What tests are done for cardiac ischemia?

Myocardial ischemia is a type of insufficient blood supply, which is a common heart problem. If the patient has severe cardiac ischemia, he or she may have symptoms such as angina pectoris. In terms of treatment, a confirmed diagnosis must be made first. Many tests can help diagnose cardiac ischemia. So, what tests should be done for cardiac ischemia?

1. Electrocardiogram examination: The main manifestations are left ventricular hypertrophy, ST segment depression, T wave changes, abnormal Q waves and various arrhythmias, such as sinus tachycardia, atrial premature beats, ventricular premature beats, ventricular tachycardia, atrial fibrillation and heart block, etc. The leads with ST-T changes are often distributed according to the area controlled by the diseased coronary artery, which has the value of positioning diagnosis. This is one of the diagnostic methods for myocardial ischemia.

2. Chest X-ray examination: The main manifestation is enlarged heart shadow, and most of them are aortic type heart (mainly enlarged left ventricle, and most of the right ventricle is normal), and a few heart shadows are general size. Widening of the ascending aorta and calcification of the aortic junction may also be seen. Most patients have varying degrees of pulmonary congestion, but no obvious changes in the pulmonary artery segment.

3. Cardiac ultrasound examination: The inner diameter of the heart cavity is enlarged, especially the left atrium and left ventricle. The segmental motion of the ventricular wall is weakened or disappeared. The left ventricular ejection fraction is significantly reduced. Most patients have mitral regurgitation, and aortic valve thickening and calcification can be seen. This is also the diagnostic method for myocardial ischemia.

4. Coronary angiography: diffuse severe stenosis or occlusion of multiple coronary arteries can be seen.

5. Electrocardiogram: A normal electrocardiogram with horizontal or downward depression of the ST segment ≥1mm with or without T wave inversion, but no symptoms, is the main basis for diagnosing asymptomatic myocardial ischemia.

6. Dynamic electrocardiogram monitoring: Dynamic electrocardiogram monitoring can accurately reflect the frequency, duration, severity and dynamic changes of myocardial ischemia, rarely has false positives, and is an effective method for diagnosing painless ischemia.

7. Exercise stress test electrocardiogram: Exercise stress test electrocardiogram is used to detect people with normal electrocardiogram but with risk factors for asymptomatic myocardial ischemia. It is necessary to assist in diagnosis with ischemia provocation test, but the false positive rate is high and the specificity is low.