Coronary artery disease (CAD) occurs when the major blood vessels supplying the heart become damaged or diseased. This often stems from atherosclerosis, where plaque builds up inside the arteries, narrowing them and restricting blood flow. Early detection of CAD is important for effective management and can improve long-term health outcomes.
Recognizing the Need for Detection
Individuals often seek medical attention for potential CAD when they experience certain signs and symptoms. Chest pain, commonly known as angina, is a frequent indicator, manifesting as a squeezing, pressure, or heaviness in the chest. This discomfort may also spread to the shoulder, arm, back, neck, or jaw.
Shortness of breath, particularly during physical activity or emotional distress, is another common symptom, sometimes occurring even with mild exertion. Fatigue and heart palpitations, sensations of a racing heartbeat, can also signal the heart is working harder to deliver oxygen-rich blood. Symptoms can vary in intensity and presentation among individuals.
Non-Invasive Detection Methods
Initial assessments for CAD often involve non-invasive tests. An electrocardiogram (ECG or EKG) measures the electrical activity of the heart, which can help detect heart rhythm irregularities or signs of heart muscle strain. This test records electrical signals as they pass through the heart.
Stress tests evaluate the heart’s function under exertion, typically by having a person walk on a treadmill or ride a stationary bike while their heart activity is monitored. If physical activity is not possible, medication can be administered to simulate the effects of exercise on the heart. An echocardiogram uses sound waves to create detailed images of the heart’s structure and how blood flows through it. This imaging can assess cardiac function and identify any abnormalities in the heart’s walls or valves.
Coronary Artery Calcium (CAC) scoring, also known as a CT calcium scan, is a non-contrast computed tomography (CT) scan that looks for calcium deposits in the coronary arteries. The presence and amount of calcium can indicate the extent of atherosclerosis, even before symptoms develop. These tests provide valuable information without requiring invasive procedures.
Invasive and Advanced Imaging Detection
When non-invasive tests suggest CAD or more detailed information is needed, advanced imaging or invasive procedures may be used. Coronary angiography, also called cardiac catheterization, is an invasive procedure for visualizing blockages. A thin, flexible tube is inserted into an artery, and a contrast dye is injected, allowing X-ray images to reveal narrowed or blocked areas in the coronary arteries.
CT Coronary Angiography (CTCA) is a non-invasive imaging test that uses CT scans with contrast dye to produce detailed images of the coronary arteries. This method helps detect CAD and assess plaque buildup. Cardiac MRI (CMR) uses magnetic resonance imaging to evaluate heart muscle damage, blood flow, and overall heart function. Cardiac MRI can also help explain results from other imaging tests.
Understanding Risk Factors and Screening
Several factors can increase a person’s likelihood of developing CAD. High blood pressure can damage artery walls, while elevated cholesterol levels contribute to plaque formation. Diabetes is also linked to a higher CAD risk, as high blood sugar can harm coronary arteries.
Lifestyle elements such as smoking, a sedentary lifestyle, and an unhealthy diet contribute to CAD risk. Other factors that cannot be changed include age, with risk increasing after 45 for men and after menopause for women, and a family history of heart disease. For individuals with multiple risk factors, screening may be considered even without noticeable symptoms, allowing for earlier intervention.