Angina is a condition commonly caused by underlying heart disease, such as coronary heart disease. Its symptoms consist of a tightness or pain in the chest, which often spreads to the surrounding body parts; dizziness, fatigue, weakness, nausea, and other similar signs may also accompany it. There are several types of angina, some of which may be managed over a long time, and others of which should be treated as an emergency. There are several methods for diagnosing angina and determining which type is present.
First Steps
The most frightening aspect of angina is its resemblance to a heart attack. And although angina is different from a heart attack, it can be indicative of such an occurrence in the future. Thus, according to the National Heart, Lung, and Blood Institute, the most important initial consideration is determining what's causing your chest pain. Once angina has been established, the type of angina becomes key.
The first step will always be a physical exam and review of the patient’s medical history. The risk of some heart diseases increases when there are coronary issues in the family. Additionally, if this isn’t the first time you’ve noticed chest pain, be prepared to answer questions about previous incidents, such as what triggered it (or what was going on at the time of the pain); how often, how long, and where the pain occurs; how severe it is; and if anything relieves the sensation. Once your doctor has gathered enough pertinent information to suspect angina, there are several tests available to make sure.
Diagnostic Testing
There are a variety of tests available, and each serves a different purpose. Blood tests may be given to look for certain suggestive enzymes, proteins, and the levels of fats, cholesterols and other things. Chest x-rays allow the physician to look at the lungs as well, and this may help rule out alternative diagnoses. The most common diagnostic tests for angina are:
- Electrocardiograms (EKG, ECG): An EKG involves attaching small electrodes to the patient. The machine then tracks and records the electrical signals given off by the heart. A physician or cardiologist can then review these recordings to look for slow or interrupted blood flow.
- Stress Test: Stress tests entail the use of an EKG and other monitoring while the patient exercises. Some types of angina are more easily diagnosed if the heart can be monitored during periods of activity. During a nuclear stress test, the patient is injected with a radioactive substance that can then be picked up with a scanner to create an image of the heart. The radioactive substance makes it so that if part of the heart isn’t getting enough blood it shows up differently on the image.
- Echocardiogram: Using an ultrasound machine, sound waves create moving pictures of the heart to look for problematic areas. For a better picture, transesophageal echocardiography uses a tube sent down the esophagus to get closer to the heart.
- Coronary angiography: After injecting dye into the heart’s blood vessels through a catheter, repeated images are taken using x-ray technology. According to the Mayo Clinic, this allows doctors a better look at the blood vessels, which could be blocked or subject to atherosclerosis.
- Computed tomography angiography: CTA is very similar to a coronary angiography, except that a CT machine is used. Shaped like a large donut, you lie in the center while it moves around taking multiple pictures from which a 3D image of the heart is formed.
