Is It Angina?

In brief Most chest pain in athletes is brief noncardiac, and it resolves spontaneously or with appropriately directed treatment. But when the patient's medical history suggests angina pectoris, accurate diagnosis of cardiac disease is imperative. If cardiac examination suggests an organic heart murmur in conjunction with angina, or a resting ECG reveals inappropriate left ventricular hypertrophy, Q waves, or repolarization variations, echocardiography should be done to detect hypertrophic cardiomyopathy. A standard exercise ECG is also valuable, though a thallium stress scan may be necessary to exclude a false-positive treadmill test. If these tests are inconclusive, medication trials and other diagnostic tests can help determine the athlete's source of pain.