Diagnostic Tests

I have had a echo cardiogram stress test which came back normal.My ECGs and stress test have been normal.Is it possible that I have microvascular angina or coronary spasm that just didnt happen or show up at the ime of test?My symptoms are very extreme and have been going on for a long time.I get very bad chest ,pain, preassure, ache everyday.I have difficulty walking around and get very tired and take days to recover.I am an ex-smoker,ex-drug addict. Because so many other things have been ruled out I wonder if it is microvascular or spasms.Can a heart MRI with stress diagnose these things? I am at the end of my rope. Thankyou

[Douglas Bogart, MD]

Microvascular angina is frequently a diagnosis of exclusion  and sometimes the best option is to empirically put the patient on the meds for this--beta blockers and long acting nitro-- and assess the response.  I don't know of any specific test  for microvascular angina.  Coronary spasm can be diagnosed by the ECG at the time of chest pain and if it is due to spasm in a major artery the ECG will show ST-segment elevation.