Angina Diagnosis: Understanding Symptoms and Diagnostic Methods

Angina, a common symptom of coronary artery disease, occurs when the heart muscle doesn't receive enough blood and oxygen. Diagnosing angina involves a combination of symptom evaluation and medical testing to determine the severity and cause of the condition. Here's a comprehensive overview of how angina is typically diagnosed.

Recognizing Typical Symptoms

The first step in diagnosing angina is identifying the characteristic symptoms. Patients often describe a feeling of pressure, tightness, or pain behind the breastbone. This discomfort typically lasts between 3 to 10 minutes and is usually triggered by physical exertion, emotional stress, or sudden changes in weather. The pain often subsides with rest or the use of nitroglycerin tablets. However, if chest pain persists for more than 30 minutes without relief, it could indicate a heart attack, which requires immediate medical attention.

Individuals at higher risk for angina include those with high cholesterol, hypertension, diabetes, smokers, and the elderly. These groups should be especially vigilant about monitoring any chest discomfort they may experience.

Diagnostic Tests and Procedures

In some cases, symptoms may not be clear or typical, making it necessary to rely on diagnostic tests to confirm angina. One of the most common tools used is the electrocardiogram (ECG). During an episode, an ECG may reveal changes in heart activity. Comparing resting ECGs with those taken after physical activity can provide valuable insights into how the heart responds to stress.

Advanced Imaging Techniques

For more detailed analysis, doctors may use advanced imaging technologies such as magnetic resonance imaging (MRI) or positron emission tomography (PET-CT scans). These tests can detect areas of the heart muscle that are not receiving adequate blood flow due to blockages or narrowing of the coronary arteries.

Invasive Diagnostic Procedures

If angina is strongly suspected and symptoms are typical, a coronary angiography may be performed. This procedure allows doctors to visualize blockages or narrowing in the coronary arteries. Additionally, the Fractional Flow Reserve (FFR) test may be used during angiography to assess the severity of coronary artery disease and guide treatment decisions.