Investigation of suspected angina includes baseline testing, assessment for coronary artery disease and evaluation of a murmur when present.
Baseline investigations
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The most important baseline investigations are a full blood count, fasting blood glucose, lipids, thyroid function tests and a 12-lead electrocardiogram (ECG).
Coronary artery disease assessment
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Stress testing includes exercise ECG, stress echocardiography and magnetic resonance perfusion imaging.
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Stress testing can help confirm anginal symptoms and identify high-risk patients requiring further investigation and treatment, but cannot reliably exclude coronary artery disease.
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CT coronary angiography is the investigation of choice for suspected angina due to coronary artery disease.
Investigation of a murmur
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If a murmur is present, perform echocardiography to check for valve disease or hypertrophic cardiomyopathy.