[Outpatient diagnosis of coronary artery disease]

Coronary artery disease either presents with acute chest pain or with exercise induced chest symptoms or shortness of breath. The differentiation between stable and unstable Angina pectoris is prognostically important, unstable angina is managed as an acute coronary syndrome including hospital admission, patients with stable symptoms can be further evaluated in an outpatient setting. A broad differential diagnosis of other cardiac and non-cardiac causes must be considered. Important initial diagnostic steps are cardiovascular risk stratification and prove of ischemia (or scar, necrosis) either at rest or usually exercise-induced, if necessary by additional imaging. Exercise capacity is assessed by physiological parameters (watt, VO2max., MET and distance) during exercise tests like ergometry, spiroergometry or 6-minute walking test (e.g. heart failure patients). Additional factors must be considered for the assessment of working capacity.