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1. In the emergency setting, electrocardiography (ECG) is the most important diagnostic test for angina. ECG changes that may be seen during anginal episodes include the following:
2. Laboratory studies that may be helpful include the following:
3. Diagnostic imaging modalities that may be useful include the following:

Cardiac troponin levels

Creatine kinase isoenzyme MB (CK-MB) levels

Dynamic T-wave changes: Inversions, normalizations, or hyperacute changes

Myocardial perfusion imaging

Computed tomography, including CT coronary angiography and CT coronary artery calcium scoring

Myoglobin levels

Transient ST-segment elevations

Echocardiography

ST depressions: These may be junctional, downsloping, or horizontal

Chest radiography

Cardiac angiography

Basic metabolic panel

Complete blood count