If you have diabetes, these diagnostic tests could save your life
Having diabetes puts you at increased risk of atherosclerosis, the buildup of plaques in your arteries that can reduce blood flow to the heart. The blockage of coronary arteries can lead to chest pain (angina) or heart attack. Your doctor may prescribe diagnostic tests to assess how your arteries are performing and what lifestyle changes or medications you might need to live a long, healthy life.
Some of the most important heart tests are quick and noninvasive. They include:
- Coronary calcium scan This test measures the level of calcium in your coronary arteries. The higher your coronary calcium score, the greater your risk of a heart attack. The test uses rapid computed tomography (CT) imaging, essentially a series of x-rays, as you lie face-up on an examination table; it takes about 10 minutes.
- Electrocardiogram (EKG) This quick test can detect abnormal heart rhythms and is prescribed if you're experiencing chest pain to determine whether it is caused by a partial blockage of a coronary artery and, if so, whether there is an inadequate supply of blood to the heart muscle (known as ischemia). It is also often prescribed for people newly diagnosed with diabetes to establish a "baseline" to compare with later EKGs. Small metal sensors are applied to the skin of your chest, arms and legs to detect and record patterns of electrical signals from your heart while you lie on an examination table.
- Exercise stress test Because an EKG conducted while you're at rest may not detect ischemia, your doctor may order a follow-up EKG while you perform a simple exercise. You may be asked to walk on a treadmill or ride a stationary bike. Your doctor will monitor whether changes in your EKG appear that suggest your heart is not getting the extra blood it needs to meet the demands of the exercise.
- Coronary angiography If your exercise stress test is abnormal, your doctor may order a coronary angiography, an invasive procedure to detect signs of narrowing in your coronary arteries. A tube (catheter) is threaded through a needle placed in an artery in the thigh or arm and then advanced into the coronary arteries. A contrast substance (often erroneously referred to as a dye) is injected through the catheter and an x-ray helps detect narrowing of the arteries. A coronary angiography is carried out only when there is strong evidence of coronary heart disease.
Written by: Simeon Margolis, M.D., Ph.D.; From our sister publication, Diabetes Focus (Summer 2011)