There are many causes of chest pain. If your chest pain is due to a problem with your heart you may experience pain while walking. This is called angina and is due to narrowing of your heart arteries. If you have risk factors such as diabetes, high cholesterol, high blood pressure or a family history of heart problems then you may be at risk of developing narrowing of your heart arteries. There are other heart conditions that can also cause chest pain such as cardiac arrhythmia.
There are various tests that can be done to determine the cause of your chest pain. These are:
- Exercise ECG – also called a stress test. This involves walking on a treadmill attached to an ECG to monitor your heart. The treadmill gets progressively steeper and faster and can determine if there is any strain on the heart due to narrowing of the heart arteries.
- Coronary angiogram – this is a test where the heart arteries can be directly visualised. This is done by inserting a catheter via the artery in the wrist or leg into the heart and injecting dye while taking x-ray pictures of the heart arteries. This is usually the best way to find out whether the arteries are affected and the severity to which they are affected. The procedure is a low risk procedure and can be done as a day case under local anaesthetic. It is usually performed in patients where there is a high degree of suspicion of
- CT coronary angiogram – This test is a less invasive version of the coronary angiogram and involves a focused CT scan of the heart with particular focus on the heart arteries. This test is usually performed on patients where there is only a low degree of suspicion of heart disease as it is a less invasive test than a coronary angiogram. The test will provide a calcium score – this is a measure of the amount of calcium in the heart arteries and will provide an indication of the severity of any hardening and narrowing of the heart arteries. If a patient has chest pain that we do not think is due to hardening or narrowing of the heart arteries but we won’t to eliminate all doubt a CT coronary angiogram is a very useful and non-invasive test to help confirm this and offer a great deal of peace of mind.