Your doctor will ask if you’ve had symptoms of heart disease and if CAD runs in your family. Next, your doctor will check your blood pressure and examine your heart and circulation. You’ll also be tested for cardiac risk factors.
If your doctor suspects CAD, you’ll need additional tests. Here are some of the most important ones:
Electrocardiogram (EKG). The EKG records the electrical activity of your heart.
Stress tests. While you walk on a treadmill, doctors monitor your EKG. In some cases, you’ll be given a tiny amount of a radioactive chemical to produce nuclear images of your heart.
Echocardiography. Sound waves are beamed at your heart to measure its size and pumping capacity and to evaluate the heart’s valves.
Computed tomography (CT scanning). One type measures the calcium in plaques; another produces pictures of the coronary arteries.
Coronary angiography. Doctors thread a tiny plastic catheter (tube) into the coronary arteries, then inject a dye so x-rays can show blockages.
Blood tests. During heart attacks, some heart cells die, leaking their contents into the blood. Doctors measure troponin and creatine phosphokinase (CPK) levels to learn if a heart attack has occurred.
Prevention and Treatment: Lifestyle
Avoid tobacco in all its forms, including secondhand smoke.
Eat right. Cut down on saturated fat and cholesterol by limiting meat, whole dairy products, and eggs. Avoid the trans fats in stick margarine, fried foods, and many snack and “junk” goods. Favor olive and canola oils. Eat lots of fish. Load up on whole grain products instead of refined grains and simple sugars. Eat lots of fruits and vegetables. Cut down on sodium (salt). If you enjoy alcohol and can drink responsibly, have one or two drinks a day, but not more.
Stay active. People with CAD need medical clearance and guidance, but most can—and should—spend at least 30 minutes a day walking, biking, or doing other forms of moderate exercise.
Control your weight. If you need to reduce, cut down on the calories you eat and boost the calories you burn with exercise.
Reduce stress. Anger, depression, and social isolation can be heart breaking.
Treatment: Medication and Supplements
Since no two patients are alike, your doctor will decide what’s best for you. Here are some major options:
Supplements. Most patients with CAD should take fish oil capsules to get 1 g of omega 3 fats a day. A daily multivitamin is also reasonable.
Aspirin helps prevent artery-blocking blood clots. Unless there is a specific reason not to take aspirin (such as ulcers, bleeding, or allergies), every patient with CAD should take 81 mg (one “baby aspirin”) a day. And if you think you may be having a heart attack, you should chew and swallow an aspirin tablet even before you call 911.
Anti-clotting drugs. In selected cases, your doctor may prescribe drugs such as clopidogrel and warfarin.
Nitrates are used to relieve and prevent angina.
Beta-blockers help prevent repeat attacks and angina.
Angiotension-converting enzyme inhibitors help the heart heal after a heart attack.
Calcium-channel blockers can help prevent angina.
Cholesterol-lowering drugs. Most CAD patients need medication, such as a statin drug, to achieve their goals.
Although many patients with CAD respond very well to lifestyle therapy and medication, many others benefit from angioplasties or bypass operations that restore blood flow to the heart.
Living with CAD
CAD is a serious illness. Your doctor will arrange the tests you need, but your job is just as important: follow a heart-healthy lifestyle, take your medication as directed, and report any symptoms promptly. It’s a lifelong process, but it will help keep the beat of life strong and steady.