Making the Diagnosis
To diagnose angina, a doctor will evaluate the symptoms and the triggers (e.g., exercise, meals). Certain tests may also be performed. Because angina in most people occurs during exertion, the most common test for angina involves running on a treadmill or performing some other exercise while hooked up to an electrocardiogram (ECG) monitor. This simple device can show changes in the heart's electrical activity, which signals ischemia. This is called an exercise stress test. Some people with angina show normal results on these tests; such people are far less likely to suffer a fatal heart attack than those whose ischemia can be detected.
In some cases, people are injected with a mildly radioactive dye for pictures to be taken before and after exercise. (This is safe, except for pregnant women or the rare person who is allergic to the special dye.) The procedure allows the blood supply through the heart muscle to be seen by a rotating camera in a test called an exercise cardiac scan.
The insides of the coronary arteries can also be seen directly in a procedure called coronary angiography.