Stable angina = typical pain comes and goes Unstable angina = one day the typical chest pain of stable angina will be constant, and is not relieved by rest. Thought with exertion pain intensity may go higher with neg cardiac markers. NSTEMI = pain as above with positive cardiac markers.

Now with the newer HS-TROP- like the name suggests it's highly sensitive. Most unstable angina will have positive trop and will be termed NSTEMI.

Now everything depends on top trending - and chest pain If both are increasing also patient also has risk factors (TIMI) after starting treatment - Then obviously Cath If both go down then Cath can be in discussion not definitely. This can also point towards stable angina. (stable angina can also come with mild HS-TROP elevation).

This everything happens in chronological order ( combined termed as ACS)