Greetings. Welcome to HCM and thank you for your question. I understand your concern. ST-T abnormalities, but non-specific, do not confirm and do not exclude that this pain is coming from the coronary arteries. When we treat a 56-year old for chest pain, we suspect everything, and a careful differential diagnosis is constructed to exclude first the main, most dangerous culprits and then go to confirming or excluding other less serious causes. In this case, the cardiac origin of this pain mandates further evaluation. If these episodes of pain come and go, and the EKG reveals this, then I would recommend her to do an echocardiogram, to assess the function and structure of the heart muscle and the valves. Also, I would recommend a cardiac stress test (treadmill or fixed bike stress test), to see if there are further deviations of the ST-T segment during physical effort. This would be a sign that the coronary arteries might have a blockage somewhere, but does not confirm us to where are these blockages. If the test results positive for coronary artery disease, then a coronary angiogram would be in order, to reveal where exactly is/are this/these blockage(s) and to quantitatively assess them, and decide about the further procedural or pharmaceutical treatment. If the cardiac origin of the pain is excluded, then we can look for a lung or chest problem, or musculosceletal origin of the pain. I hope I was helpful with my answer. Feel free to ask again. God bless you, too. Dr. Meriton