Coronary artery disease, also known as coronary heart disease, is by far the most life-threatening cardiovascular disease. A detailed examination is crucial in identifying the underlying signs and symptoms of heart disease. Early diagnosis of problems related to heart disease helps the doctors in planning the best treatment options for you.

A variety of techniques are used to diagnose heart disease. Some of them are as basic as taking the medical history, performing a physical examination, ordering an electrocardiogram, while some are high-tech strategies such as nuclear imaging, computed tomography (CT) scanning and coronary angiography. Normally, a patient undergoes the tests that are most suitable to determine his condition, but in some cases, a patient might have to undergo various tests in order to reach a conclusive diagnosis.

The doctor usually starts with easy tests and then goes on to the sophisticated ones, if required, until the diagnosis is clear. If you have mild, stable or atypical symptoms, for example, momentary episodes of stabbing pain, then an experienced physician might not go further than the basic examination. On the other hand, if your symptoms are threatening, for example, abnormal ECG, breathlessness, squeezing sensation in your chest, then your doctor may go straight to the advanced methods of diagnosis.

Medical History of the Patient

This is one of the first and most important steps towards the diagnosis of heart disease. It helps your doctor predict whether you have coronary heart disease. Some of the basic things a doctor asks are:

• To describe your medical background and symptoms
• Whether you’re a smoker or not
• The diet you follow daily
• Whether you exercise regularly or not
• Whether your parents or other family members have had heart problems such as hypertension, high cholesterol or diabetes

During the time the doctor takes your medical history, he also wants to know whether you experience chest pain and also a description of that pain. This is to distinguish between angina and other types of chest discomfort.

Angina is the most common symptom of coronary heart disease. It has certain characteristics that are typical only of angina. Angina is usually felt as a pressure, heaviness, squeezing  or tightness in the chest. Some people also complain of burning or aching, and a very few also describe it as sharp or stabbing pain. The symptoms can be felt anywhere in the chest, but usually a deep, central discomfort is felt behind the breastbone. Some people clench their fists because of the pain. 

Patients often report the feeling of discomfort spreads to the shoulders, arms, neck or jaw and is often accompanied by shortness of breath or sweating. In medical terms doctors call this particular pattern of pain radiation.

If you’re experiencing angina, the next step is to find out whether it’s the stable or unstable form of angina. 

Physical Examination

This is a routine examination where most doctors check the patient’s vital signs, including blood pressure, heart rate, pulse and breathing pattern.

They also listen to the chest for heart murmurs and gallops that may result from damage to the heart. A murmur is an abnormal sound caused by the flow of blood through heart chambers or valves. Gallops are abnormal, soft, thudding noises the heart makes when it fills with blood.

These sounds do not always indicate coronary heart disease, but they do indicate there’s some underlying trouble in the heart. The doctors also examine lungs, feet, eyes and rest of the body for signs of heart trouble.