First, your doctor will do a physical exam and ask about your symptoms. Tests to diagnose angina include:
- Electrocardiogram (ECG or EKG) to see if the blood flow through your heart has been slowed or interrupted or if you're having a heart attack.
- Stress test.
- Echocardiogram to produce images of the heart.
- Nuclear stress test to measure blood flow to your heart muscle at rest and during stress.
- Chest X-ray to look for other conditions that might explain your symptoms and to see if you have an enlarged heart.
- Blood tests for the presence of certain heart enzymes.
- Coronary angiography to examine the inside of your heart's blood vessels.
- Cardiac computerized tomography (CT) scan to collect images of your heart and chest.
- Cardiac MRI to see detailed images of your heart's structure and its blood vessels.
The goals of treatment for angina are to reduce the frequency and severity of your symptoms
and to lower your risk of a heart attack and death
- Lifestyle changes if your angina is mild:
- If you smoke, stop smoking. Avoid exposure to secondhand smoke.
- If you're overweight, talk to your doctor about weight-loss options.
- Eat a healthy diet with limited amounts of saturated fat, lots of whole grains, and many fruits and vegetables.
- Start a safe exercise plan.
- Pace yourself and take rest breaks.
- Treat diseases or conditions that can increase your risk of angina, such as diabetes, high blood pressure and high blood cholesterol.
- Avoid large meals that make you feel overly full.
- Avoiding stress by learning about stress-reduction techniques.
- Limit alcohol consumption to two drinks or fewer a day for men, and one drink a day or less for women.
- Medications include:
- Nitrates. It relax and widen your blood vessels, allowing more blood to flow to your heart muscle.
- Aspirin. It reduces the ability of your blood to clot, making it easier for blood to flow through narrowed heart arteries.
- Clot-preventing drugs. They can help prevent blood clots from forming by making your blood platelets less likely to stick together.
- Beta blockers. They work by blocking the effects of the hormone epinephrine, also known as adrenaline.
- Statins. They work by blocking a substance your body needs to make cholesterol.
- Calcium channel blockers. They relax and widen blood vessels by affecting the muscle cells in the arterial walls.
- Blood pressure-lowering medications. They bring your blood pressure down.
- Ranolazine (Ranexa). It can be used alone or with other angina medications.
- Medical procedures and surgery such as angioplasty, stenting and coronary artery bypass surgery.