Instrumental intermezzo
In the 19th century, the intermezzo acquired another meaning: an instrumental piece which was either a movement between two others in a larger work or a character piece that could stand on its own. These intermezzi show a wide variation in the style and function: in Mendelssohns incidental music to A Midsummer Nights Dream the intermezzo serves as musical connecting material for action in Shakespeares play; in chamber music by Mendelssohn and Brahms, the intermezzi are names for interior movements which would otherwise be called scherzi; and the piano intermezzi by Brahms, some of his last compositions, are sets of independent character pieces not intended to connect anything else together. Stylistically, intermezzi of the 19th century are usually lyrical and melodic, especially compared to the movements on either side, when they occur in larger works. The Brahms piano intermezzi in particular have an extremely wide emotional range, and are often considered some of the finest character pieces written in the 19th century. Opera composers sometimes wrote instrumental intermezzi as connecting pieces between acts of operas. In this sense, an intermezzo is similar to the entracte. The most famous of this type of intermezzo is probably the intermezzo from Mascagnis Cavalleria rusticana. Puccini also wrote intermezzi for Manon Lescaut and Madama Butterfly, and examples exist by Wolf-Ferrari, Delius and others. Also, incidental music for plays usually contained several intermezzi. Schuberts Rosamunde music as well as Griegs Peer Gynt contained several intermezzi for the respective plays. In the 20th century, the term was used occasionally.
The use of echocardiography, stress cardiac imaging, and/or advanced non-invasive imaging is not recommended on individuals who are exhibiting no symptoms and are otherwise at low risk for developing coronary disease.The diagnosis of "Cardiac Syndrome X" – the rare coronary artery disease that is more common in women, as mentioned, is a diagnosis of exclusion. Therefore, usually, the same tests are used as in any person with the suspected of having coronary artery disease:
Baseline electrocardiography (ECG)
Exercise ECG – Stress test
Exercise radioisotope test (nuclear stress test, myocardial scintigraphy)
Echocardiography (including stress echocardiography)
Coronary angiography
Intravascular ultrasound
Magnetic resonance imaging (MRI)The diagnosis of coronary disease underlying particular symptoms depends largely on the nature of the symptoms. The first investigation is an electrocardiogram (ECG/EKG), both for "stable" angina and acute coronary syndrome. An X-ray of the chest and blood tests may be performed. Stable angina
In "stable" angina, chest pain with typical features occurring at predictable levels of exertion, various forms of cardiac stress tests may be used to induce both symptoms and detect changes by way of electrocardiography (using an ECG), echocardiography (using ultrasound of the heart) or scintigraphy (using uptake of radionuclide by the heart muscle). If part of the heart seems to receive an insufficient blood supply, coronary angiography may be used to identify stenosis of the coronary arteries and suitability for angioplasty or bypass surgery.Stable coronary artery disease (SCAD) is also often called stable ischemic heart disease (SIHD). A 2015 monograph explains that "Regardless of the nomenclature, stable angina is the chief manifestation of SIHD or SCAD."