Diseases & Conditions
Screening and Diagnosis
You'll probably have your
blood pressure, pulse and temperature checked right away. In addition,
the doctor will ask you questions about your chest pain: Where is the
pain located? How would you describe the pain? Do you have other signs
and symptoms along with the pain?
Chest pain doesn't always signal a heart attack. But that's what
emergency room doctors will test for first because it's potentially the
most immediate threat to your life. They may also check for
life-threatening lung conditions, such as pulmonary embolism, aortic
dissection or a collapsed lung (pneumothorax), that can cause chest
Tests you may have to determine the cause of your chest pain include:
This test can help doctors diagnose a heart attack as well as other
heart problems. It records the electrical activity of your heart
through electrodes attached to your skin. Heart rate and rhythm and
the electric impulses going through your heart are recorded as waves
displayed on a monitor or printed on paper. Because injured heart
muscle doesn't conduct electrical impulses normally, the ECG may
show that a heart attack has occurred or is in progress.
These measure how your heart and blood vessels respond to exertion,
which may indicate if your pain is related to your heart. There are
many kinds of stress tests. You may be asked to walk on a treadmill
or pedal a stationary bike while hooked up to an ECG. Or you may be
given a drug intravenously to stimulate your heart in a way similar
to exercise. Stress tests may be combined with imaging of the heart
using ultrasound (echocardiography) or radioactive material (nuclear
Your doctor may order blood tests to check for increased levels of
certain enzymes normally found in heart muscle. Damage to heart
cells from a heart attack may allow these enzymes to leak, over a
period of hours, into your blood.
An X-ray of your chest allows doctors to check the condition of your
lungs and the size and shape of your heart and major blood vessels.
Doctors can also use a chest X-ray to check for tumors in the chest.
This test helps doctors diagnose cardiac causes of chest pain, such
as a narrowed heart artery. Trace amounts of radioactive material,
such as thallium or sestamibi, are injected into your bloodstream.
Special cameras can detect the radioactive material as it flows
through your heart and lungs.
Coronary catheterization (angiogram).
This test helps doctors identify individual arteries to your heart
that may be narrowed or blocked. A liquid dye is injected into the
arteries of your heart through a catheter — a long, thin tube that's
fed through an artery, usually in your leg, to arteries in your
heart. As the dye fills your arteries, they become visible on X-ray
Electron beam computerized tomography (EBCT).
This procedure, also called an ultrafast CT scan, scans your
arteries for signs of calcium, which indicates that fatty deposits
along with calcium may be accumulating and blocking arteries
supplying your heart.
Magnetic resonance imaging (MRI).
MRI is an imaging technique that uses magnetic fields and radio
waves to create cross-sectional images of your body. Recent research
has suggested that MRI may be an effective way to determine if a
cardiac problem is causing chest pain.
An echocardiogram uses sound waves to produce a video image of your
heart. This image can help doctors identify heart problems.
In this test a thin, flexible instrument attached to a camera is
passed down your throat, allowing doctors to view your esophagus and
stomach and check for gastroesophageal problems that can cause chest
Many types of chest pain may at first seem related to heart problems.
But often, after careful evaluation, doctors can distinguish the
symptoms of noncardiac chest pain from the pain caused by a heart
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