Julie,

Thanks for your question.  Unstable angina is chest pain due to blockage in one or more coronary arteries that occurs with minimal activity or exertion.  It usually indicates a severe narrowing of the artery and is a high risk of causing a heart attack.  Immediate attention is needed to evaluate the severity of disease as well as correcting it. Yes, you can have a normal EKG, but doubtful a full treadmill stress test would be normal in a patient with true unstable angina. 

Though you do have three risk factors for heart disease (high cholesterol, family history, and excessive weight) your cardiologist may feel that your symptoms are not actually angina.  Despite your exercise program, the next step to prove or disprove heart disease would be a stress test.  If that were negative, then, if still suspicious, cardiac catheterization would have to be considered.  Doctors sometimes have to make a decision of where to stop, based on their findings in your case, plus their overall knowledge and experience. 

I suggest you discuss this all with your doctor and tell him of any concern you might still have.

Best wishes.

Martin Cane, M.D.