I’m not a doctor, just a patient. I think the gold standard short of the cath lab is a nuclear stress test where they put dye into your veins and do scans before and after exercising. I believe you have to have symptoms like chest pain or trouble breathing before a nuclear test is covered by insurance.
What probably happened to Sanders is what happened to me. I had a syncope incident followed by breathlessness. I was take by ambulance who did a EKG which was normal. At hospital they drew blood early in morning (to test for changes in the blood that indicate a your heart was stressed) my first results were negative but results from a test later in day came back elevated. I was then sent to cath lab where they send a probe into the veins that serve the heart that measure blockages and if a partial blockage how well the blood is flowing by the blocked area. For me their were partial blockages but not enough to warrant a stent.
Two years after that the doctors want me to do a nuclear stress test to see if any sign of additional blockage. Apparently my recent nuclear stress test is much better than the base line when I had my heart attack.
I have seen the information regarding the places that will scan you for plaque but do not know how well the results are in false positives and false negatives. My recommendation is to discuss any symptoms you may be having with your GP and see if h/she would give you referral to cardiologist.
I had something similar years ago. Spent a week in the hospital..only for them to finally figure out I had vasodepressor Syncope after putting me on a tilt table.
One more thing that I learned about heart attacks and blockages that may be important to women (i’m a guy). The doctors do not know why my heart attack occurred. My veins are not blocked enough to cause a heart attack. They speculate that a spasm occurred in my veins causing the blood flow to stop and then a partial blockage may be more dangerous.
What I learned is that for women spasms are more common and very little research has been done. So even if you have little or no blockage a spasm can still cause a heart attack.
There is medication -calcium channel blockers- which can lower the risk of a spasm.