The relation of self-reported chest discomfort to the presence of atherosclerosis was examined, taking age and gender differences into account. Sixteen practicing cardiologists independently rated the items of a self-report questionnaire of angina pectoris (AP) symptoms according to their adjudged likelihood of being associated with coronary artery disease (CAD). Inpatients' (130 male and 82 female) responses to this questionnaire were obtained on the day prior to coronary angiography and scored according to their reporting of 12 symptoms endorsed by all 16 cardiologists, 25 symptoms endorsed by at least 90% of the cardiologists, and responses to items used in the Rose questionnaire, a brief survey tool for diagnosis of chest pain. Finally, patients' angiographic results were rated for presence of 75% or more CAD of one or more coronary arteries. Surprisingly, more symptoms were reported by patients without significant CAD, regardless of age or gender.