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Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Medical
Satisfied Customers: 9126
Experience:  17 yrs experience in treating OPD & Emergency patients.
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5/6 times over the last 3 years I have experienced chest pain.

Resolved Question:

5/6 times over the last 3 years I have experienced chest pain. I stopped smoking over 3 years ago and do not drink to excess. I am 62 years of age and am still working with home support.
I have a greyhound and do walk regularly.
First,second and third time this pain came I was admitted to hospital and told it was not a heart attack and they couldn't actually give me a diagnosis.
This caused them to investigate and I went through the treadmill then bike with the radioactive dye, and just last year an angiogram . All came back negative, just about 3 weeks ago I had another attack and within 20 mins it was away. I have to point out this never comes with exercise and a few times has actually happened while I have been sleeping, and has wakened me. Monday I had another attack and within 30 mins it had disappeared . I made an appointment with my doctor and this locum seems to think it is coronary artery vasospasm.
I have been reading about this and I honestly don't know whether I should be worrying a bit more than this doctor is making out.
I have to say I probably am about a little overweight 5 ft 3 and nearly 12 stone.
Think I would like to know whether or not I need to get a second opinion.
Can I just say that I think this does worry me when it happens especially since I get this peculiar pain in my right jaw and this happens every time. And I read somewhere that this is a sign of a heart attack.
Most times in between attacks I am very healthy and on no medication at all.
Thanking you in advance .Linda
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. P. Jyoti replied 2 years ago.
Dr. P. Jyoti :

Hello,

Dr. P. Jyoti :

hello

Dr. P. Jyoti :

would you like to chat on this?

Dr. P. Jyoti :

when did you do the angiogram?

Customer: The angiogram was prob done about 2 years ago
Dr. P. Jyoti :

Well as the angiogram was normal you have very little cause for worry

Dr. P. Jyoti :

since you were already having chest pain at that time the angiogram indicates that this chest pain was not due to coronary artery causes

Dr. P. Jyoti :

ie, not due to heart causes

Customer: But it's the reoccurrence of the attacks which are scary is there nothing I can do
Dr. P. Jyoti :

yes thats right, i was just going to add that that is the established wisdom

Dr. P. Jyoti :

but it is now well known that coronary chest pain can occur with normal angiogram also

Dr. P. Jyoti :

an angiogram checks for decrease in lumen of arteries below 50%

Dr. P. Jyoti :

so if your lumen is decreased by only 60% say, you would still have a normal angiogram

Customer: What on earth is this lumen
Dr. P. Jyoti :

i mean lumen or diameter of the coronary arteries, the arteries that supply the heart

Dr. P. Jyoti :

it is this diameter that is studied by angiogram

Dr. P. Jyoti :

so even if the arterial diameter is slightly decreased you would have a normal angiogram but continue to have chest pain

Dr. P. Jyoti :

the locum may have been right in calling it coronary vascular dysfunction

Dr. P. Jyoti :

Coronoary Vascular Dysfunction is a possibility in your case

Dr. P. Jyoti :

the examination that you need is called SPECT

Dr. P. Jyoti :

askyour doctor about doing SPECT

Customer: So would you advise me to go back to my dr again and just say what has happened and perhaps look into getting something if there is anything to stop it happening
Dr. P. Jyoti :

it is non-invasive and not like an angiogram

Dr. P. Jyoti :

yes thats right

Dr. P. Jyoti :

here's an article that I would like you to read later and perhaps take a printout to your doctor

Dr. P. Jyoti :

ask your doctor about doing SPECT

Dr. P. Jyoti :

Discuss this with your treating doctor. You will get more attention when you are able to ask informed questions. Ask about this Coronary Artery Dysfunction and whether it is likely for you, and if so, what further investigations need to be done to confirm the diagnosis.

Customer: Like the part where you say non invasive at least that doesn't freak me out. After this test would this put my mind at rest more
Dr. P. Jyoti :

yes thats right

Dr. P. Jyoti :

it would be a further confirmation

Dr. P. Jyoti :

Take care - wish you good health and a quick recovery.

Dr. P. Jyoti :

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is always welcome Thank you.
Dr. P. Jyoti

Dr. P. Jyoti :

any further questions?

Customer: Thank you very much and this is much appreciated Linda
Dr. P. Jyoti :

glad to help

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