Angina Diagnosis

A diagnosis of angina is based on a person's risk factor assessment, physical examination, laboratory tests, and other medical tests. In life-threatening situations, emergency treatment is started before the diagnosis is finalized.

Risk factor assessment

An angina risk factor assessment is based on person's medical history and the medical history of their family members. A doctor or other healthcare provider gathers information by asking specific questions. A questionnaire is often used to help organize the information.

• The medical history contains information about a person's:
  • Health (high blood pressure, diabetes, previously diagnosed heart disease condition, thyroid condition)
  • Lifestyle (physical activity, smoking, alcohol use)
  • Drug use (prescription and over-the-counter medications, supplements, herbs, illegal drugs)
• The family medical history contains information about health problems of family members.
  

Physical examination

The physical examination helps identify any heart disease symptoms. In addition to measuring a person's blood pressure and pulse, the doctor:

• Listens to the chest for abnormal heart and lung sounds.
• Examines the person's eyes, arms and legs, and skin.

Laboratory tests

Laboratory tests are ordered based on a person's risk factor assessment and physical examination. The tests check for test results that fall outside of the normal ranges. Laboratory tests for angina may include:

• BNP (brain natriuretic peptide, which is a cardiac biomarker)
• Cardiac enzymes (checks creatine kinase, myoglobin, and troponin)

Medical tests

Additional medical tests help:

• Identify the presence of a person's angina risk factors.
• Rule out other diseases.
• Identify the type and severity of angina.
• Determine a person's treatment options.

A person's risk factor assessment and physical exam determine which medical tests the doctor will order. Tests for the angina include:

• Chest X-ray
  A chest X-ray uses electromagnetic radiation to produce images of the heart, lungs, and blood vessels in the chest.
• Coronary angiography with cardiac catheterization
  Coronary angiography uses X-rays to examine the coronary arteries after a radiopaque substance is injected into a coronary artery using cardiac catheterization. Cardiac catheterization passes a thin, flexible tube through a coronary artery or into the heart's chambers.
• Echocardiogram or stress echocardiogram
  An echocardiogram uses sound waves (ultrasound) to create moving images of the heart. The test identifies blood flow, heart contractions, and muscle damage. During a stress echocardiogram, ultrasound images of the heart are taken before and immediately after walking on a treadmill or riding a stationary bike.
• Electrocardiogram (ECG, EKG)
  An ECG measures the heartbeat's rate and regularity.
• Nuclear stress test
  A radioactive tracer is injected into a person's bloodstream, and then a special camera shows the flow of blood through your heart and arteries.
• Stress test
  A stress test measures ECG and blood pressure while people exercise or after they take medication to make their hearts beat faster.