From the Guidelines
If you have symptoms of angina, you should undergo a series of lab tests, including blood tests for cardiac biomarkers, complete blood count, lipid profile, and blood glucose, as well as an electrocardiogram (ECG) and often a stress test, to evaluate your heart health and determine the underlying cause of your symptoms. These tests are essential to assess the severity of your condition, identify potential underlying causes such as coronary artery disease, and guide appropriate treatment decisions. According to the guidelines from the American College of Physicians 1, and the European Society of Cardiology 1, a comprehensive evaluation of patients with suspected stable angina should include a carefully taken history and physical examination, a comprehensive risk factor evaluation, and a resting electrocardiogram.
Key Lab Tests for Angina
- Blood tests for cardiac biomarkers like troponin and CK-MB to check for heart damage
- Complete blood count to assess for anemia
- Lipid profile to evaluate cholesterol levels
- Blood glucose to screen for diabetes
- Thyroid function tests to assess for thyroid disorders
- Electrocardiogram (ECG) to detect heart rhythm abnormalities or signs of heart damage
- Stress test to see how your heart functions during physical activity
Advanced Tests
- Coronary angiography to visualize blockages in heart arteries
- Echocardiogram to assess heart structure and function
- Cardiac CT or MRI for detailed imaging
These tests help determine if your chest pain is truly angina, assess its severity, and guide appropriate treatment decisions. Prompt testing is crucial as angina can indicate serious heart conditions requiring immediate attention, as highlighted in the guidelines from the American College of Physicians 1 and the European Society of Cardiology 1.
From the Research
Lab Tests for Angina Symptoms
When experiencing symptoms of angina, several lab tests can be useful in diagnosis and management. These include:
- Coronary computed tomographic angiography: This is a first-line diagnostic test for evaluating patients with stable angina, as it has higher sensitivity and comparable specificity compared to imaging-based stress testing 2.
- High-sensitive troponin I (hs-TnI) testing: This test can help identify patients with coronary artery disease and predict future cardiovascular events 3.
- Electrocardiogram (ECG): This test can show signs of myocardial ischemia or infarction, and can be used in conjunction with troponin testing to diagnose acute myocardial infarction 4, 5.
- Troponin T testing: Higher levels of cardiac troponin T can predict the risk of acute myocardial infarction in patients with stable angina pectoris 6.
Diagnostic Value of Lab Tests
The diagnostic value of these lab tests can be summarized as follows:
- Coronary computed tomographic angiography can detect nonobstructive atherosclerosis and improve risk assessment 2.
- Hs-TnI testing can identify a significant low-risk group of patients with stable chest pain without known cardiovascular disease 3.
- ECG and troponin testing can be used to diagnose acute myocardial infarction, but may not reliably distinguish between stress cardiomyopathy and acute coronary syndromes 5.
- Troponin T testing can predict the risk of acute myocardial infarction in patients with stable angina pectoris, and may attenuate the relations between traditional coronary heart disease risk factors and acute myocardial infarction 6.