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Coronary artery disease (CAD) is the most common cause of coronary ischemia. [7] Coronary ischemia and coronary artery disease are contributors to the development of heart failure over time. [ 10 ] Diagnosis of coronary ischemia is achieved by an attaining a medical history and physical examination in addition to other tests such as ...
The first investigation when CAD is suspected is an electrocardiogram (ECG/EKG), both for stable angina and acute coronary syndrome. An X-ray of the chest, blood tests and resting echocardiography may be performed. [73] [74] For stable symptomatic patients, several non-invasive tests can diagnose CAD depending on pre-assessment of the risk profile.
In patients with UA/NSTEMI, the TIMI risk score is a prognostication scheme that categorizes a patient's risk of death and ischemic events and provides a basis for therapeutic decision making. [1] TIMI Score Calculation (1 point for each): Age ≥ 65 years; Known coronary artery disease (CAD) (stenosis ≥ 50%) ≥ 3 risk factors for CAD*
People who have a normal ECG and who are able to exercise, for example, do not merit routine imaging. [13] Imaging tests such as stress radionuclide myocardial perfusion imaging or stress echocardiography can confirm a diagnosis when a person's history, physical exam, ECG and cardiac biomarkers suggest the likelihood of a problem.
In the absence of an ST elevation, a non-ST elevation MI, known as an NSTEMI, or an unstable angina may be presumed (both of these are indistinguishable on initial evaluation of symptoms). ST elevations indicate a completely blocked artery needing immediate reperfusion. In NSTEMI the blood flow is present but limited by stenosis.
Ischemic cardiomyopathy is a type of cardiomyopathy caused by a narrowing of the coronary arteries which supply blood to the heart. [4] Typically, patients with ischemic cardiomyopathy have a history of acute myocardial infarction, [5] however, it may occur in patients with coronary artery disease, but without a past history of acute myocardial infarction.
Acute coronary syndrome (ACS) is a syndrome due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. [1] The most common symptom is centrally located pressure-like chest pain , often radiating to the left shoulder [ 2 ] or angle of the jaw, and associated with nausea and ...
The instantaneous wave-free ratio (iFR, sometimes referred to as the instant wave-free ratio or instant flow reserve) is a diagnostic tool used to assess whether a stenosis is causing a limitation of blood flow in coronary arteries with subsequent ischemia. iFR is performed during cardiac catheterisation (angiography) using invasive coronary pressure wires which are placed in the coronary ...