What is angina and how do we diagnose it?

By: Dr. Christian Avalos
DHR Health Heart Institute

The evaluation of chest pain is one of the main reasons for outpatient visits in Cardiology and can be a diagnostic challenge given the variety of causes such as musculoskeletal, gastrointestinal, or pulmonary. As cardiologists, angina is one of the primary causes we evaluate closely in patients with multiple risk factors for atherosclerosis.

Angina is chest pain provoked when the heart does not receive enough blood and oxygen such as in coronary artery disease. This occurs when plaque builds up in the arteries of the heart and causes them to narrow. Angina can present as pressure, heaviness, tightness, or constriction in the center or left of the chest that is triggered by exertion and relieved by rest. Diabetics, elderly women, and younger adult patients may have atypical symptoms such as weakness, nausea and vomiting, palpitations, or loss of consciousness.

The first step in diagnosing angina includes an electrocardiogram which records the electrical activity of the heart to detect abnormal rhythms or heart muscle damage. A stress test may be used to detect coronary artery disease and involves walking on a treadmill to monitor the heart’s function under stress such as exercise. An alternative study used in patients with limited mobility is a nuclear stress test which uses medications to stimulate the heart like during exercise. In severe cases, a cardiac catheterization may be necessary. This procedure requires using catheters to inject contrast into the coronary arteries and obtain X-ray images to locate any blockages.

The best way to reduce the risk of angina is by managing risk factors such as lowering high blood pressure, lowering high cholesterol levels, quitting cigarette smoking, exercising, and weight loss. Patients with suspected angina should note their pattern of symptoms and seek an evaluation from their primary care physician or cardiologist. If you have questions regarding your heart health or would like to speak to one of our experts, please contact the DHR Health Heart Institute at (956) 362-8340.