Ischaemia of the heart muscle – review of non-invasive diagnostic methods

The article is a review of accessible non-invasive diagnostic methods which are recommended by American cardiological associations. It is considered that the so-called intermediate risk of coronary artery disease is an indication to perform these examinations. The cheapest and the most popular examination is still resting ECG. The 24 h ECG plays an important role in the diagnostics of rhythm and conduction abnormalities, but as far as myocardial ischaemia is concerned the usefulness of this method is limited. Exercise test on a moving track or a cycle ergometer is characterized by high sensitivity and specificity, and it is most popular in the diagnostics of coronary artery disease. There is a big group of patients for whom this examination is for various reasons impossible to conduct or the exercise ECG record is non-diagnostic. In such a situation the patients are offered equally credible stress echocardiography or radioisotopic SPECT examination. As far as new diagnostic methods are concerned, attention should be paid to more often performed 32 or 64 row spiral computed tomography, magnetic resonance (rarely performed because of its cost) and PET.