Angina, generally referred to as angina pectoris, is one form of chest pain that occurs due to insufficient blood supply to the heart muscle. Though it is not a standalone illness, angina is often associated with coronary artery disease (CAD). Early detection of angina can avert some dire heart problems like heart attacks and heart failure.

Why Is Timely Diagnosis of Angina Important?

Although the chest pain experienced during an angina attack resembles other illnesses, it serves as an indicator that the heart is not getting enough blood. Undiagnosed and untreated angina may result in:

Myocardial infarction (heart attack)
Arrhythmia (irregular heartbeats)
Sudden cardiac death

Timely diagnosis of angina helps practitioners identify and treat root problems, allowing for significant lifestyle adjustments, pharmacological therapy, or even surgery if the situation calls for it.

Symptoms That Lead to Angina Diagnosis

Angina symptoms and their associated signs can certainly aid in the diagnosis of the condition. Angina can be diagnosed from the symptoms described below:

Chest discomfort that can be described as pain, pressure, squeezing or burning.
Pain radiating to the shoulders, arms, jaw, neck, and back.
Breathing difficulties.
Fatigue or feeling lightheaded.
Sickness.
Perspiring.

These symptoms usually accompany some form of physical exertion and relieve with rest. Angina is usually of two types: stable angina, which is predictable, and unstable angina which is sudden or worsening.

Causes That Necessitate Diagnosis

The causes of this condition often help focus the scope of investigation. Obstruction of an artery due to plaque buildup leads to reduced blood supply to the heart muscle, which may be caused by:

Coronary artery disease (CAD): Narrowing or blockage of coronary arteries due to plaque buildup.
Coronary artery spasm: A temporary tightening of the muscle wall of an artery.
Anemia or hypoxia: Conditions that reduce the oxygen-carrying capacity of the blood.
Aortic stenosis: Narrowing of the aortic valve.
Hypertension: Increased workload on the heart.

The lack of these conditions often leads patients to a multitude of unexplained symptoms that doctors begin to investigate.

How Is Angina Diagnosed?

1. Medical History and Physical Examination

The initial phase in diagnosing angina involves gathering the medical history. The history includes:

Character and length of the chest pain
What triggers it (physical activity, certain meals)
Heart disease in relatives
Habits (smoking, diet, physical activity)
Other relevant medical issues (diabetes, hypertension)

Follows the history examination where the clinician evaluates the patient’s blood pressure, heart sounds, and assesses for signs of edema or poor perfusion.

2. Electrocardiogram (ECG or EKG)

Diagnostic test that is common for most patients with chest pain is an ECG. It is useful in diagnosing:

Arrhythmias
Evidence of a previous or current myocardial infarction
Ischemic changes (ischemia: lack of oxygen supply).

3. Stress Testing

A stress test may be done to evaluate the heart’s functional capacity. Types include:

Exercise stress test: A treadmill walk while ECG is recorded.
Pharmacologic stress test: For patients unable to exercise, medication mimics stress of physical activity.
Stress echocardiogram: Ultrasound combined with stress testing for dynamic imaging.
Nuclear stress test: Injection of radioactive tracer to visualize perfusion and identify hypoperfused areas.
These tests are very helpful in diagnosing stable angina.

4. Echocardiogram

An echocardiogram is a technique that uses sound waves to obtain images of the heart. It aids in:

Identifying heart muscle damage
Evaluating the function of the valves
Estimating ejection fraction (the efficiency of the heart’s pumping mechanism)
This procedure does not involve any surgical incisions and allows for real-time observation of the heart.

5. Blood Tests

Blood tests done routinely can identify various cardiac biomarkers such as troponin, which show signs of heart muscle injury. Other tests include:

Lipid profile: Evaluates the concentration of cholesterol in the blood
Sugar levels: Assess for diabetes
C-reactive protein (CRP): An inflammation marker
These tests help determine additional risk factors as well as ongoing damage to the heart.

6. Coronary Angiography

If contradicting evidence suggests there is a high probability of having coronary artery disease, one may recommend doing a coronary angiogram. This test consists of:

Catheterization of a coronary artery (through the groin or wrist)
Contrast dye injection
Taking X-ray images while monitoring the blood flow

This test is the gold standard in investigating the presence and degree of blockages or narrowing in the coronary arteries. It is done with the possibility of performing immediate treatment such as angioplasty and stenting.

7. CT Coronary Angiogram (CTA)

CT Coronary Angiogram is a less invasive form of conventional angiography. It is used for:

Visualizing the coronary arteries
Identifying the presence of plaque and narrowing
Evaluating the anatomy and function of the heart
It is very good for patients with intermediate risks for heart diseases.

8. Cardiac MRI

Offering detailed images of the heart’s anatomy and physiology, cardiac MRIs can be quite helpful in complicated scenarios. In addition to helping with complex cases, it can:

Identify regions with insufficient blood supply.
Determine extent of damage following a myocardial infarction.
Consider other possible causes of chest pain.

Differential Diagnosis – Ruling Out Other Conditions

Chest discomfort may not always be angina in nature; therefore, doctors may consider:

GERD (Gastroesophageal reflux disease)
Pulmonary embolism
Panic and anxiety disorders
Costochondritis (inflammation of the chest wall)
Aortic dissection

Hence, this necessitates a collaborative and comprehensive approach for diagnosis.

Conclusion

Angina poses significant risk from developing serious cardiovascular complications. Diagnosis can range from a simple ECG to more advanced methods such as angiography and a myriad of tools exists to detect underlying angina accurately. Delay in appraisal often results in exacerbation of condition, while timely intervention leads to vastly improved health outcomes.

If you or someone close experiences unexplained discomfort in the chest region, consult a cardiologist promptly so you are not missing out on timely intervention. Preventive measures go a long way in safeguarding cardiac well-being.