Tests and Diagnosis for Angina

Initial Diagnosis

To make a diagnosis the doctor starts by carrying out an assessment by:

• Asking questions about what brings on the pain, what relieves it and ruling out other possible causes of pain.
• Checking for any risk factors that may be contributing to your angina.
• Taking blood: to check your haemoglobin (for anaemia), your blood glucose (for diabetes) and your cholesterol level. 
• Taking or sending you for an electrocardiogram (ECG), which gives a record of the electrical activity of the heart when you are at rest. This is a painless test where small patches called electrodes are attached to your chest, wrist and ankles.
  

The doctor may refer you to a clinic where further tests and investigations can be carried out.

Further Tests and Investigations

Exercise ECG or Exercise Treadmill Test (ETT): This is not a way of measuring how fit you are.  An ETT records the activity of your heart as you walk on a treadmill.  There will be staff to supervise you throughout.  It is used to help diagnose coronary artery disease and assess how severe it is.

Chest x-ray: This is a picture taken using high frequency radiation.  The health of your lungs, heart, bones and gullet can be checked using an x-ray. 

Echocardiography: Known as an ‘echo’ this is an ultrasound scan of the heart.  High frequency pulses are sent via a probe on the chest.  Lubricant jelly is rubbed on the chest first to ensure good contact.  An ‘echo’ shows the structure of the heart.  The speed and direction of blood flow within the heart can also be looked at.  The test is not painful.

Myocardial Perfusion Scan:  This is helpful in people who are not suitable for an ETT.  A tiny amount of radioactive material is injected into the blood stream.  This is sometimes done in two parts, at rest and also whilst exercising.  A special camera is able to show the heart muscle working and assess the extent of the problems resulting from narrowed arteries.

Magnetic Resonance Imaging (MRI) Scan:  Magnetic Resonance Imaging allows pictures of your heart to be taken by putting you inside a large magnet.  You need to lie very still and take off all jewellry.  This test is painless but you may hear ‘knocking’ while the scan is being done. 

Angiography (cardiac catheterisation):  This is an x-ray examination of the coronary arteries.  Under local anaesthetic a catheter (thin tube) is inserted into a main artery in the wrist, arm or groin and then passed gently through the blood vessels until it reaches the heart.  Injecting some dye through the catheter allows the coronary arteries to be seen using a special camera.  These show up any narrowing in the arteries and give a lot of information to the cardiologist.

NHS Tayside have also produced information dealing with Cardiac Catheterisation.

Last updated: 14/11/2007