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To find out if you have angina, your doctor will ask you some questions about your chest discomfort or pain and your health. He or she will also examine you and will probably suggest some tests.

It isn't always easy to diagnose angina because there are so many other causes of chest pain. Here are some things your doctor might do to figure out if you have angina.

Your doctor may ask you these questions.

• How would you describe the discomfort or pain you feel?
• What brings on this feeling?
• How long does it last and what makes it go away?
• Is there a regular pattern to it, and can you tell when it will happen?
• How long have you had it, and is it getting any worse?
• Do you smoke?
• Does heart disease run in your family?
• Do you have high blood pressure?
• Do you have high cholesterol?
• Do you have diabetes?
• What kind of work do you do?
• What kinds of foods do you eat?

If there is any doubt about what is causing your discomfort or pain, your doctor will ask you more questions. For more, see Other causes of chest pain.

Your doctor will give you a physical exam to learn more about what could be causing your symptoms. Here are some things he or she may do.

• Measure your blood pressure and feel your pulse. Your pulse tells your doctor how fast your heart is beating and if your heartbeat is regular.
• Listen to your heart, especially for any extra noises called murmurs. These may be a sign of a problem with your heart valves. Sometimes valve problems can cause angina.
• Listen to the blood flowing though the arteries in your neck to see if there are any extra noises. These noises could mean that your arteries are narrowed.
• Look for bumps under your skin that are a sign of high cholesterol. For example, you might have firm white bumps around your eyes. High cholesterol can put you at risk for narrowing of your arteries.
• Listen to your lungs for any extra noises while you breathe. These could be caused by lung disease or by heart failure. You can get heart failure if your heart is damaged so that it doesn't pump well.
• Measure your height and weight to figure out if you are overweight. If you are overweight, this puts an extra strain on your heart.
• Check for less common causes of angina. For example, your doctor will look for signs of anemia and an overactive thyroid gland. Both can cause angina. For more, see Other causes of angina.
• Check for causes of chest pain that don't have anything to do with your heart. For more, see Other causes of chest pain.

If you do have angina, your doctor will also try to find out what type you have. We have looked at treatments for the type called stable angina. But there are two other types. For more, see Other types of angina.

Your doctor may suggest you have some of these tests. After you have the results, your doctor may also suggest that you see a doctor who specializes in heart problems (a cardiologist).

The first test your doctor will suggest is an electrocardiogram, or ECG for short.¹ The ECG shows the electrical activity in your heart as a line on a graph. This test helps your doctor tell if your heart is beating properly and if you have certain heart problems. For more, see Tests for angina.

Your doctor will also suggest some blood tests. These can help tell if you have anemia, diabetes or high cholesterol. If your doctor thinks you might have an overactive thyroid gland, you'll need a blood test for that, too.

You will need an X-ray of your chest if your doctor thinks you might have lung disease or heart failure.

Your doctor might give you a treatment for angina to see if it takes away your discomfort or pain. The treatment is called nitroglycerin (NTG for short).

Your primary care doctor might set up a stress test. This test shows how much stress your heart can take before it is under too much strain. For more, see Tests for angina.

Your cardiologist can set up any more tests you need. Here's a list of some that he or she might suggest.²

• A stress test. Your cardiologist might suggest this test if your primary care doctor hasn't already.
• An echocardiogram. This test uses sound waves to make a picture of your heart. The picture shows how blood flows through your heart and if your heart is pumping properly, among other things.
• Coronary angiography. This test uses a dye to make your coronary arteries show up on an X-ray. It can show blockages. Your doctor might suggest this test right away if he or she thinks you have bad coronary artery disease.¹

For more, see Tests for angina.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.