 [ Symptoms ] i am having frequent left chest pain – echo stress test ecg all normal [ Disease ] hi v4 slight elevationright ventricle and atrium can be due to partial sodium channels block causing early repolarization or partial right branch block due to coronary artery stenosis it is usually not important but if you are concerned then i recommend checking sodium potassium and calcium levels also an angiogram is helpful if you have risk factors for stenosis like weight smoking or even stress good luck