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After a patient is diagnosed with CAD, there are many diagnostic tests that a physician might use in order

to discover how far advanced the disease is. After these tests have determined the severity of disease, complimentary treatments, such as prescription medications, invasive procedures, and alternative treatment measures may be used in treatment. The tests will tell the doctor important information about how a patients heart is functioning, and the treatments will help the patient function and prolong life. A physician may begin his diagnosis by measuring blood pressure in the arm, and may even take blood pressure in the ankle to check for blockages in the legs. He may order an EKG, which measures the hearts electrical activity (Frazier, M & Drzymkowski, J, 2009). The doctor may also order blood tests to determine blood levels of cholesterol, and to check for malfunctions of other organs, such as the kidneys, or liver. Further, the physician will order stress tests, which evaluate how the heart behaves when a patient is active. The best known of these tests is probably the cardiac stress test, which monitors the heart with an EKG machine while a patient uses a treadmill. This test may also be performed by giving the patient medication that makes the heart beat faster. The idea is for the patient to reach their individual target heart rate while the EKG monitors the hearts response to activity. Depending on any abnormal findings of this test, a physician may order a echocardiogram, which uses ultrasound to view pictures of the heart and its function. This test helps determine areas of weak blood flow, and if the heart muscle and the heart valves are as strong as they should be (NLH, 2010). More testing can be performed using Computed Topography (CT) scans with or without radioactive dyes, and through a procedure called a cardiac catherization that uses a very thin tube directly into the artery, usually starting at

the groin. A tiny camera is used to view the artery, the heart chambers, and other areas. This procedure can be useful for invasive treatments to correct a blockage occluding the artery. Treatment for CAD usually begins with medications that may reduce angina (heart pain) by opening the blood vessels so more blood can reach the heart, and thus more oxygen. Some of these medications are called ace inhibiters, beta blockers, and calcium channel blockers (Frazier, M & Drzymkowski, J, 2009). If these medications do not help the heart get the oxygen it needs through blood flow, then the invasive procedures of balloon angioplasty, the use of stents in arteries to open the blockage, and with bypass surgery that creates new pathways for blood flow by using veins from other body sites (NLH, 2010). Along with traditional therapies to treat CAD, there are alternative therapies recognized as beneficial to recovery and control of this disease. Touch therapy, or massage therapy, helps a patient to relax and relieve stress. Behavior modification also teaches relaxation, and smoking cessation classes are very popular, as smoking makes CAD even more lethal. Some researchers are investigating the use of Vitamin D in heart disease, and it has been recommended that adults take up to 2000 mg. a day for optimal effect. Dr. J. Brent Muhlestein, MD, who has conducted research about Vitamin D and CAD, states, "Our findings show that vitamin D could have far greater implications in the treatment and reduction of cardiovascular disease and other chronic conditions than we previously thought" (ScienceDaily, 2010). Some physicians recommend fish oil supplements, and other vitamins, such as the B vitamins, E and C to help. Taking one baby aspirin a day is still recommended by many physicians (NLH, 2010). For patients living with coronary artery disease there are various ways a physician can properly diagnosis and treat this disease. The future will include more diagnostic procedures and treatment options as well. As heart disease is the number one killer in the United States, learning

as much about the disease, its treatment and, especially, prevention, will hopefully reduce mortality rates due to CAD.

References: Frazier, M. & Drzymkowski, J.,(2009). Essentials of Human Disease and Conditions, Fourth Edition. pg. 441-445. Saunders Elsevier, St. Louis, Missouri

Intermountain Medical Center (2010, March 17). Treating vitamin D deficiency significantly reduces heart disease risk, studies find. ScienceDaily. Retrieved October 4, 2011, from http://www.sciencedaily.com /releases/2010/03/100315161716.htm

NHL. (2010). Coronary artery disease. NIH Medline Plus the Magazine, 5(3), 23-27. Retrieved from http://www.nlm.nih.gov/medlineplus/magazine/issues/fall10/articles/fall10pg2627.html