One of the main causes of chest pain is a blockage of blood flow down the coronary arteries, the blood vessels that deliver oxygenated blood to our heart muscle to allow it to beat. Depending on how fast the blockage forms, it is labeled as either a stable or unstable blockage.
Unstable blockages occur quickly when an atherosclerotic plaque ruptures within the coronary artery and a clot forms on top of it. The clot, along with the plaque, can obstruct blood flow, deprive heart muscle of oxygen, and lead to a heart attack. This is called an acute coronary syndrome, and it frequently requires a minimally invasive procedure called a cardiac catheterization to diagnose the blockage and then provide options to treat it.
When the buildup of plaque in the coronary arteries occurs gradually, most patients have little to no symptoms. As the blockage expands over time, patients can experience chest pain with activity that usually goes away with rest. When a blockage causes this predictable pattern of chest pain, it is called stable coronary artery disease (CAD). A cardiac catheterization may or may not be needed to manage stable CAD.
A stress test can be used to determine the likelihood of having a coronary artery blockage. The main goal of the test is to see how your heart works during physical activity. Because exercise makes your heart pump harder and faster, an exercise stress test can reveal problems with blood flow within the coronary arteries. Certain types of stress tests can even detect how much of the heart has ischemia, or inadequate blood supply.
A stress test usually involves walking on a treadmill or riding a stationary bike while your blood pressure, heart rate and rhythm, and symptoms are closely monitored. (Some patients are given medications that imitate the effects of exercise because they are unable to exercise.) Depending on the type of stress test, some patients are given a radioactive tracer to help create an image of how well blood is reaching different parts of their heart muscle, both during exercise and while at rest, to detect ischemia. If the stress test is abnormal, patients may need cardiac catheterization to confirm the presence of any potential blockages, and possibly even undergo invasive treatment of them.
What is cardiac catheterization?
Cardiac catheterization is a diagnostic procedure that involves taking a long, thin tube called a catheter and threading it within an artery in the arm or leg to get to the coronary arteries. The coronary arteries are then injected with contrast dye to look for blockages.
Depending on the location and severity, the blockages can be treated with medications alone; with angioplasty plus stent placement (expanding a balloon located at the end of the catheter to open the blockage and placing a stent), which can be done d