ECG
Characteristically demonstrates transient ST elevation during spasm
May be followed by ST depression or T-wave inversion
Labs
Troponin(often negative)
Toxicology screen (if cocaine suspected as etiology)
Imaging
CXR (R/O other etiologies)
Other
Holter monitor (helpful in identifying dysrhythmia or silent cases)
Stress testing
Typically done to evaluate for fixed CAD; often yields negative results
Coronary angiography considered in following patients:
ECG with STE
History strongly indicative and stress testing/ambulatory monitoring are normal
Characteristically demonstrates transient ST elevation during spasm
May be followed by ST depression or T-wave inversion
Troponin(often negative)
Toxicology screen (if cocaine suspected as etiology)
CXR (R/O other etiologies)
Holter monitor (helpful in identifying dysrhythmia or silent cases)
Stress testing
Typically done to evaluate for fixed CAD; often yields negative results
Coronary angiography considered in following patients:
ECG with STE
History strongly indicative and stress testing/ambulatory monitoring are normal
Typically done to evaluate for fixed CAD; often yields negative results
ECG with STE
History strongly indicative and stress testing/ambulatory monitoring are normal
Coronary artery vasospasm
Acute coronary syndromes 
Anomalous coronary arteries
STEMI
Cocaine-associated chest pain
Non-STEMI
Digoxin toxicity
Unstable angina