Continuing Pressure

Very glad to see this forum, and thank you for the opportunity to post a question.  I have 5 stents in my LAD resulting from 8 heart caths done over the past 2 years.  Throughout the past two years, I've had continuous chest pressure, although it was minimized after my last stent.  I am now taking Ranexa which helps, but I still have daily pressure in the center of my chest right at the sternum (kind of like someone is poking a finger on the inside).  I am taking Plavix, Lisinipril, Zetia, Toprol, Isosorbide Mononitrate, Cilostazol, Ranexa, Lipitor and Niacin.  My questions are:
(1)  Of my 8 heart caths, the last two have been clear and I passed my last nuke stress test about 4 months ago.  My cholesterol is down to 120 and HDL/LDL are finally within normal levels.  Are there any meds you'd recommend I get off - seems to me like I'm on too many and I'm often dizzy:
(2)  I still have continuing chest pressure.  When do you think it would be reasonable to go in for another test (nuke stress, etc) to ensure I'm doing well?  With my history of blocking back up (again, 8 caths in 2 years and all but the last two required some form of angioplasty), I want to stay on top of things.
(3)  If I go to the hospital everytime I have chest pressure in the middle of my chest, I'd be there quite often.  I am also out of breath a lot of the time, especially when exerting myself.  What should be my rule for going to the ER?  I don't want to go anymore if my symptoms are not serious b/c I've grown a little less fond of hospitals :-), but don't want to die of a heart attack either.  Suggestions?
(4) Any idea what could be causing the chest pressure?  I don't have reflux, asthma, or diabetes (been tested), but this chest pressure while not disabling is certainly distracting and lessens my quality of life somewhat.  Hard to exercise when you have chest pressure.

Thanks for any info you can provide!

[Mukesh Garg, MD]

1. You say your symptoms are better but not totally gone. You should continue to take your medications and think of cutting back only if you are symptom free.
2, 3 You should get a check up if your symptoms worsen or change in any way
4. Sometimes spasm of the esophagus (food pipe) can cause this .