The ACP offers 28 specific recommendations about when to use specific strategies and tests for evaluating SIHD. The recommended evaluation strategy starts with history and physical examination. This is followed by electrocardiography to test the electrical activity of the heart to rule out heart attack and blood tests to measure various chemicals in blood. If needed, stress tests can check if the heart is getting enough blood during exercise and identify patients who might benefit from invasive treatment, such as stents or surgery. Finally, coronary angiography, where a small tube is inserted in the heart through the leg and a dye is injected, can determine if a blood vessel is clogged. Tests are done on the basis of the results of the electrocardiography, patient risk factors, and preferences.