Diagnosing Heart Disease

Calcium Scoring CT Scan

Coronary Calcium Scoring is a test that helps evaluate a person’s risk of developing coronary artery disease. It provides additional prediction of coronary events beyond standard cholesterol screening and risk-factor assessment.

Calcium is a marker for coronary artery disease and the amount of calcium detected on a heart scan is a helpful diagnostic tool. Coronary Calcium Scoring is a non-invasive way to obtain information about the location and extent of calcified plaque in the coronary arteries.

The goal of the heart scan for calcium scoring is to detect coronary artery disease (CAD) at an early stage before there are evident symptoms, such as chest pain, and to determine its severity. The heart scan can suggest the presence of CAD when the coronary arteries are less than 50% blocked. More than half of all heart attacks occur with less than 50% blockage.

What is involved with the test?

The test is performed on a Computed Tomography (CT) machine. While holding your breath the CT machine takes a series of pictures (X-rays) of your heart that will take approximately 20 seconds.

Who should get the test?

Anyone with multiple risk factors such as:

Find out your risk of developing coronary artery disease with a coronary calcium scoring heart scan by calling (940) 764-5050 to schedule one today.

Blood flow study/pressure wire

This is a procedure where a wire is passed though the artery to the area under examination. It measures the blood flow through the narrowed portion of the artery.

Cardiac catheterization

Cardiac catheterization is a diagnostic procedure during which a long thin tube called a catheter is placed in a blood vessel and then guided to the heart. The catheter may be inserted into either arteries or veins, depending on the information needed, in either an arm or leg.

An X-ray dye (contrast material) is injected through the catheter into the patient’s arteries while images are being taken. This will show the location and the severity of the blockage, and will measure how well the heart valves and heart muscle function. The catheter also serves the purpose of monitoring blood pressures in these different locations inside the heart.

Several specialized procedures may be performed during the catheterization, each tailored to the patient’s special needs. The catheterization takes several hours, depending on the complexity of the procedure.

Why is this procedure necessary?

While stress tests, electrocardiograms (EKG), echocardiograms, and physical examinations provide considerable information on heart muscle function and the status of the valves and surrounding tissue, these procedures do not provide all the answers. Cardiac catheterization allows the physician to see an outline of the coronary arteries and more precisely determine the extent of blockages in these vessels.

All of the above procedures are used together to obtain as much information as possible so that an accurate diagnosis can be made and proper treatment provided.


This procedure helps determine the size of the heart and thickness of the chambers by using a high-frequency ultrasound waves. It also shows if there is: fluid around the heart; abnormalities with any of the heart structures; how well the heart is able to pump blood; and if any of the heart valves are narrowed or leaking.

Electrophysiology (EP) studies

An EP study is a method of assessing the heart’s electrical system. A special electrode catheter is inserted into the heart which locates sites inside the heart that may be causing abnormal heart rhythms. The catheters can also deliver tiny impulses that stimulate parts of the heart.

Transesophageal Echocardiogram (TEE)

The TEE is an echocardiogram, but instead of imaging through the chest wall, images are taken via a tube that is passed into the esophagus and stomach. This test provides very clear images of the heart structures, blood flow and clots in the heart. Patients are typically placed under light anesthesia during the procedure. The TEE is used to:

Intravascular Ultrasound (IVUS)

Intravascular ultrasound is a catheter-based system that allows physicians to obtain images of diseased vessels from inside the arteries. This diagnostic procedure is used to detect the severity of the blockage which is not visible on the cardiac catheterization.

With IVUS, a miniature sound probe on the end of a catheter is inserted into the arteries. The probe uses ultrasound to see the plaque area and amount, as well as the size of the vessel and the lumen (the internal opening of the artery) from the inside.

Nuclear Stress Test

This procedure shows how well blood flows to the heart muscle while the patient is at rest and during physical exertion. A radioactive substance is injected into the body that allows images of the heart to determine how well the heart muscle is receiving blood, if the heart is damaged, and if any of the arteries that feed the heart are blocked.