Angina pectoris during rest and shortness of breath

Dear Ask The Doctor: I'm a 19 year old male who is suffering from chest pain for the last 4 years now, I'm slightly overweight and have a family background of hypertension, diabetes and heart failure, it usually occurs during rest, and there have been times where I woke up from it including dizziness and shortness of breath. I have hypertension and a fatty liver with high SGOT and SGPT along with high cholesterol. I had an EKG around 3 years ago and they found nothing on my heart rhythm, but for the last few months, my chest pains have become unbearable and it radiates throughout my back and my left arm. I'm easily tired and I get palpitation whenever I do strenuous activities. I have been listening to my own heart rhythm whenever I get my chest pains for the last few days now and I can safely say that it's abnormal due to the fact that it goes fast with signs of murmurs then it gets slower again. How should I proceed with this, another EKG or a CT?

Dear John: From your description, the chest pain seems to be related to a condition called Angina Pectoris, in which there is decreased oxygen supply to heart muscle, usually due to narrowing of the coronary arteries as a result of atherosclerosis (fat deposition in the arteries) or coronary artery spasm. There may not be any positive findings on the EKG or CT scan, however, stress test is the test of choice for the diagnosis of the condition. Treatment involves medications like nitroglycerine, beta blockers, calcium channel blockers etc. to treat the acute episode as well as prevent future attacks.