Diagnosing Heart Desease

Although heart disease continues to be the number one killer in the United States, great strides have been made in its detection and treatment. Accurate diagnosis is an important first step in fighting the disease.

Coronary artery disease, or blockage in the arteries, is the most common form of heart disease. “The most frequent symptom is chest pain, although pain can also occur in the neck, jaw or arms,” says Patrick Reagan, M.D., a cardiologist at Virginia Mason, Federal Way. “It usually lasts for a few minutes. Not all patients have typical symptoms, however. Women often experience different symptoms than men such as fatigue, nausea, shortness of breath and heart palpitations.”

During an exam, a physician can assess the cause of the chest pain—the most common causes are cardiac, gastrointestinal or musculoskeletal. If further diagnosis is needed, usually a cardiologist will evaluate the patient with a stress test.

The patient exercises on a treadmill and the EKG (electrocardiogram) is monitored for signs that the heart muscle is not receiving enough blood because of blockage in the coronary arteries. Sometimes the treadmill is not accurate enough, especially in women, and more sophisticated testing is necessary.

“The two most commonly used tests that increase the accuracy of a diagnosis are the stress echo and the nuclear stress test,” says Dr. Reagan.

Using test information, the cardiologist can assess whether previous damage has occurred and whether a person is at risk for developing a heart attack.

“If you are at risk for heart disease, you can reduce your risk factors by quitting smoking, controlling your blood pressure and lowering your cholesterol,” says Dr. Reagan. “The key is to reduce your risk factors, be aware of the warning signs and seek proper medical attention.”

For more information on The Heart Institute at Virginia Mason, visit www.VirginiaMason.org/Heart

Source: Virginia Mason Magazine, Winter 2003

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