Symptoms:

Symptoms of angina may include:

• Chest pain that you may also feel in the shoulder, arm, jaw, neck, back, or other area
• Discomfort that feels like tightness, squeezing, crushing, burning, choking, or aching
• Discomfort that occurs at rest and does not easily go away when you take medicine
• Shortness of breath
• Sweating

With stable angina, the chest pain or other symptom only occurs with a certain amount of activity or stress. The pain does not occur more often or get worse over time.

Unstable angina is chest pain that is sudden and gets worse over time. You may be developing unstable angina if the chest pain:

• Starts to feel different, is more severe, comes more often, or occurs with less activity or while you are at rest
• Lasts longer than 15 - 20 minutes
• Occurs without cause (for example, while you are asleep)
• Does not respond well to a medicine called nitroglycerin
• Occurs along with a drop in blood pressure or shortness of breath

Unstable angina is a warning sign that a heart attack may happen soon. It needs to be treated right away. If you have any type of chest pain, see your doctor.

Signs and tests:

The doctor will perform a physical examination and check your blood pressure. The doctor may hear abnormal sounds, such as a heart murmur or irregular heartbeat, when listening to your chest with a stethoscope.

Tests for angina include:

• Blood tests to show if you have heart tissue damage or are at a high risk for heart attack, including troponin I and T-00745, creatine phosphokinase (CPK), and myoglobin
• ECG
• Echocardiography
• Stress tests
  • Exercise tolerance test (stress test or treadmill test)
  • Nuclear stress test
  • Stress echocardiogram
• Coronary angiography (taking pictures of the heart arteries using x-rays and dye) -- this is the most direct test to diagnose heart artery narrowing)