart attack, get to your closest ER immediately or dial 911. Also, talk with your doctor about your family history and individual risk level. Your doctor can recommend routine tests and preventive habits to help manage your heart health.

(Editor’s Note: Gundeep Singh, M.D., FACC is a board-certified cardiologist practicing with Desert Cardiology of Tucson. The office phone is 797-8550 www.desertcardiology.com.)

Heart Attack Symptoms

If you think you’re having a heart attack, don’t wait: go to the nearest ER, immediately. Be sure you know the warning signs and symptoms of a heart attack. 

Chest discomfort, such as uncomfortable pressure, squeezing, fullness or pain

Pain in one or both arms, the back, neck, jaw or stomach

Shortness of breath, with or without chest discomfort 

Cold sweat

Nausea or vomiting

Weakness, lightheadedness or dizziness

Recent research has shown that women may experience different heart attack symptoms – instead of, or in addition to the “classic,” better-known heart attack symptoms. These may include:

Unusual fatigue

Indigestion

Sleep disturbances

Anxiety or a feeling of impending doom

Back or jaw pain