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Episodic chest pain is something that can afflict a large portion of the population. It is called angina pectoralis and can be caused by pathologies that can point to a problem with your heart or lungs. X-rays are necessary to differentiate the source.

When it comes to a chest X-ray, this inexpensive test can point to a number of different possibilities when suspicious densities on the lungs are found. A lesion is a very broad term but is used to describe any irregularity that could be visualized on imaging by a radiologist [1]. As we have seen already, lesions can be in the shape of a small ball like a lesion for lung cancer or could have a very characteristic formation like in tuberculosis, abscesses or pneumonia so the signs of a lung infection on X-ray will be quite obvious. Another irregularity that we are able to suspect from a chest X-ray would be a condition like angina pectoris [2]. Normally, this is a condition that deals with the heart and ischemia but there are some telltale signs on a chest X-ray that can point the finger to a diagnosis of this disease. Here, we will cover signs of angina pectoralis and what you need to know about the disease. 

What You Need to Know About Angina Pectoralis 

If you think back, you can probably easily think of a family member who has complained about having angina. Even if it is a relatively rare condition, it seems to be a trendy diagnosis in the hospitals and on self-help websites so that may explain why it has become such a popular diagnosis at the family dinner table. To shed some light on what you are actually dealing with when you have this condition, I'll give you a brief rundown of what a diagnosis of angina pectoralis entails. [3]

To start off with, angina pectoralis can be caused by two sources: cardiac and non-cardiac infections. Cardiac causes are self-explanatory and non-cardiac causes can range from conditions like gastric reflux disease, lung infections or potential tumors just to list some of the more common occurrences in the wards. [4]

You can begin to suspect that you may be suffering from angina if you have an uncomfortable pressure or tightness in your chest wall, pain that can radiate to your shoulder, jaw or down your arm, lightheadedness, shortness of breath, an accelerated heart rate and general discomfort.

If you think this sounds similar to what you would have if you were suffering from a heart attack, you would be correct. Cardiac causes of angina are essentially warning signs of an impending heart attack. They can be broken down into stable and unstable angina. Stable angina would entail this chest pain only after excessive exercise. Unstable angina, however, is the more alarming of the two and chest pain can occur even without some type of exertion. This makes cardiologists worry because a heart attack is soon to follow in most cases. [5]

Angina is a disease created when the heart is unable to have enough blood flow resulting in temporary ischemia to the tissues. It will resolve, unlike a heart attack, but you can do your part to help reduce the chances of getting this condition. 

How Will it Present on a Chest X-ray 

A chest X-ray is an examination that is absolutely necessary when it comes managing a patient with angina pectoralis. We need this examination because it can help show what the likely source of the angina pectoralis is. If it is cardiogenic in nature, what will be seen on the imaging studies will be that the lungs will be mostly clear but you can see some congestion in the pulmonary arteries. This will be the wide spacing that you can see in the middle of the lungs. 

Other than to determine if there are signs of cardiac problems, a chest X-ray is also important because it can help rule out other causes of chest discomfort that could mimic angina pectoralis. If you truly do have angina pectoralis, there will be no suspicious densities on the lungs when you check the images. You will see absolutely no signs of lung infections on X-ray so diseases like pneumonia or tuberculosis can be ruled out. [6]

This necessary chest X-ray, along with a cascade of other necessary diagnostic studies will help to finally make a diagnosis of angina pectoralis. You will also need to have an EKG study, a CT of the chest, a catheter angiography and to perform a stress test in order to make the final diagnosis.

An angiography is just a test that we use in medicine in order to determine the blood flow in the heart.

A stress test is a test where patients walk and run on a treadmill to determine if their heart worsens when you are doing physically-demanding activities. Once these tests are all completed, doctors will have a much better idea if there are true signs of angina pectoralis. [7]

If you are diagnosed with angina pectoralis, treatment includes making sure that the blood pressure is monitored in order to maximize the heart effectively or to treat non-cardiac causes of the disease [8]. 

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