30 years old, had chest pains on left side for 11 months. ecg, bloods, chest x-ray clear. history of recreational cocaine and alcohol use. pain in left arm, dizziness and slightly out of breath. chance of early disease? more tests?

Typically a negative maximal or symptom limited nuclear or echo stress test will be sufficient to exclude significant coronary artery blockages&omit the need for cardiac catheterization with angiography or a CT scan angiogram. However coronary vasospasm wouldn't be ruled out unless a test to provoke it is done to see if it produces your symptoms. This vasospasm can be treated & has a good prognos