If signs or symptoms of CHD are observed further investigation is warranted. The following tests can be used to identify any coronary artery atheroma.

• An electrocardiogram (ECG) reading can show evidence of a previous or current myocardial infarction. ECGs carried out over 24 hours by Holter monitoring may help to detect ischemia.
  

• Stress tests are used for shortness of breath and chest pain evaluation.
  

• Angiography can be used to follow the flow of blood around the heart, detecting any narrow spots or blockages.
  

• Electron beam computed tomography (EBCT) detects calcium levels, which are present in atherosclerotic plaques. Increased levels of calcium increase the chance of having CHD.
  

• Intravascular ultrasound (IVUS) is considered the definitive test for CHD. A sound wave transducer is mounted on a catheter and introduced into a coronary artery. These catheters can demonstrate how severe the narrowing produced by a blockage is and show the composition of the underlying plaque.

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