Coronary Artery Disease Diagnostic Testing

How is coronary artery disease (CAD) diagnosed?

Your cardiologist (heart doctor) will diagnose coronary artery disease based on your symptoms, your medical and family history, your risk factors, and the results from tests and procedures. There are several diagnostic tests that doctors can use to diagnose coronary artery disease (CAD). Depending on your symptoms and medical history, your cardiologist may order a combination of the following medical tests.

Blood Tests

Blood tests may be ordered to check the levels of blood cholesterol, especially in those who are over 40 years old, have a family history of heart or cholesterol-related conditions, are overweight, and have high blood pressure or another condition, such as an underactive thyroid gland, or any condition which may elevate blood levels of cholesterol.  The blood test may also measure triglycerides, sugar, lipoproteins, or proteins that are markers of inflammation. Abnormal levels are risk factors for coronary artery disease (CAD).

Electrocardiogram (EKG)

An electrocardiogram, better known as an EKG or ECG, is a non-invasive diagnostic test that uses electrodes to record the electrical activity of the heart. This test will check your heart rate and rhythm and can assist in diagnosing a number of heart conditions, including problems with heart size, heart rhythm, or the heart muscle.  An EKG can also diagnose a heart attack. Even when there is no suspicion of coronary artery disease, an EKG is often part of a general physical examination and the results used as a baseline for comparison with any future testing.


An echocardiogram, also known as echocardiography or ECHO, uses ultrasound to produce images of your heart's size, structure, and motion.  Echocardiograms are used to check the heart's pumping capacity, observe the function the hearts valves and chambers, and detect congenital abnormalities. 

Stress Tests

A stress tests, sometimes called an exercise stress test or treadmill stress test, helps to determine how the heart functions during exercise.  The results of the stress test help the doctor with diagnosing coronary artery disease, possible causes of symptoms you may be experiencing, heart-related conditions and the level of physical activity that is right for you.  During the stress test, you will be asked to walk or run on a treadmill to make your heart work hard and beat fast. Your heart rate, blood pressure, and EKG are monitored while you exercise. If you are unable to walk on a treadmill your doctor may give you medications that make your heart work as hard as it would during exercise, these are called pharmacologic stress tests.  Nuclear stress studies and echocardiography stress studies are also performed at San Antonio Regional Hospital.

Cardiac CT Angiography and Calcium Scoring

Computerized Tomography (CT) scanners work by directing x-ray beams through the patient's body, which are then caught by detectors that spiral around the body and create 2D and 3D images.  San Antonio's 64-slice CT scanner provides images of cardiac anatomy with exceptional detail and clarity. There are two main types of Cardiac CT.  They are Coronary CT Angiography (CTA) and Coronary Artery Calcium Scoring.

Coronary CT Angiography (CTA)  is used to examine your heart chambers and coronary arteries.  A small amount of contrast is injected through an IV in your arm which allows doctors to visualize blood vessels and identify narrowed or thrombosed sections of the coronary arteries.

Coronary Artery Calcium Scoring, which is also known as a calcium score, is a non-invasive CT scan that does not use contrast.  . The calcium score is a test that measures the amount of calcium in the walls of the heart’s arteries.    Patients with higher levels of calcium have an increased risk of developing coronary artery disease, which may result in a heart attack.

Coronary Angiogram (Heart Catheterization)

A coronary angiogram is a minimally invasive diagnostic procedure performed in the cardiac catheterization laboratory.  A coronary angiogram helps your doctor determine if you have narrowing or blockages in the coronary arteries, which are the arteries that supply blood to your heart muscle.  Doctors thread a long, thin tube (called a catheter) into an artery in the groin or wrist and pass it up into the heart. Once the catheter is in place, a dye is injected to allow the doctors to clearly see if the arteries are narrowed or blocked.  The movement of the dye through your heart and coronary arteries is recorded as an angiogram and viewed on monitor.

Cardiac Magnetic Resonance Imaging

Cardiac magnetic resonance imaging (MRI), also known as a heart MRI, is an advanced imaging technology that is used by our doctors to evaluate the heart's anatomy and function. Cardiac MRI uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within and around the heart. Cardiac MRI is a safe, painless, and non-invasive way for your cardiologist to see detailed images of your heart and heart chambers.

At San Antonio Regional Hospital's Heart Center, our cardiologists, heart surgeons, and staff are here to help you regain control of your cardiovascular health.