I have had several problems with chest pain. I had two stress tests done, both were fine. I also had an Ecko done, it was fine. My cardiologist recommend I have a cardiac catherization. Do you think I should have one, even though everything else is clear. Please advise.
A stress test should have been able to visualize any induced ischemia (blockage) or any irregularities of blood flow through the vessels. Did the cardiologist tell you why a cath? Usually a cath procedure is done after a stress test to open any blocked vessels discovered with a stress test as well as measure any gradient pressures and intra-chamber, vessel pressures, etc.!. Are you having chest pains that can not be relieved with medication? Pain with exertion and relief with rest?
I was admitted to the hospital on two occasions for chest pains, 2007, 2008. Both times I had a stress test, they were find. Recently I experienced chest pain again, I visited my doctor and he wanted me to have a ecko which I did, it was fine. He also wanted me to have the cath. I was prescribed nitro for the chest pains which I have had to take on occassion, pain was relieved. I don't have to be doing anything to bring the pain on. I just don't know what to do.
From the limited information you have provided, could be ideopathic (cause unknown) coronary artery spasms could be the underlying cause. Arteries would appear normal during a stress test unless there is an event at the time of the test.
The spasm often occurs in coronary arteries that have not become hardened due to plaque buildup (atherosclerosis). However, it also can occur in arteries with plaque buildup...your stress test indicates no occlusions. . The coronary artery may appear normal during angiography, but it does not FUNCTION normally.
Coronary artery spasm affects approximately 4 out of 100,000 people. About 2% of patients with angina (chest pain) have coronary artery spasm. Cocaine use and cigarette smoking can cause severe spasm of the arteries, and can cause the heart to work harder. In many people, coronary artery spasm may occur without any other heart risk factors (such as smoking, diabetes, high blood pressure, and high cholesterol).
Treatment of coronary artery spasms may include medications such as nitrates, calcium channel blockers and 1-arginine, which may reduce the risk of recurrence. You can also reduce your risk by discontinuing tobacco use and controlling high cholesterol and high blood pressure.
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