Tests for Examining Your Arteries

Is there any way to tell how much plaque you have before a heart attack occurs? If you’re having angina or have several risk factors for heart disease, your doctor may order a series of tests to determine if you have coronary artery blockages. These include:

Electrocardiograms. In this test, known as an ECG or EKG, electrodes are attached to your chest to detect any irregular heart rhythm or damage from a heart attack and determine whether your heart is getting enough blood and oxygen.

Imaging techniques. These can determine if you have any artery blockages and if so, how severe they are. The most common ones are:

  • Radioisotope scan. A radioactive dye is injected into the bloodstream, and a special machine takes pictures of your heart and arteries as the dye passes through.
  • Echocardiogram. This test uses sound waves instead of dye or X-rays to trace a
    picture of your heart, revealing any damage to the muscle or abnormal blood flow.
  • CT scan. A more advanced form of X-ray, the CT machine takes detailed pictures of your heart from various angles, providing a cross-sectional view.
  • MRI. Using a magnetic field and radio waves, MRI records energy signals emitted by the atoms that make up the cells of the body. MRI can measure blood flow through arteries, providing information about blockages.

Cardiac catheterization, or angiography. In this procedure — an invasive test — a pencil-sized plastic tube is threaded through an artery in your groin. A catheter is then passed through the tube toward the heart and into a coronary artery. Iodine-based dye is then injected, and a special camera takes pictures to show any blockages.

EBCT. This sophisticated test measures calcification of the arteries, a possible indication of coronary heart disease (CHD).

Once your doctor determines you have plaques, the goal is to stabilize them and prevent a heart attack. But it’s far better to prevent the plaques in the first place. Bringing down your cholesterol is a key strategy for both. For instance, having 60 percent of the surface area of a coronary artery covered in plaque is considered significant atherosclerosis. If your cholesterol is 150 you’ll be 80 years old before you get that much plaque. But if your cholesterol is 300 you’ll reach that level before you hit 40.

Of course, cholesterol isn’t the only factor that plays a role in the development of heart disease. There are many other factors involved — inflammation, high blood pressure, even germs — that can significantly affect your risk.

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