Information for the public
Investigations for stable angina
Some tests may not be appropriate for you, depending on your exact circumstances. If you have questions about specific tests and options covered in this information, please talk to a member of your healthcare team.
Your healthcare professional, usually your GP, should ask you about your chest pain and other related symptoms you have now, and any you have had in the past. They will also want to know whether you have a history of coronary heart disease. You will be checked for cardiovascular risk factors. With your permission, your healthcare professional should also examine you physically. This is to check for any signs of other cardiovascular disease, other causes of stable angina or other reasons for your chest pain.
If your healthcare professional thinks that that you have stable angina, further tests will be needed to make a diagnosis. An electrocardiogram (ECG) should be taken as soon as possible to check your heart. You should also be offered a test called CT (computed tomography) coronary angiography (see tests used to diagnose stable angina) and a blood test to check for any conditions that could make angina worse, for example, anaemia. You may be offered treatment with aspirin (unless you are already taking it regularly or you are allergic to it) while you have further tests done.
If your healthcare professional thinks it is unlikely that you have stable angina, they should consider what else could be causing your chest pain. You may not need further tests, but sometimes a chest X‑ray, for example, may be carried out to help find out what is wrong.
If your chest pain is not related to your heart, but you have any cardiovascular risk factors, you should be offered advice and you may be offered treatment to help lower your cardiovascular risk.
Tests used to diagnose stable angina
A number of tests are used to help diagnose stable angina. You should be offered information about the risks and benefits of these tests.
What tests should I be offered to find out if I have stable angina?
The following tests are recommended in the NICE guideline, some of which may be appropriate for you. You should be offered CT coronary angiography if your healthcare professional thinks you have stable angina and you may also be offered more of the following tests. You can find more detailed information from the organisations listed in sources of advice and support.
CT coronary angiography uses a type of X‑ray called computed tomography (CT) scanning. Dye is injected into the person's veins to show whether the coronary arteries are narrowed or blocked.
Invasive coronary angiography uses X‑rays to see how dye (called contrast medium) moves through the arteries up to the heart. This shows whether there are any narrowed or blocked arteries. It is invasive because it involves a fine, hollow tube called a catheter being inserted through the artery of the person's leg or arm and up to the heart.
Functional imaging tests show how the heart works under stress. Different tests can be used depending on the circumstances and the person's preferences.
Exercise ECG is a test that shows how the heart works while a person is exercising (walking on a treadmill or using an exercise bike).
You should not be offered MR coronary angiography to diagnose stable angina, which is a type of coronary angiography that uses magnetic resonance (MR) imaging to produce pictures of the coronary arteries.
If you are not diagnosed with stable angina, other reasons for your chest pain should be investigated.
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Questions you might want to ask about the tests for stable angina
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