Angina Symptoms and Diagnosis

It is important to know what the symptoms of angina are. As mentioned earlier, chest pain can occur due to a number of reasons. Knowing the symptoms helps one to decide whether the uneasy feeling in his chest is actually because of angina or not.

The primary symptom of angina, as the name suggests, is a constricting, strangulating feeling in the chest region. This feeling is not the usual chest pain; it is more a feeling of uneasiness, like the presence of something heavy in the region. Sometimes there may be a tightening feeling in the chest region. This feeling usually starts off just beneath the breastbone.

As the duration of the attack increases, the pain radiates to other adjoining areas. It spreads to the neck, arms, and back. In some cases it can progress to the teeth and jaws as well. Other symptoms, besides the pain, include sweating, gasping for breath as the oxygen supply diminishes, cramping, heartburn, and indigestion.

In certain cases, when there is an associated stimulation of the autonomous nervous system, angina symptoms include a feeling of nausea, and a sudden fading of the skin color.

Diagnosing Angina

Any irregularity related to the heart is usually captured using an electrocardiogram (ECG, or EKG), which is taken when the patient is at rest. This is also called a resting ECG. A resting ECG is usually not very effective when it comes to angina, because angina is usually seen when the person is hyperactive - emotional or doing some heavy work.

Therefore to diagnose angina, a patient is connected to an ECG machine and asked to run on a treadmill, till he starts to experience chest pain. This is called an exercise ECG, or exercise tolerance test. If the patient actually has angina, the pain will appear, or changes in the ECG associated with the heart muscle lacking oxygen will be noticed may confirm presence of angina. The exercise ECG test has an accuracy level of 60% to 70%.

Thallium studies provide accurate diagnosis

Another method of determining angina is by performing a thallium scintigram. This test involves injecting a dosage of thallium intravenously while the patient is exercising. The thallium travels through the blood, illuminating its passage and showing up any blockages that may be there and restricting the flow of blood. This is a highly accurate test, with an accuracy level of around 80% to 85%.

Dipyridamole can help diagnose those unsuitable for exercise stress tests

Some people are infirm or too frail to undergo an exercise stress test. Dipyridamole, which increases the heart rate of sedentary people, can be administered to mimic the increased heart activity of those performing an exercise test so that an accurate thallium study can be performed.

Stress Echocardiography

Another method of determining angina is by stress echocardiography. Here, an echocardiogram is used in tandem with exercise treadmill testing. This is also a highly accurate test, as anomalies in muscle contraction are captured in an echocardiograph. The accuracy level of this test too stands at around 85%.

Imaging coronary arteries with arteriography (angiography)

While all these are ways of determining angina, another option is to check for coronary artery disease itself. This can be done by capturing x-ray images of the coronary artery walls using a process called coronary arteriography.

Narrowing of individual coronary arteries can be seen in the resultant x-ray images and an assessment made as to the severity of the problem.

A new technique is to use magnetic Resonance Imaging to produce images of the larger blood vessels and determine the presence of calcium or cholesterol in the arterial walls.

Angina Treatment >>