• Diagnosing Angina

    Type Size

    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
    • Nausea
    • Lightheadedness
    • Weakness
    • Anxiety

    Click here to learn more about the symptoms of angina including how they can be different for women and men.

    Personal Characteristics

    Your doctor will also consider the following:

    • age
    • race
    • sex
    • weight

    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.

  • More About Angina/Chest Pain

    Type Size

    Angina Causes and Risk Factors

    Your heart is a muscle that works hard to pump blood throughout your body. To do that critical work, it needs oxygen. Oxygen is carried by the blood from the lungs and through the coronary arteries to the heart.

    Angina Treatment

    Angina is your body’s way of telling you that you have coronary artery disease (CAD). Plaque has built up in the arteries to the point where blood flow is restricted and your heart is not getting enough oxygen to do its work. Treating angina means treating this underlying problem. In other words, increasing the blood flow to your heart will ease your symptoms.

    Angina/Chest Pain

    Heart disease is the number one cause of death in the United States. And yet for so many, a heart attack seems like a bolt out of the blue. It isn’t. Heart disease develops over time and can affect you in many ways. A heart attack is just one way. Angina is another.

    Diagnosing Angina

    Angina is usually caused by coronary artery disease (CAD), so diagnosing angina really means diagnosing CAD—the underlying condition.

    Is Angina Ruining Your Life?

    Life was certainly easier before you had angina. But as scary and overwhelming as it is, it does not have to ruin your life. Medications, lifestyle changes, and in some cases medical procedures such as angioplasty and stenting, coronary artery bypass graft surgery (CABG), or enhanced external counterpulsation (EECP) are all treatment options that could help you live your life to the fullest. Take a few minutes to answer the questions below to see if you should talk with your doctor about doing more to treat your angina.

    Living with Stable Angina: Prepare Your Action Plan

    Angina can be painful and frightening but it doesn’t have to ruin your life. If you take action and work with your doctor to find a treatment plan that’s right for you, you can find relief from your symptoms. Learn what to do when angina strikes and how to work with your doctor on a long-term treatment plan.

    Questions to Ask Your Doctor About Angina

    Use the following questions as a tool to help you talk to your physician about your angina. Print them out and take them with you to your next appointment. Take notes to help you remember your discussion when you get home.

    Resources and Support If You Have Angina

    If you are looking for additional information and support, consider reading and hearing what others have to say about their experiences with angina.

    Symptoms of Angina

    According to the National Heart, Lung, and Blood Institute, as many as 7 million people in the United States have angina. So, if you have angina, you’re not alone—but how it feels can vary a lot from one person to the next.

    Tracking Your Angina Worksheet

    You know how angina feels to you, but can you describe it to someone else? Sometimes it’s difficult to find the right words to tell someone how you’re feeling. But the more you can share with your doctor about how often you have angina, how it feels, and how it is affecting your life, the more he or she can help.

    Treating Angina with COURAGE and FAME-2: Meds, Stents, or Both?

    Clinical trials and other studies provide important data for you and your doctor to consider when you work together to develop a treatment plan for your angina. Doctors and other healthcare professionals use evidence from these studies to develop guidelines for the most effective treatment for patients whose diagnosis, medical history, age, race, and other characteristics and circumstances are similar to those of patients in the study.

    What’s Causing Your Chest Pain?

    Chest pain is one of the most common symptoms of angina. You can learn more about Angina Causes and Risk Factors on this website, but chest pain can also signal other problems. This is why it is very important to discuss your symptoms with your doctor to determine the underlying problem and the best course of treatment.