The evaluation of chest pain begins with a medical history and physical examination.

Physical findings in those with chest pain may include:

• Congested lungs
• Wheezing
• Heart murmur
• Pericardial rub
• High blood pressure
• Low blood pressure
• Irregular heartbeat
• Rapid breathing
• Rapid pulse
• Swelling of the legs and feet
• Leg swelling (unilateral)
• Swelling of the veins in the neck
• Xanthelasma

Testing is often necessary to determine the underlying cause for the chest pain.

Tests that may be used to evaluate chest pain include:

• Complete blood count
• Cardiac enzymes
• Troponin level
• C-reactive protein
• Cholesterol level
• Triglyceride level

Additional tests that may be used to evaluate chest pain include:

• Urinalysis
• Chest x-ray:
• Normal chest x-ray
• Heart failure
• Collapsed lung
• Pulse oximetry
• Rib x-rays
• Sternum x-ray
• CT scanning of the chest
• Aortography
• Ventilation perfusion scanning of the lungs
• Pulmonary angiogram
• Pulmonary function tests

Additional tests that may be used to evaluate the heart include:

• EKG
• Exercise stress test
• Cardiac catheterization
• Echocardiogram
• Intracoronary ultrasound:
• Shows images of the inside of coronary arteries
• MRI scan of the heart:
• Shows detailed images of the heart and coronary arteries
• Detects structural abnormalities of the heart
• 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
• MUGA scan
• Cardiac monitoring