Angina - Diagnosis

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Why is it important to establish the diagnosis of angina?

Angina is usually a warning sign of the presence of significant coronary artery disease. Patients with angina are at risk of developing a heart attack (myocardial infarction). A heart attack is the death of heart muscle precipitated by the complete blockage of a diseased coronary artery by a blood clot.

During angina, the lack of oxygen (ischemia) to the heart muscle is temporary and reversible. The lack of oxygen to the heart muscle resolves and the chest pain disappears when the patient rests or takes nitroglycerin. In contrast, the muscle damage in a heart attack may be permanent, if there is a delay in obtaining emergency treatment. The dead muscle turns into scar tissue when healed. A scarred heart that results from a heart attack cannot pump blood as efficiently as a normal heart, and can lead to heart failure.

Many patients with significant coronary artery disease have no symptoms at all, even though they clearly lack adequate blood and oxygen supply to the heart muscle. These patients have "silent" angina. They have the same risk of heart attack as those with symptoms of angina.

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See what others are saying

Comment from: Kathleen, 65-74 Female (Patient) Published: October 31

My first serious episode was during a divorce and was diagnosed as a panic attack. I was 35 then. I had a few episodes over the years that were mild - always at times of high stress but I ignored them. When I was 64 and working on a very stressful project with a very tight deadline when I suddenly had an extreme heaviness in my chest and pain in my shoulder and neck. I was having trouble getting a good breath so I had my husband take me to the emergency room where they gave me nitroglycerin which relieved the pain. The EKG was normal but the kept me overnight because the pain reoccurred. A stress test the next morning was slightly abnormal. The cardiologist I was referred to believed I had GERD because my cholesterol levels are so low, so he referred me for an endoscopy. That was negative but that doctor thought I might have esophageal spasms. That didn't seem right since nitroglycerin helped so I was finally able to get in to see my mother's cardiologist, who doesn't take new patients, and got the final diagnosis. I have the rarer variant angina just like my mother and just like I told the first doctor in my family history!

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Comment from: ghweigel3, 45-54 Male (Patient) Published: February 04

About five years ago I was having problems with severe chest pains and was rushed to the hospital emergency room. After describing my chest pain I had an angiogram done and a chemical stress test was done the next day. The hospital doctor diagnosed me with angina and I was given Nitrostat to take when chest pains occur. I have been having chest pain about twice a month since then but recently the frequency of the pain increased to 2 or 3 times per week. Yesterday I saw my primary care doctor and explained my situation. I had and EKG and blood work done. I also have to have a chest x-ray and a chemical stress test done. She also prescribed Nitrostat and told me if chest pains persist after taking 3 Nitrostat pills to go to the emergency room at the hospital.

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