Angina, stable - Diagnosis
In this section
To find out if you have angina, your doctor will ask you some questions about your chest discomfort or pain and your health. He or she will also examine you and will probably suggest some tests.
It isn't always easy to diagnose angina because there are so many other causes of chest pain. Here are some things your doctor might do to work out if you have angina.
Questions your doctor might ask
Your doctor might ask you these questions.
- How would you describe the discomfort or pain you feel?
- What brings on this feeling?
- How long does it last and what makes it go away?
- Is there a regular pattern to it, and can you tell when it will happen?
- How long have you had it, and is it getting any worse?
- Do you smoke?
- Does heart disease run in your family?
- Do you have high blood pressure?
- Do you have high cholesterol?
- Do you have diabetes?
- What kind of work do you do?
- What kinds of foods do you eat?
If there is any doubt about what is causing your discomfort or pain, your doctor will ask you more questions. For more, see Other causes of chest pain.
Physical examination
Your doctor will give you a physical examination to learn more about what could be causing your symptoms. Here are some things he or she might do.
- Measure your blood pressure and feel your pulse. Your pulse tells your doctor how fast your heart is beating and if the beat is regular.
- Listen to your heart, especially for any extra noises called murmurs. These can be a sign of a problem with your heart valves. Sometimes valve problems can cause angina.
- Listen to the blood flowing though the arteries in your neck to see if there are any extra noises. These noises could mean that your arteries are narrowed.
- Look for bumps under your skin that are a sign of high cholesterol. For example, you might have firm white bumps around your eyes. High cholesterol can put you at risk for narrowing of your arteries.
- Listen to your lungs for any extra noises while you breathe. These could be caused by lung disease or by heart failure. You can get heart failure if your heart doesn't pump well because it is damaged.
- Measure your height and weight to work out if you are overweight. If you are overweight, this puts an extra strain on your heart.
- Check for less common causes of angina. For example, your doctor will look for signs of anaemia and an overactive thyroid gland. Both can cause angina. For more, see Other causes of angina.
- Check for causes of chest pain that don't have anything to do with your heart. For more, see Other causes of chest pain.
If you do have angina, your doctor will also try to find out what type you have. We have looked at treatments for the type called stable angina. But there are two other types. For more, see Other types of angina.
Tests
Your doctor may suggest you have some of these tests.
An electrocardiogram (ECG)
The first test your doctor will suggest is an electrocardiogram, or ECG for short. The ECG shows the electrical activity in your heart as a line on a graph. This test helps your doctor tell if your heart is beating properly and if you have certain heart problems. For more, see Tests for angina.
Blood tests
Your doctor will also suggest some blood tests. These can help tell if you have anaemia, diabetes or high cholesterol. If your doctor thinks you might have an overactive thyroid gland, you'll need a blood test for that too.
An X-ray
You will need an X-ray of your chest if your doctor thinks you might have lung disease or heart failure.
A trial of treatment
Your doctor might try giving you a treatment for angina to see if it takes away your discomfort or pain. The treatment is called glyceryl trinitrate (GTN for short).
A stress test
Your GP or a doctor who specialises in heart problems (a cardiologist) may set up a stress test. This test shows how much stress your heart can take before it is under too much strain. For more, see Tests for angina.
Seeing a cardiologist
A cardiologist can set up any more tests you need. Here's a list of some that he or she may suggest.[1]
- A stress test: Your cardiologist may suggest this test if your doctor hasn't already.
- An echocardiogram: This test uses sound waves to make a picture of your heart. It's sometimes called an 'echo' for short. The picture shows how blood flows through your heart and if your heart is pumping properly, among other things.
- Coronary angiography: This test uses a dye to make your coronary arteries show up on an X-ray. It can show blockages.
For more, see Tests for angina.
References
- National Heart, Lung, and Blood Institute. What is angina? Available at http://www.nhlbi.nih.gov/health/dci. Accessed on January 16, 2006.
Glossary
- high cholesterol
- The term high cholesterol is a bit misleading. High levels of are actually good for you. But if you've been told that you have high cholesterol it means that your total cholesterol level is 5 or higher or your is 3 or higher or both. Having high cholesterol can make it more likely that you'll get certain diseases in your heart and arteries.
- high blood pressure
- Your is considered to be high when it is above the accepted normal range. The usual limit for normal blood pressure is 140/90. If either the first (systolic) number is above 140 or the lower (diastolic) number is above 90, a person is considered to have high blood pressure. Doctors sometimes call high blood pressure 'hypertension'.
- diabetes
- Diabetes is a condition that causes too much sugar (glucose) to circulate in the blood. It happens when the body stops making a called (type 1 diabetes) or when insulin stops working (type 2 diabetes).
- arteries
- Arteries are the blood vessels that take blood that is rich in oxygen and food away from your heart. The arteries carry this blood to all the tissues in your body.
- anaemia
- Anaemia is caused by having too few red blood cells. People with anaemia look pale and get tired easily, among other things.
- thyroid gland
- Your thyroid gland is a small organ that sits in your neck, just in front of your windpipe. It sends out a hormone called thyroxine. This acts on receptors within cells. By acting on the receptors it gives the cells a message to speed up their metabolism and work harder.
- heart failure
- When the heart loses its ability to push enough blood through the blood vessels, it is called heart failure.
- heart disease
- You get heart disease when your heart isn't able to pump blood as well as it should. This can happen for a variety of reasons.
- blood pressure
- Blood pressure is the amount of force exerted by the blood on the walls of the vessels that carry it. You can think of it like the water pressure in your home: the more pressure you have, the faster and more forcefully the water flows out of the shower. Blood pressure is measured in millimetres of mercury (written as mm Hg). When your blood pressure is taken, the measurement is given as two numbers, for example 120/80 mm Hg. The first, higher, number is called the systolic pressure, and the second, lower, number is the diastolic pressure. The systolic number is the highest pressure that occurs while the heart is pushing blood into the arteries. The diastolic number is the lowest pressure that happens when the heart is relaxing and is not pushing the blood.
- pulse rate
- Your pulse rate is the number of times that your heart beats in one minute. A normal rate is usually between 60 and 100 beats per minute, but the heart can speed up under certain circumstances, such as when you exercise or when you have an infection.
- X-ray
- X-rays are pictures taken of the inside of your body. They are made by passing small amounts of radiation through your body and then onto film. Larger amounts of radiation are used to treat some kinds of cancer.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
