Your doctor may suspect that you have angina based on your symptoms and your risk of coronary artery disease. The doctor will review your medical history to see if you smoke (or have smoked) and whether you have diabetes and high blood pressure. Your doctor will ask about your family's medical history and will review your cholesterol levels, including LDL (bad) and HDL (good) cholesterol.
The doctor will check your blood pressure and pulse, and listen to your heart and lungs. You may need one or more diagnostic tests to determine if you have coronary artery disease. Possible tests include:
Electrocardiogram (EKG) — An EKG is a record of your heart's electrical impulses. It can identify problems with heart rate and rhythm. Sometimes it can show changes indicating a blocked artery.
Stress test — If your EKG is normal and you are able to walk, you'll be sent for an exercise stress test will be ordered. You'll walk on a treadmill while your heart rate is monitored. Other stress tests use medications to stimulate the heart, inject dyes to look for blockages and take ultrasound pictures to provide more information.
Coronary angiogram — These X-rays of the coronary arteries are the most accurate way to measure the severity of coronary disease. A thin, long, flexible tube (called a catheter) is inserted into an artery in the forearm or groin. The doctor guides the catheter toward the heart using a special camera. Once the catheter is in position, dye is injected to show blood flow inside the coronary arteries, highlighting any areas that are narrow or blocked.