all symptoms of heart attack but good test results

I am 33 years old, I had open heart surgery in Aug '09 to correct a birth defect in my heart, I didn't know that I had until then.  One of my main arteries had to be removed, rerouted and reimplanted.  Since then I had to have a stent put in Jan. '10 due to scar tissure in the artery. I've been having trouble since. My meds I'm now taking Plavix 75mg daily, Asprin 325mg daily, hydrochlorot 12.5mg  daily, metoprol 25mg twice daily and I just started Ranexa 500mg twice daily. I have no energy, if I exert myself in any way the chest pain/pressure starts with sharp pains and then they radiate to the left arm and up the left side of my neck. All of my test have come back normal. This is scarring me to death and as a coal miner I'm afraid I'm going to lose my job. I just don't know what to do they said the Ranexa is kinda a last option, I have a wife and three kids to take care of, I really need help to find out whats causing this.

[CCF HeartMD-1]

Ranexa is not the last option.  There are 2 other medications that work well for angina that I would usually start prior to Ranexa which are Imdur (Isosorbide mononitrate) or Norvasc (Amlodipine) which can both help with angina and coronary vasospasm (spasm of the large and small vessels which give blood to the heart) which you may possible have.  It may be worth being reevaluated and rule our coronary vasospasm or microvascular dysfunction which are 2 things that can cause chest pain and would have normal tests (need to do special tests to rule these things out).  You may want to consider a second opinion and come to the Cleveland Clinic.  Dr. Steve Ellis at CCF is good at evaluating the above issues.  

Hope this helps.  Good Luck.

[tjk975]

I have already tried Imdur and it didn't work. I've had several test CT with contrast, heart cath (Nov), many EKG's and heart Echo as well as many others.  What kind of test do these require?

[CCF HeartMD-1]

Another heart catheterization where we use medication while looking at your coronary arteries to see if there is any spasm or microvascular dysfunction.  Calcium-channel blockers such as Norvasc (Amlodipine) helps with these sorts of issues.  

Good Luck!

[tjk975]

The chest pain is getting worse, I've been off work since Friday,Jan.7 and have literally been on the couch since. I haven't been able to do anything. My last episode of chest pain came while on the couch watching tv and it took 3 sub. tablets to get it to start to ease off. Everytime I go to the ER they do EKG and blood work and tell me I'm fine. Whatever this is, is getting worse. Thanks for your help, do you have any idea how long the wait is to get in to see Dr. Steve Ellis?