A physical examination for coronary artery disease may include:

• A blood pressure check.
• An examination for fatty deposits (xanthomas) under the skin.
• A general assessment of blood circulation. Circulation can be evaluated by checking skin color, fingernails and toenails, and pulses in several locations, including the neck, wrist, and feet.
• A funduscopic exam of the back of the eye (retina). Changes in the blood vessels in the retina give clues to the presence and severity of high blood pressure or diabetes.
• An examination of the blood vessels of the neck by looking at them and by listening to blood flow using a stethoscope.
  • Bulging or swollen neck veins may be a sign of heart failure.
  • Changes in how the blood sounds as it flows through a narrowed artery can be heard when listening to the arteries in the neck (carotid arteries).
• Listening to the heart with a stethoscope for heart murmurs and extra heart sounds.
• Listening to the lungs for abnormal breath sounds. Soft crackling sounds (crepitations or rales) may be a sign that heart failure has caused fluid to build up in the lungs.
• An examination of the abdomen. Using a stethoscope, the doctor will listen to blood flow in the abdomen. Changes in the sounds of blood flow (bruits) may indicate a narrowed blood vessel in the abdomen. This is a sign of hardening of the arteries (atherosclerosis) in the large blood vessels that run through the abdomen.
• A check for swelling in the feet and legs (a sign of heart failure). Fluid buildup in the legs causes swelling (edema) and may be a sign of heart failure. To assess swelling in the legs, the doctor will press down on the skin over the lower leg bone. Edema is present if the pressure leaves a dent in the skin.