How can you tell the difference between heart attack and angina?

Troponin: Serial troponin elevation is very sensitive for myocardial cell death. Clinical suspiciousness may lead to diagnose an acute myocardial infarction before the troponins begin to elevate and lead to emergency coronary revascularization within an hour of arrival to the emergency room thus preventing death and significantly preserving myocardial function and improving patient survival.

Disease vs. symptom: Angina is the symptom of chest pain. It does not necessarily mean you are having a heart attack or even have heart disease. Heart attack is a laymen's term for damage to the heart muscle from inadequate blood to part of the heart muscle, usually due to a temporary or permanent blockage of one or more coronary arteries. Only a doctor can tell the difference.