Tests and Diagnosis of Angina of Effort

It is essential to examine a patient thoroughly in order to make an accurate and early diagnosis. Patients often fail to tell their doctors about some sensations because they feel they are unrelated to the heart. Instead, patients may emphasize secondary symptoms, which add some difficultly in diagnosing angina.

In order to confirm the diagnosis a number of tests should be performed:

• ECG – a simple, affordable and informative method of effort angina diagnosis. The most informative ECG is the recording made during the attack;
  
  
• Bicycle ergometry, treadmill-test, cold pressure test, etc. Stress tests play a significant role in the diagnosing of angina of effort. During these tests the conditions that increase myocardial oxygen demand are created, which then make possible to detect probable myocardial ischemia during the exercise;
  
  
• Holter monitoring. This procedure involves recording of ECG during the whole day with the help of a portable ECG device. Patients keep a diary and write down all the activities they perform. The analysis of this data helps identify the episodes of myocardial ischemia;
  
  
• Ultrasound of the heart. It is performed to evaluate the state of the valve apparatus, and detect any myocardial contractility disorders, which may be an indirect sign of the myocardial ischemia;
  
  
• Biochemical blood test (cholesterol, lipid profile, etc.). The data obtained may indicate the increased risk of atherosclerotic vascular disease;
  
  
• Coronary angiography – an invasive X-ray test of the coronary arteries. This method provides detailed understanding of the arterial involvement nature;
  
  
• Nuclear medicine examination in combination with stress test provides valuable information about the nature of the disease. This examination helps evaluate the blood flow in the cardiac muscle and thus, not only confirms ischemia but also reveals its location as well as the volume of the heart muscle suffering from ischemia.

Next chapter: Angina of Effort treatment and prevention