The evaluation of acute coronary syndrome begins with a history and physical examination.

Physical findings in those with acute coronary syndrome may include:

• Congested lungs:
• During examination with a stethoscope
• Excessive sweating
• Creased ear lobe
• Heart murmur
• Rapid pulse
• High blood pressure
• Low blood pressure
• Irregular heartbeat
• Leg swelling
• Foot swelling (bilateral)
• Swollen veins in the neck
• Xanthelasma

Testing is necessary to confirm the diagnosis of acute coronary syndrome.

Tests that may be used to evaluate acute coronary syndrome include:

• Cardiac enzymes
• Troponin level
• C-reactive protein
• Cholesterol level
• Triglyceride level

Additional tests that may be used to evaluate acute coronary syndrome include:

• Chest x-ray:
• Normal chest x-ray
• Heart failure
• EKG
• Exercise stress test
• Cardiac catheterization
• Echocardiogram
• Intracoronary ultrasound:
• Shows the structure of the arteries inside the heart
• MRI scan
• MRI scan of the heart:
• Shows detailed images of the heart and coronary arteries
• Detects structural abnormalities of the heart
• MUGA scan
• SPECT scanning of the heart:
• Detects blood flow abnormalities to heart muscle
• Thallium heart scan
• Coronary artery CT scanning:
• Checks for possible obstructions in the coronary arteries
• Can show a build-up of calcium in a coronary artery
• Rubidium PET/CT scanning of the heart:
• Combines positron emission tomography or PET scanning with CT angiography
• Obtains information about the heart's anatomy and function in a single test

For more information:

• Angina evaluation
• Heart attack evaluation
• Coronary artery disease evaluation