Diagnosis and assessment involves clinical examination, laboratory tests, and specific cardiac investigations for confirmation of the presence of myocardial ischemia in patients, and for identification or exclusion of associated conditions or precipitating factors.

CoronaryArteryDisease01Figure 1. Algorithm for the initial evaluation of patients with clinical symptoms of angina.
(Management of Stable Angina Pectoris of the European Society of Cardiology)

Patients with Coronary Artery Disease (CAD) may display one or more of the following signs and symptoms:

  • Pain or pressure in the chest, arm, jaw, shoulder, or neck
  • A feeling of tightness, heaviness, squeezing or burning in the chest
  • Shortness of breath
  • Sweating
  • Fatigue
  • Reduced exertional capacity.

However, a significant number of people with underlying CAD and ischemia will experience no symptoms. Others will show only very subtle signs such as decreased endurance or energy. As a result, CAD is often a silent disease which progresses undetected until the first effects of ischemia appear. Symptoms of angina are the most common presentation of CAD. However, the underlying coronary atherosclerosis may also manifest suddenly as an acute heart attack or sudden cardiac death.6


6. The CLARIFY Registry: Management of Stable Coronary Artery Disease in Clinical Practice. Brochure for participating doctors. Edited by G Steg on behalf of the BEAUTIFUL Executive Committee.