Cardiac disease construction on the borderland

The diagnosis of possible heart disease in the well patient has undergone remarkable shifts over the past century. The traditional medical view places strong emphasis on the contribution of technological data to the diagnosis of disease. In the case of serious heart disease, cardiac diagnostic technologies can play a defining role but, more often in the clinical context, patients are assessed for heart disease which is minor. The question is whether disease is present at all. In this borderland between health and disease, the interpretation of technological data is inherently uncertain. The diagnosis then depends more heavily on the social utility of particular disease categories. Shifts in diagnostic categorisation are not therefore attributable solely to more extensive forms of cardiac imaging but are socially constructed in an interactive context which involves the technology, the medical profession and the wider social structures which exist at the time of diagnosis. Claims of technological certainty create a social space within which the medical profession generates disease categories. These shifting disease categories may serve the needs of patients but may also be influenced by those of other players.