Hello! Thanks for using healthcaremagic.com I read carefully your question and understand your concern. I think you may have myocardial ischemia. Symptoms in middle-aged persons are so diferent from the aged ones with myocardial ischemia, cause they may be so atypical, compared to younger patients, that the symptoms may be misdiagnosed as being caused by another disorder or as related merely to aging. But this is not your case since you are 33. Exertional angina pectoris is commonly the first manifestation of CAD in middle-aged persons(like you), luckly for us is usually easily recognized due to its typical features in middle-aged ones. The goals of treatment with myocardial ischemia are 1) to relieve symptoms, if present, and to stabilize the acute pathophysiologic process; 2) to prevent recurrence or new onset of symptoms; and 3) to prevent progression and induce regression of the underlying pathophysiology to reduce future coronary events, including death. So as you have point out you should visit your medic today!!! Your doctor will start with a medical history and physical exam. After that, your doctor might recommend: Electrocardiogram (ECG),Echocardiogram,Stress test as a primaries test. Kind regards, Dr. Oscar Martinez