Angina Symptoms & Diagnosis

Symptoms

• Pressure or squeezing chest pain
  • Some people do not experience the pain as severe
  • Elderly people, women, and people with diabetes more likely to have atypical or subtle symptoms
  • Some people have silent ischemia and experience no symptoms of chest pain
  • Chest pain of any kind deserves a medical evaluation to determine its cause
  • Chest pain or discomfort is the hallmark symptom of angina

The likelihood of a heart attack is increased when chest discomfort is severe, lasts more than 15 minutes, and is accompanied by other symptoms such as:

• Pain in the shoulder(s) or arm(s), or into the jaw
• Weakness
• Sweating
• Nausea
• Shortness of breath

Diagnosis

Tests will be done right away to see if you are having an episode of angina or a heart attack. If you have a stable pattern of angina, other tests may be done to determine the extent of your disease. The test results will help to create a treatment plan.

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

• Blood tests—to look for certain blood markers to determine if you are having a heart attack
• Electrocardiogram (ECG, EKG) —a record of the heart's electrical activity, to look for evidence of past heart attacks, acute heart attacks, or heart rhythm problems
• Echocardiogram —high-frequency sound waves (ultrasound) to examine the structure and function of the heart
• Exercise stress test —records the heart's electrical activity during increased demand
  • A medication is used to simulate the effects of physical exertion for those that can not exercise
• Nuclear scanning—radioactive material is injected into a vein to highlight areas with low blood flow
• Electron-beam CT scan (coronary calcium scan, heart scan, CT angiography )—a type of x-ray that uses a computer to make detailed pictures of the heart, coronary arteries, and surrounding structures
  • Type of CT scan measures the amount of calcium deposits in the coronary arteries to determine the risk of heart disease or heart attacks
  • American Heart Association (AHA) guidelines state that heart scans are not for everyone and are most likely to benefit patients at intermediate risk of CAD
• Coronary angiography —dye is injected into the arteries to highlight abnormalities (narrowing or blockage) in the arteries