to have angiogram or not

i  have  2 angiograms last one 3 years ago.  went inwith chest pain december this was  caused by given a beta blocker that didnt agree with me. since then my medication has been all mixed up causing mor side effects and now i am back to what i was oeiginally on. cardioligist sent me for exercise tolerance test this showed up slight racing of heart. dr now wants me to have another angiogram even though he dosent think its comming from the small narrowing i have in right artery.  I have to make decision as have letter to go for this in 3 weeks time and i am frightened of this angiogram especially when doctor feels its not coming from there and its stressing me out. is there any other test i can have instead  

[ed34]

There are three ways to look at the condition you describe, but each has its pros and cons.
The angiogram is great for actually looking inside the arteries. A stress echo will show if the heart muscle is affected by a lack of blood flow. Another option is a nuclear stress scan which will show any areas not receiving enough oxygen, but this has to be backed up by an angiogram/stress echo if the findings are positive.
You could also inquire about using a CT scan, although I asked my cardiologist and she refused, saying it's only good for showing the larger vessels.

[kenkeith]

Slight racing heart should not be symptom of much concern when visiting a doctor or taking test, etc.  Many individuals have a faster than normal caused by some anxiety with the circumstances and that should be taken into consideration for any evaluation and no issue.

Beta Blocker is not expected to directly reduce any chest pain if the chest pain is related to the narrow right artery. Have you been given a nitrate medication?...that medication will dilate the narrow vessel and provide a better blood flow and should relieve any chest pain if vascular related. However, many people have a problem with nitro causing severe headaches to relieve chest pain (angina) so the only option available for them would be a stent implant (angioplasty).

There is an MRI and that is a radiographic angiogram of coronary artery and a contrast agent can be injected into the blood stream to have a display on a monitor of blood perfusion. Some individuals find it uncomfortable to remain still during MR imaging. Others may experience a sense of discomfort of being closed-in, but a sedation can be arranged for those patients who anticipate anxiety, but fewer than one in 20 require it.

Angiography literally means visualizing vessels for blood flow with a contrast medium and available:
•x-rays with catheters angiogram
•computed tomography (CT) angiogram
•magnetic resonance imaging (MRI) angiogram.

The reason I believe the best option for you would be a cath angiogram is because if the non-invasion procedures show blockage, you would require an angioplasy for your chest pain. If your chest pain can be controlled with medication, you can avoid any physical intervention and rely on other tests to determine if there are any abnormal conditions with the heart such as heart wall and chamber size, normal heart wall movement, normal heart functionality (adequate blood pumped with each heartbeat), etc. Or you can get a second opinion regarding your chest pain especially when your current doctor states (s)he doesn't believe there is a vascular association.

Thanks for sharing your concerns, and if you have any further questions or comments you are welcome to respond. Take care