(Washington Post) — Cardiovascular disease remains the No. 1 killer of men and women in the United States, in part because heart attack victims often don’t recognize the symptoms and delay getting care. Of course, it’s better to identify heart disease before you have an attack, but that’s not always easy. And doctors sometimes push high-tech tests and treatments when simpler measures are safer, cheaper and at least as effective. Here are several tests and what you need to know about them:
Stress test. This measures the heart’s function while it is stressed by exercise or, in some cases, medication. For people with symptoms of heart disease, a stress test should usually be the first test ordered. And it should be combined with an electrocardiogram and an echocardiogram or a nuclear test, both of which produce an image of the heart.
Coronary angiography. This is the gold standard for confirming heart disease in people with worrisome stress-test results. It involves threading a flexible tube from the groin into the coronary arteries and injecting a dye to make blockages visible on an X-ray. Going straight to such an invasive test is warranted only for people who are at very high risk of having heart disease or who have symptoms or an underlying condition that could make stress testing risky.
CT angiography and electron beam computed tomography. These tests have almost no role in treating people without symptoms of heart disease and are of limited use even for those who do have them.
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