### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
hi,i am 40 yrs old last one week i was feeling lightheadness and anxity. a went to see the doctor. there was some abnormality in ecg so i went for tmt that was also mildly positive but CD echo cardiogram is normal. still i feel dizzyness and pain in chest in left side what to do?

### output:

Hello. Thank you for your question and welcome to Chat Doctor. I understand your concern. Well, you are young to have coronary artery disease, but this is not the rule of thumb. It is not impossible do have this disease even at your age. This chest pain, should it come from coronary artery blockages, has to be described like a squeezing feeling or heaviness with moderate to severe intensity, starting in the mid-chest, then propagating to the jaw, the shoulders and the left arm, triggered by exercise and stopped from ceasing it. This chest pain is called stable angina. Now, in my experience there is positive, non-conclusive and negative result of a cardiac stress test. After my description, if you have had typical angina, your cardiac stress test is positive, and you have a risk factor such as smoking, history of myocardial infarction or sudden death in your family, or high cholesterol levels, I would recommend you for a coronary angiogram. Although the index of suspicion is low at your age, I would suggest you to undergo this procedure and, at least, the coronary artery disease is excluded. There is no cardiologist who would ignore angina + a positive cardiac stress test, although mild. There are relatively novel studies that can serve as bridge between cardiac stress test and coronary angiogram, but none of them can be more precise in confirming or excluding coronary artery disease, than coronary angiogram. I hope this is of help. Take care and good luck. Best regards, 