Common Methods for Diagnosing Angina Pectoris

Angina pectoris, a common symptom of coronary artery disease, can be diagnosed through a combination of clinical evaluation and diagnostic tests. Proper diagnosis is essential for effective treatment and risk management.

Initial Assessment and Medical History

The diagnostic process often begins with a thorough review of the patient's symptoms, medical history, and risk factors. Typical angina symptoms include chest discomfort triggered by physical exertion or emotional stress and relieved by rest or nitroglycerin. Doctors also consider age and the presence of risk factors such as hypertension, diabetes, smoking, and family history of heart disease.

Electrocardiogram (ECG)

An ECG is one of the most fundamental tools in diagnosing angina. During an angina episode, the ECG may show ST-segment and T-wave changes indicative of myocardial ischemia. Once the symptoms subside, these changes often normalize, which supports the diagnosis of angina. However, if the ECG is normal between episodes, additional testing may be necessary.

Stress Testing

In cases where the ECG during an angina attack is not captured, a stress test—such as treadmill exercise testing—can be performed. This test evaluates how the heart responds to physical activity and can reveal signs of reduced blood flow to the heart muscle, which may not be apparent at rest.

Coronary Computed Tomographic Angiography (CTA)

Coronary CTA is a non-invasive imaging method that provides detailed information about the coronary arteries, including the severity of luminal narrowing and characteristics of plaque buildup. In experienced medical centers, coronary CTA has become a valuable alternative to invasive angiography for diagnosing coronary artery disease.

Invasive Coronary Angiography

When a definitive diagnosis is required, especially before considering interventions such as stenting or bypass surgery, invasive coronary angiography is performed. This gold-standard diagnostic procedure allows physicians to visualize the coronary arteries directly, assess the extent of blockages, and plan appropriate treatment strategies.