Angina is usually caused by coronary artery disease (CAD), so diagnosing angina really means diagnosing CAD—the underlying condition.
Your doctor or cardiologist will consider a number of factors before determining whether your angina is from CAD. First, your doctor will want to know how you are feeling. Try to be as descriptive and specific as possible when describing your symptoms. Here are some of the most common symptoms of angina:
- Pain, pressure, or a tightness in the chest, arms, neck, jaw, shoulders, or back
- Difficulty breathing or trouble catching your breath
Click here to learn more about the symptoms of angina including how they can be different for women and men.
Your doctor will also consider the following:
Medical and Family History
Your doctor will want to know if you or anyone in your family has a history of heart disease and diabetes. If they do, you are greater risk for CAD and angina.
The diagnosis of angina may be suspected by listening to your symptoms. Generally though, the actual diagnosis will be made by testing that confirms the presence of CAD. Tests for CAD may include:
- Blood tests are a key diagnostic tool that your physician will consider in conjunction with other test results and your individual risk factors, including your current health and individual and family medical histories.
- An electrocardiogram (ECG or EKG) records the electrical activity in your heart. It can detect abnormalities in your heart's rhythm and certain patterns that suggest portions of the heart may not be getting enough blood flow.
- A chest x-ray produces an image of the inside of the chest showing the bones, heart and blood vessels. Although chest x-rays are not as sophisticated as some other diagnostic technologies, they provide information that cannot be obtained in an examination.
- An echocardiogram, sometimes called a Doppler, heart ultrasound,or“echo,” is a noninvasive test that uses sound waves to create a moving picture of the heart.
- During a stress test(exercise treadmill stress test, echo stress test, or nuclear stress test), you will usually exercise by walking or running on a treadmill, or by pedaling a stationary bicycle. While your heart is working hard, one of several types of stress tests will be used to evaluate how much blood flow is getting to the heart and how effectively the heart is pumping.
- A CT coronary angiogram is a noninvasive test, which is essentially a specialized CT scan that provides pictures of the arteries of the heart.
- A conventional coronary angiogram/cardiac catheterization is an invasive test where an interventional cardiologist threads a slender, flexible tube called a catheter into the arteries of your heart and injects x-ray dye. The dye allows the interventional cardiologist to see inside your arteries, find any blockages, measure how severe they are, and determine what kind of treatment is needed. The conventional coronary angiogram is considered the gold standard for diagnosis of CAD. Angioplasty and stenting can be done at the same time to reduce the blockage.
Most commonly, a stress test may suggest the presence of CAD and then, due to the abnormal stress test, the patient will then be sent for further testing with either a CT coronary angiogram or a conventional coronary angiogram. These two tests actually show the blockage in the vessel wall and confirm the diagnosis of CAD.