2. Lesson 3 How to diagnose Coronary Artery Disease? Diagnostic

3. Cardiac Stress Exercise Test Used to screen for CAD. Exercise induced ischemia or arrhythmias. Used to evaluate cardiac risks. Patient exercises on a treadmill with progressive increase in speed and elevation. http://ncd.org.jo/index.php?option=com_content&task=view&id=29

4. Nuclear Studies Nuclear persantine/ Adenosine stress- Used for clients who are unable to walk a treadmill. -IV persantine is inserted and dilates the coronary arteries and increases myocardial blood flow. -In CAD coronary arteries are narrowed and cannot dilate to increase perfusion. Nuclear Dobutamine Stress- Adrenergic drug that increased myocardial contractility, HR and BP. -Increases coronary oxygen consumption and blood flow. Cardolite Scan- Evaluates blood flow in different areas of the heart.

5. Coronary angiography/ Cardiac Catherization Radiography of the vascular system of the heart muscle after injection of a contrast medium. It uses dye and special x rays to show the inside of your coronary arteries. Most of the time, the coronary arteries can't be seen on an x ray. During coronary angiography, special dye is injected into the bloodstream to make the coronary arteries show up on an x ray. http://www.heart.org.in/diseases/cardiac-mri.html

6. Echocardiogram/ EKG High frequency sound waves are sent through the heart and bounce back to a transducer. The reflected sound waves change in predictable ways depending of the substance they strike (blood, water, tissue, calcium) Used to evaluate intracardiac structure, function, and flow characteristics. EKG- is a recording of the electrical activity of the heart, and can demonstrate signs of oxygen starvation of the heart (ischemia) or heart attack. Often, the resting EKG is normal in patients with coronary artery disease and angina. http://yourtotalhealth.ivillage.com/Echocardiogram,Echocardiogram.html

7. Blood Tests Troponin- both myocardium and skeletal muscle -Most sensitive and specific test for myocardial injury. Cholesterol- high levels associated with cardiac risk. Serum Electrolytes including sodium, potassium, calcium, magnesium, BUN, and glucose are also important to test. CPK, CKMB indicative of a MI. CBC- evaluate for increased white blood cells. Lipid Profile http://www.topnews.in/health/simple-blood-test-may-improve-treatment- response-breast-cancer-patients-22564