Angina Diagnosing

Chest pain that is alleviated by rest and caused by physical exertion is a reasonably clear indication of angina. Those symptoms alone may be enough to make a medical diagnosis. However, medical diagnostic tests should be used to distinguish between symptoms of angina and symptoms of a heart attack.

Diagnostic tools such as the EKG, ultrasound, myocardial perfusion scan, and coronary angiography are used to monitor as well as diagnose angina. Progressive narrowing of the coronary arteries can eventually cause heart attacks.

EKG Results

An EKG, or electrocardiogram, is one of the mainstays of angina diagnosis and monitoring. An EKG tracks the heart’s electric impulses using electrodes attached to the chest. Deviations in EKG results provide clues about heart function.

A standard EKG produces quick results. Holter monitoring is an extended EKG test. Usually performed overnight, Holter monitoring provides several hours of EKG results. An EKG is often combined with a heart exercise stress test. While attached to the EKG, the patient uses a treadmill or stationary bicycle. EKG results provide important information about how the heart operates under stress and may capture evidence of an angina attack.

Ultrasound: Examining the Beating Heart

An echocardiogram uses ultrasound to examine the heart. A transducer emits high frequency ultrasound waves that “bounce” off the heart muscle. The returned ultrasound waves are detected by the transducer and transmitted to the echocardiography machine as electrical impulses. The electrocardiography machine’s computer then uses the information to form a picture of the heart on an ultrasound monitor.

Ultrasound is mainly used to assess blood flow from the heart and the integrity of the heart valves. A heart attack or long-standing angina can damage the heart muscle and the heart valves resulting in leakage, arrhythmias and further reduction of blood flow.

Coronary Angiography

Coronary angiography is used to detect obstructions in the coronary arteries. During a coronary angiogram, a dye is injected into the bloodstream, and x-rays are taken as the dye moves through the coronary arteries and the heart. The x-rays show the progress of the dye through the arteries: areas with scant amounts of dye or narrowings indicate obstructed coronary arteries.

Myocardial Perfusion Scan

A myocardial perfusion scan uses mildly radioactive material to create an image of blood flow to the heart muscle. Thallium-201 or technetium-99m is injected into the arteries. The radioactive material passes through the coronary arteries and is taken up by the heart muscle. Areas of the heart that receive a low amount of blood will not “light up” on the scan and allow the examiner to see exactly what section of the heart is in danger.

A myocardial perfusion scan is often combined with an exercise test to better evaluate the heart’s function under stress.

Heart Attack Diagnosis

Diagnostic tools used to evaluate angina are often used to diagnose heart attacks and other forms of heart disease. EKG, ultrasound, coronary angiography, and myocardial perfusion scan results can all provide information on the extent and severity of a heart attack.


British Heart Foundation. (nd). Cardiac Syndrome X. Retrieved January 29, 2004, from