Need assurance

[ConsueloMaru]

My cardiologist has ran every test possible and all have come back negative, which in itself is good.....But as of 2 years I have had pain in chest started on left side under left arm and has over time progessed to the center of my chest and now even as we speak a severe pinching under my left breast with onset of severe sweating.....I am 45/fem former mild smoker (stopped 26 years ago) no history of cardio problems in family, my doctor had assured me after a nuclear stress test that my heart was "ok" but after that test, I still continued to feel the pains and discomforts, then my doc recommended an angiogram, which I still have not done (am afraid) but when he was going to do it, he had to stop with the procedure since my potassium was low........since then I have felt better some days but some days the pains are severe, and I saw my cardio on Monday 9/15/08 and he said that the cathederization was the only way he could be 100% sure it was not my heart.....but that all the previous test were negative that I would have to learn to live with this pain, I can't it scares me I am afraid of a heart attack..............even if the tests were negative....he told me that the angiogram covered the last 5% possibility of something being wrong......5% to me is to much especially feeling what I feel.............is this test safe and without complications and is this true that it can give 100% guarantee that it is not my heart??????????????????

[ConsueloMaru]

I thank you, for answering me, I just wanted to know if the likelyhood of a heartattack is less possible, since I am a non smoker now for 25 years, no family history of heart problems and ALL cardiac tests have come back negative??????

[Cleveland Clinic]

If the cath is normal the possibility that you chest pain is related to epicardial coronary artery occlusive disease is essentially eliminated.  I say it that way because coronary vasospasm and microvascular disease cannot be ruled out by catheterization alone.  At the same time, those are not that severe and are typically treated medically.  As far as a heart attack is concerned, unfortunately, nothing rules out the possibility of having one.  The fundamental difference between chest pain related to obstructive disease and a massive MI, is that massive MI usually are not preceded by chest pain episodes.  The massive heart attacks occur in pt who have very little coronary artery disease.  They take place because of increased inflammation in the vessel that leads to plaque rupture, clot formation and vessel obstruction.  The only way to prevent this is with medications, not a catheterization.  Things that are highly predictive of this are for example:  family history of heart attacks, smoking, diabetes, high cholesterol and high stress level.  Finally, on a good note, I don;t think that you chest pain is related to the heart at all based on how you describe it.  The fact that you had a normal stress test pretty much rules out severe coronary artery disease, again, it does not rule out that you won't have a heart attack in the future.  Nothing does.  I would not have the catheterization if I were you.  I wouldn't even have the stress test because your pain does not sounds cardiac in nature at all.