Chapter 03
Chest pain and coronary assessment
Investigation of chest discomfort and assessment of the coronary arteries.
Performed in the rooms — assessment, stress echo and stress ECG; invasive angiography referred to hospital
Chest pain has many causes, and only some of them are cardiac. The purpose of a coronary assessment is to work out how likely it is that your symptoms are coming from the arteries supplying the heart, and what — if anything — should be done about it.
That starts with the character of the symptom itself: what brings it on, what relieves it, how long it lasts and what comes with it. Those details do more diagnostic work than most people expect, and they shape which test is worth doing.
Depending on that assessment, the next step might be an exercise stress test, a CT scan of the coronary arteries, or a functional imaging test. Sometimes the right answer is that no further cardiac testing is needed.