Did you know? On average, 2 Thais die from coronary artery disease every hour.
Did you know? More than 37,000 Thais die from coronary artery disease each year.
Did you know? Coronary artery disease is the number 1 cause of death worldwide.
These facts confirm that “coronary artery disease” can affect anyone, regardless of race or country! And many people with coronary artery disease may experience sudden heart attacks, which can take your life and the lives of your loved ones within 15 minutes after symptoms begin. Screening for coronary artery disease risk is the best way to be aware of your risk before symptoms appear.
How many methods are there to check coronary arteries?
The common methods to screen for the risk of coronary artery stenosis or blockage nowadays are
- Coronary Artery Calcium Score (CAC)
This test uses a high-speed computed tomography (CT Scan) to calculate the amount of calcium deposited in the walls of the coronary arteries, which helps indicate your risk of coronary artery disease. If no calcium is detected, a Calcium score of 0 means you have a low risk. However, if the Calcium score is high, especially above 400, you are likely at risk of coronary artery stenosis within 2-5 years, even without any symptoms. This test is simple: just lie down, raise your arms above your head, and hold your breath intermittently as instructed by the staff. The test takes no more than 10 minutes.
- Vascular stiffness measurement (Ankle Brachial Pressure Index or ABI)
This test measures blood pressure in the arteries of the arms and legs. The device used is similar to a blood pressure monitor and is placed on both upper arms and ankles. The measured pressures are then used to calculate the ABI index, which helps determine if there is any blockage in the arteries supplying the arms and legs. This also indicates the risk of coronary artery and cerebrovascular diseases. The ABI value should be greater than or equal to 1. An ABI less than 0.9 indicates arterial blockage in one or more areas. If the ABI is below 0.5, urgent treatment is required.
- Coronary CT Angiography (Coronary CT Angiography or CTA)
This test is similar to the coronary artery calcium score but uses contrast dye along with a CT scan, allowing a 360-degree view of the coronary arteries. It can assess the severity of artery stenosis and detect congenital abnormalities. Contrast dye is injected through a vein in the arm, and you will be asked to hold your breath intermittently as instructed. Each breath-hold usually lasts no more than 10 seconds. The test takes 15-60 minutes, depending on heart rate. This method is accurate, simple, and does not require hospital recovery.
- Coronary Angiography (Coronary Angiography or CAG)
This test examines the coronary arteries by inserting a small catheter through an artery in the wrist or groin until it reaches the coronary arteries. Contrast dye is injected to observe the flow through the three coronary arteries, and X-ray images are recorded. This reveals the location of any artery narrowing. The advantage of this method is that balloon angioplasty or stent placement can be performed during the same procedure. It is convenient, fast, and does not require general anesthesia—only local anesthesia is used. The test takes about 20-60 minutes, depending on whether an intervention is performed. If no intervention is done, patients can be monitored until bleeding stops and usually go home the same day.
Limitations of tests using contrast dye
Normally, iodine-based contrast dye may cause side effects in people allergic to seafood. Therefore, if you have underlying conditions such as allergies, asthma, thyroid disease, or are at risk of kidney disease or have chronic kidney failure, you should consult a doctor before undergoing the test.