What Are the Diagnostic Criteria for Angina?

Angina, a common symptom of coronary artery disease, is diagnosed through a combination of clinical evaluation and diagnostic testing. Understanding the criteria for diagnosing angina is essential for timely and accurate treatment.

Key Diagnostic Standards for Angina

1. Clinical Symptoms

One of the primary indicators of angina is the presence of specific symptoms. Patients often experience chest pain or discomfort, which may be accompanied by a feeling of tightness or pressure in the chest. Additional symptoms may include palpitations, shortness of breath, and a sense of unease or anxiety. These symptoms are typically triggered by physical exertion or emotional stress and tend to subside with rest or medication.

2. Electrocardiogram (ECG) Changes

An ECG is a crucial diagnostic tool used to detect changes in heart rhythm and electrical activity. During an angina episode, the ECG may show ST-segment depression or T-wave inversion, indicating myocardial ischemia. However, these changes may not always be present, especially in cases of stable angina or when the test is performed during a non-episode period.

3. Coronary CT Angiography (CTA)

Coronary CTA is a non-invasive imaging test that provides detailed images of the coronary arteries. It helps identify blockages or narrowing in the arteries that could be causing angina. This test is particularly useful for patients with intermediate risk or inconclusive ECG results, offering a clear view of the heart's blood vessels without the need for more invasive procedures.

4. Coronary Angiography – The Gold Standard

Coronary angiography remains the most accurate method for diagnosing angina. This invasive procedure involves injecting a contrast dye into the coronary arteries and using X-ray imaging to visualize blood flow. It is considered the gold standard due to its high diagnostic accuracy.

If the angiography results are negative, it is unlikely that the patient suffers from significant angina. On the other hand, if the results are positive and show a blockage of 75% or more in the coronary artery, this indicates severe angina requiring immediate medical attention and potential intervention such as stenting or bypass surgery.