Heart checkup: When tests for heart health may be appropriate

A New York patient discovered a 99% blockage in a major heart artery after testing, and cardiologists say choosing tests depends on individual risk factors and symptoms.

Christopher Malin, 59, had routine screenings but reported new dull left shoulder and arm pain with exercise. His primary care doctor ordered an EKG and an exercise stress test with nuclear imaging. Those results led a cardiologist to perform a coronary angiogram, which showed a 99% blockage of the left anterior descending artery. Interventional cardiologists placed a stent and the patient was discharged the same day. Tests and findings: - Patient: 59-year-old from Melville, New York, with high blood pressure and a family history of heart disease. - Symptoms were reported as dull, intermittent left shoulder and arm pain during exercise. - Initial tests included an electrocardiogram (EKG) and an exercise stress test with nuclear imaging. - A coronary angiogram was reported to show a 99% blockage in the left anterior descending (LAD) artery. - Interventional cardiology placed a mesh stent to restore blood flow, and the patient left the hospital later the same day. - The article lists common diagnostic options—cardiac MRI, chest X-ray, coronary calcium CT, CT angiography, echocardiogram and EKG—and summarizes what each test can show about heart structure or risk. Summary: The case illustrates how targeted testing can identify serious coronary disease that might not be apparent from routine checks alone. Doctors reported that selecting appropriate tests is individualized and depends on a patient’s symptoms, risk factors and clinical assessment.