A diagnosis of angina pectoris is usually made on the basis of:

• the symptoms described by the sufferer
• the patient’s medical history
• a physical examination.
  

Electrocardiogram (ECG)

An electrocardiogram or ECG assesses how quickly and frequently the heart beats and can sometimes detect signs that the heart muscle is not receiving enough oxygen. It is a simple, painless test that records electrical activity in the heart via electrodes attached to the chest and limbs and can be performed in the doctor’s office or hospital outpatient clinic.

An ECG may be performed while a patient is “at rest”, meaning that he/she is sitting or lying down, or before, during, and after undertaking some light exercise.

The latter is known as an exercise tolerance test or exercise stress test. The exercise, such as walking on a treadmill or pedaling an exercise bike, may be performed until the patient develops chest pain or other symptoms. This gives an indication of how well the heart responds.

In many patients with angina, an ECG performed at rest shows no abnormalities.

Coronary angiogram

Also known as cardiac catheterization, a coronary angiogram usually needs to be performed during a day visit to hospital. The test is used to see the heart’s blood vessels and can show whether or not these are blocked.

To perform the test, a long flexible tube called a catheter is inserted into an artery in the arm or leg and threaded along until it reaches the heart. A dye is then injected through the catheter, allowing the heart and coronary arteries to be seen on an X-ray machine.

Myocardial perfusion scan

Also known as a radioisotope scan or stress imaging. This test is used to detect how much blood flows through the heart during exercise. To do this, a small amount of radioactive substance is injected into the blood. The patient then exercises while a special camera positioned close to the chest detects the radiation and highlights which parts of the heart muscle are short of blood.