The diagnosis of atherosclerotic disease is based on assessing symptoms of the condition (see symptoms) and looking for physical signs of the condition, coupled with specific investigations. A positive family history of early death from heart attacks or strokes and or/a history of high blood fat levels in close relatives makes you more likely to suffer from atherosclerosis. Risk factors such as diabetes, smoking, high blood pressure and obesity will also alert your doctor to the possibility you may have atherosclerosis.

Signs of atherosclerosis:
When examining a patient suspected of having atherosclerosis, the doctor feels the pulses in the arms, legs and neck and listens to them for a "bruit". This sounds like water roaring over rocks when listened to with a stethoscope. It is made by turbulence caused as the blood tries to flow past the narrowing caused by the plaque on the artery wall.

The doctor also looks for pale, cold feet, absence of pulses, leg ulcers, black toes and signs of gangrene caused by death of the tissues deprived of oxygen.

Listening to the heart may reveal extra beats, abnormal beating rhythms or even a "murmur" if the heart valves have been damaged by previous undetected heart attacks.

In the abdomen, a doctor may find a wide pulse caused by a widened aorta or even a large, pulsating mass if the aorta has developed a large aneurysm.

Investigations:

	An electrocardiogram (ECG) of the heart may reveal signs of damage caused by lack of oxygen. An electrocardiogram done while the patient is exercising (usually walking on a treadmill) may show signs of poor oxygen supply to the heart muscle, which is called ischemia.
	Ultrasound measures of blood flow, known as doppler studies can tell doctors how much blood is getting through the affected arteries and how thick the walls have grown. These are often used when deciding how severe the disease is in the carotid, aorta and leg and arm arteries.
	An echocardiogram-an ultrasound of the heart also looks at blood flow and the thickness of vessel walls in the heart.
	Xrays performed after injecting dye into the arteries will reveal blockages in the artery systems under investigation.
	The most informative investigation for atherosclerosis in the heart is a cardiac catheterization where a tube is threaded up into the heart arteries via the femoral artery in the groin. Dye is injected into the artery as the wire goes up revealing the location and extent of the atherosclerotic blockages. If the doctor performing this test finds blockages suitable for removal, he can remove them by pushing the wire past the blockage then inserting a smaller tube with a balloon at its tip. The doctor inflates the balloon and then pulls it back, flattening the fatty atherosclerotic plaque. Often a wall strengthening device, a tiny coil known as a stent, is then inserted to help keep the artery open. This procedure, known as angioplasty is now the most popular means of treating atherosclerotic heart disease, especially the milder forms.

Based on four examination techniques, TCM practitioners will diagnosis osteoporosis according to its clinical symptoms and further characterize it by the disharmony patterns displayed by each individual. At various stages of disease, different disharmony patterns are present and individuals with the same disease will be treated differently depending on the type of disharmony pattern they have. Atherosclerosis usually classify into 6 type:

According to TCM theory, individual with chest pain syndrome should be differentiated from either a fluid retention syndrome in the throat, stomach pain or emergency heart pain.

Fluid Retention Syndrome in the Thorax (Chest):
'Fluid retention syndrome in the thorax' is an accumulation of fluid dampness in the thorax. Its presentation is similar to chest pain syndrome. Both lead to chest pain, but fluid retention syndrome is usually associated with persistent distension of the lower chest region, which will be aggravated by coughing, spitting and breathing. Shortness of breath might also be present.

Stomach Pain:
Some forms of chest pain originate from the stomach area and can easily be confused with chest pain syndrome. However, stomach pain is usually associated with hiccupping, flatulence (gas) and regurgitation of stomach acid.

Emergency Heart Pain:
Emergency heart pain is a complication of chest pain syndrome. It is marked by persistent, severe heart pain. Patients look pale, have purple lips, cold limbs and sweat. The pulse is frail and weak. This is an emergency and must be treated immediately by trained medical staff, preferably in a hospital emergency room.

Note: If a TCM practitioner suspects there might be a serious problem that Chinese medicine alone cannot treat, he or she will recommend the individual to see a Western doctor for further follow-up.