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
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
angina or those who are at risk for heart
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
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
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.
Complete the medical test information form (PDF)(What is a PDF document?) to help you prepare for this test.
April 6, 2012
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
& Robert A. Kloner, MD, PhD - Cardiology
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