There is chest pain with high BP. Is it due to heart attack?

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Heart attack in your grandfather's case is diagnosed on the basis of CKMB (Creatinine Phosphokinase MB), and Qualitative Troponin T tests (attachment removed to protect patient identity). CKMB is not specific test to diagnose heart attack and it may come positive in many other conditions. Same is the case with "qualitative" troponin t test. Yes, but if there is no kidney problem, no severe infection in body and patient has chest discomfort, then we can say its heart attack. ECG may help in making diagnosis as well. Echocardiography is overall normal. To diagnose heart attack best tests are ECG and "Quantitative" Troponin I test. If your grandfather still has chest pain, I would advise go directly for angiography and then angioplasty if indicated on angiography. If your father has no chest pain, then go for a test called Stress Echocardiography or Myocardial Perfusion Imaging. And if positive for changes consistent with heart attack then angioplasty. Please note, in some cases angioplasty is preferred and in some cases bypass is preferred, that is decided on many factors including angiography report, patient's overall condition, and patients wish. In some cases of very frail old peoples, only medical treatment is preferred and no angioplasty or bypass is attempted. This also depends upon overall condition of the patient and angiography report. In any case whether angioplasty, bypass, or only medical treatment, medicines are continued throughout life keeping in view contraindications and side-effects of medicines. Please tell about overall health of your grandfather, any other diseases he is suffering from such as kidney diseases, lung problems, walking issues, etc. Also, show me his ECG and other reports if already done. When overall picture/scenario of patient is in mind then I can guide you properly for further management.