ANGINA DIAGNOSIS

Physicians can usually diagnose angina based on the patient's symptoms and the precipitating factors. However, other diagnostic testing is often required to confirm or rule out angina, or to determine the severity of the underlying heart disease.

Electrocardiogram (ECG)

An electrocardiogram is a test that records electrical impulses from the heart. The resulting graph of electrical activity can show if the heart muscle isn't functioning properly as a result of a lack of oxygen. Electrocardiograms are also useful in investigating other possible abnormal features of the heart.

Stress test

For many individuals with angina, the results of an electrocardiogram while at rest will not show any abnormalities. Because the symptoms of angina occur during stress, the functioning of the heart may need to be evaluated under the physical stress of exercise. The stress test records information from the electrocardiogram before, during, and after exercise in search of stress-related abnormalities. Blood pressure is also measured during the stress test and symptoms are noted. A more involved and complex stress test (for example, thallium scanning) may be used in some cases to picture the blood flow in the heart muscle during the most intense time of exercise and after rest.

Angiogram

The angiogram, which is basically an x ray of the coronary artery, has been noted to be the most accurate diagnostic test to indicate the presence and extent of coronary disease. In this procedure, a long, thin, flexible tube (catheter) is maneuvered into an artery located in the forearm or groin. This catheter is passed further through the artery into one of the two major coronary arteries. A dye is injected at that time to help the x rays "see" the heart and arteries more clearly. Many brief x rays are made to create a "movie" of blood flowing through the coronary arteries, which will reveal any possible narrowing that causes a decrease in blood flow to the heart muscle and associated symptoms of angina.