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Diagnosis of CAD

ECG, Echocardiography, TMT and CAG

Electro Cardio Gram (ECG)

  • One of the simplest bedside test
  • Shows electrical activity of heart patient. Can have normal ECG and abnormal heart or abnormal ECG and normal heart. Patient may require further test in spite of normal.
  • ECG. It is useful for Diagnosis of coronary artery disease.


  • Based on Principle of Ultrasound
  • Gives important Information about structure and function of heart
  • Helps to assess valve structure and their abnormalities
  • Gives information about the function of valves and severity of valve disease
  • Overall effectiveness of pumping of heart for medical or surgical treatment
  • Limitation - Cannot show Coronary Arteries

Tread Mill Test (Stress test)

  • Performed on OPD basis
  • Patient exercises on a treadmill under supervision of a physician and his/her ECG is monitored continuously. In addition blood pressure and pymptoms are also monitored.
  • ECG changes detected during stress test can clinch the diagnosis of Coronary Artery Disease
  • Limitation - Significant number of false positive and false negative tests can just suggest possibility of Coronary Artery Disease.

Coronary Angiography (CAG)

  • Coronary Angiography (CAG)
  • Invasive test
  • Generally requires 24 Hrs of Hospitalisation
  • Procedure is performed in Cath Lab
  • Carries a negligible amount of risk of complications

The CAG Procedure

  • Light sedation may be given
  • Patient remains awake in order to respond to Various instructions("take a deep breath and Hold your breath", "cough", etc.)
  • The access for Angiography is acquired through an Artery in groin called femoral Artery
  • Coronary Angiography can also be performed through arteries of Upper Limb when the access is not possible through groin because of various conditions. When viewed in motion under X-rays, reveals any obstructions or plaques located within the coronary vessels.
  • This procedure also helps in recording pressures Inside the heart and allows assessment of left Ventricular function.
  • The procedure is then stored on a CD or a video cassette