The purpose of the present article is to emphasize that both of these questions can be answered correctly in most cases provided a few simple procedures are employed in addition to the usual examination. In general, the history must be taken with more care and in greater detail than is usual in regard to precipitating factors. The physical examination of the heart is important because occasionally one will detect aortic stenosis, an ectopie rhythm, or some other abnormality which may be related to the pain. However, in the majority of instances the physical examination of the heart will be negative. In the course of the physical examination certain procedures not commonly utilized, which can be carried out within a few minutes, will in many instances yield the correct answer as to the cause. If upon completion of a meticulous and detailed history and a reasonably careful physical examination, the physician does not either have the complete answer or at least have a strong clue to the answer, it is unlikely that the correct decision as to the cause of the pain will ever be made. If, on the other hand, the history has furnished a clue, it is frequently possible with a few simple office procedures to establish the diagnosis in a way which is not only scientifically satisfying to the physician but which is emotionally satisfying to the patient. It is with such procedures that this article deals.