Exams and Tests for ACS

December 1, 2023 | 3 min read

Your healthcare team will conduct a thorough medical assessment, take your medical history, inquire about your symptoms, and listen to your heart using a stethoscope. Diagnostic tests may be ordered to ascertain the presence and extent of the disease with the results guiding subsequent treatment decisions. These tests may include:

  1. Routine blood tests to assess levels of fats, cholesterol, sugar, and proteins. These are the risk factors for heart disease which can be modified with lifestyle changes and, if necessary, medication.
  2. Electrocardiogram (ECG) to record the heart’s electrical activity and check its rhythm (how fast or evenly the heart is beating). It can also show existing damage or insufficient blood supply to the heart.
  3. Echocardiogram to examine the structure and overall function of the heart.
  4. Stress testing, which involves exercise – usually on a treadmill or stationary bike, or simulated exercise using medicines (if you are unable to be active) to non-invasively assess blocked arteries.
  5. Chest X-ray to scrutinize the heart and lungs for abnormalities which could explain your symptoms.
  6. Computed tomography (CT) angiography scan to assess images of the heart’s arteries, detecting plaque buildup even in early, non-hardened stages.
  7. Coronary angiogram, conducted in the cardiac catheterization laboratory, which involves threading a catheter into an artery, usually in the wrist or leg, to inject dye and evaluate for blockages. This is recommended if non-invasive tests yield abnormal results or if symptoms strongly suggest coronary artery disease, or after a heart attack.

 

Understanding the results

Interpreting the results involves understanding the degree of CAD based on the percentage of artery blockage:

  • Mild: Less than 49%
  • Moderate: 50%-70%
  • Severe: More than 70%

For instance, if your care team informs you of “less than 70% blockage in an artery,” it signifies non-obstructive CAD, where blood flow isn’t reduced at rest but may be limited during intense activity. Lifestyle modifications and medication are recommended in this scenario.

Alternatively, if you’re told of “over 70% blockage in one artery,” it indicates severe blockage, likely explaining symptoms like chest pain or shortness of breath. Stepped-up medical treatment and potential procedures or surgery may be recommended in this case.