A medical history and physical exam are always a part of evaluating a person who has symptoms of chest pain or risk factors for coronary artery disease.
During the medical history, the doctor will focus on areas such as:
A complete physical exam will also be done. This may include:
The combination of medical history, physical exam, and electrocardiography (ECG or EKG) is used to evaluate most people who have chest pain that does not have a clear cause. This combination of tests also is used to evaluate people who have chest pain that appears to be stable angina or those who are at risk for heart disease.
A medical history and physical exam may provide the following results.
A normal medical history and physical exam do not always mean that no further tests are needed.
The following are normal results:
An abnormal medical history reveals risk factors for heart disease. An abnormal medical history, physical exam, or EKG may lead to further testing, depending on how likely it is that you have heart disease. The following are abnormal results:
The decision to do further testing based on the medical history and physical exam will depend on:
An EKG usually is done whenever a heart-related problem is suspected. If the medical history and physical exam indicate that coronary artery disease is present, other tests, such as the stress echocardiography or stress thallium test, may be used.
If the medical history and physical exam suggest that the cause of chest pain is not related to the heart (such as a stomach ulcer or gastroesophageal reflux disease), other testing may be done to evaluate for other conditions. For information on the symptoms of these conditions, see the topics Peptic Ulcer Disease and Gastroesophageal Reflux Disease (GERD).
After the medical history and physical exam, the doctor may have a better idea about whether the symptoms are caused by coronary artery disease and how severe it may be. Risk factors are an important part of deciding what further testing is needed. The history and physical exam help to guide further decisions about testing and treatment. Extensive testing is not always necessary to diagnose coronary artery disease.
Last Revised: April 6, 2012
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