If you think you're at risk of having coronary artery disease, you need to see your GP to have your absolute risk assessed (which may involve some testing) and a plan of action decided upon. Most people who go to their doctor thinking they have angina - the most common symptom of coronary artery disease - have had symptoms for a while that have crept up on them. But you don't need to wait until you have symptoms to ask your doctor about your risk.
If you’re one of the many people who don’t have overt symptoms, seeing your GP for regular checks is the best way to detect coronary risk. If your blood pressure, blood cholesterol and blood glucose tests show signs that you may have heart disease risk, your doctor will want you to have further testing.
In the first instance your doctor will want to listen to your chest to see if they can hear any abnormal sounds in the heart or lungs. They will then want to discuss your personal story and symptom pattern. This can often make a diagnosis of coronary artery disease for your doctor.
Your story may have important clues such as a family history of stroke, angina, blocked arteries in the legs and/or heart attacks. People with type 1 (juvenile or insulin dependent) or type 2 (adult onset) diabetes are also at higher risk, as are smokers, the inactive and people with raised blood pressure and/or raised cholesterol (see Risk Factors).
Your doctor may then want to order tests. And, because your story may be making the diagnosis for your doctor, tests are usually to confirm your diagnosis so you can be sure what’s causing the symptoms, work out how severe your condition is and your treatment options.
Some GPs will request their own testing while others may refer you early to a cardiologist and/or cardiology clinic, depending on a range of factors. Here, your heart function and coronary arteries can be thoroughly examined to determine the causes and extent of the problem and your treatment options. Even if you’ve already had a heart attack, you will still need tests to establish where the coronary artery blockage(s) are, assess your heart damage and help determine the best treatment.
If you’ve already been diagnosed with coronary artery disease but experience any new symptom or changed symptom involving
then you must immediately call an ambulance. You need to be taken safely by people with the right equipment and training to the nearest emergency department. If you develop the symptoms above, or new or changed symptoms, on exertion and they settle at rest then you need to make an urgent appointment with your GP.
The objectives of testing are to develop or confirm ideas of causes, whether direct (such as coronary artery disease) or indirect (such as diabetes), the extent of any damage, and the risks of any future problems or damage. The other benefit of your tests, is that they give you and your doctor useful information that can help with and inform any decisions that need to be made about your ongoing treatment.
However, not all tests are the same. Some give a more accurate picture than others, and some carry greater risks or benefits. The most effective tests are those where the results can change treatment decisions. Knowing the pros, cons and other facts about the tests that are recommended can help you make informed decisions about your diagnosis and treatment.
Next: Which Tests
Last published 31 October 2010
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