My one-year-old angiography report was normal, but I still have chest pain; Why?
ADVERTISEMENT

Q. Is my angiography report normal?

Answered by
Dr. Muhammad Majid Hanif
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Sep 16, 2017 and last reviewed on: May 31, 2023

Hi doctor,

One year ago, I had chest pain. I thought that it is may be due to some excessive spicy food I took the last night and also I did not sleep till late due to some work. So, I just ignored it and left for my work. That day, I had to go somewhere driving myself and I thought it as just a minor chest pain and will go away eventually. Hence, I left with my car driving myself. That pain did not go away rather stayed with me the whole day and by afternoon, it became worse. That day I was so busy and I was almost with empty stomach. So, I had some food and thought it would go away. I felt a little better for some time, but the pain was still there. At evening, I had to admit to a hospital and they gave me medication like Sorbitrate, etc., but the pain was there. I was not fainted, but I felt that I am going to be. The hospital suggested for ICU and when they were taking me there, I suddenly felt fine. The pain went away out of the blue; I sat up on my bed from lying down and was feeling that I can go running now, just like nothing happened to me. Still, doctors suggested an ICU and I got admitted. They did all tests in the next two days and discharged me with a suggestion of an angiogram. I got angiogram within a week and the report came normal. Now, my problem is, sometimes I feel very little chest pain, which is usually sharp. But, it is sometimes vague in various areas of my upper body. I do not know what my problem is. Can you please check my reports? That incident occurred one year back and I just recently did some usual basic tests. Please tell me your suggestion. Thank you.

#

Hi,

Welcome to icliniq.com.

I want to assure you, do not worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case, reports (attachment removed to protect patient identity) and can well understand your genuine health concerns.


The Probable causes:

You have got a normal coronary angiography report. Nothing found abnormal in it. There is nothing serious seen in echocardiogram attached here. Your blood work done recently has been totally unremarkable and there is no harm seen. No lipid profile derangement to pose a cardiac risk. But, you had supraventricular tachycardia of unknown origin with chest pain one year back. Such a pain is usually seen in young adults who remain busy in their daily life routine. This is the disease of the modern era. People have more stress at work, take very less rest, take little quality sleep, do not exercise, take a junk diet and take less nutritious diets. Fluid and electrolyte imbalances and nutrient deficiency leads to muscular weakness and the ache. Undefined painful chest areas are also a problem with smokers and alcoholics. If you take alcohol, smoke or use any other illicit drug, please try to leave that. I want to run a battery of some tests that are necessary to be done right now. Once you get the reports, upload in a follow up.

Investigations to be done:

Do HBSAg (hepatitis B surface antigen), Anti-HCV (hepatitis C virus), vitamin D levels, vitamin B12 levels, LFTs (liver function tests) and RFTs (renal function tests).

Treatment plan:

I suggest Excedrin (combination of Acetaminophen, Aspirin and Caffeine) daily after breakfast for three days. Then, take it only at the time you feel pain. Try to avoid as much as you can but if unbearable, then it is fine to take. Take Citrucel (Methylcellulose) dietary fiber supplement. Take tablet Surbex-Z - multivitamin once daily and continue for a month. Start jogging, walking10,000 steps daily at a healthy pace is your goal. It gives endurance, muscular power and many more benefits. Consult a specialist doctor, discuss with him or her and take the medicine with consent.

Regarding follow up:

Revert back with the reports to a cardiologist online.

Thank you doctor,

I did the tests as per your suggestion and have few reports in my hand except RFT, vitamin D and vitamin B12. Kindly check and tell me what is the matter. In my unprofessional observation, I see some problem with my liver. I want to mention that I am not an alcoholic. Probably, I will take one or two drinks in a year with some request in social gatherings. I am worried about the results of SGPT and ALP. I found on the net that elevated ALP is usually associated with cancer, etc. Also, to tell about myself, I was living a sedentary lifestyle till a few days back. My weight was 165 pounds and height is 5'7" feet. I am 34 years old. Previously, I was two times meal person. I used to skip my breakfast and will take a large amount of white rice with fish or meat or chicken or biryani. Occasionally, I will eat vegetables and fruits. Before two months, I bought a treadmill and walking almost regularly up to 8 to 10 km every day. I have greatly reduced my carb intake and increased vegetables and fruits. In the last 2 months, I reduced my weight and now my weight is 152 pounds. I do not know whether my weight loss is due to my treadmill session and reduced carb intake or any underlying serious disease. Previously, I used to sleep late. Almost never sleep before morning 4 AM and woke up after 11 AM. But, I am trying to sort that out, right now.

#

Hi,

Welcome back to icliniq.com.

It is necessary to screen liver and kidneys in such cases of pain. Your blood reports (attachment removed to protect patient identity) show no significantly remarkable finding to get worried right away. There is not much deranged. A little higher limit of the liver enzymes are seen in which nothing is needed to do right now as far as medications are concerned. But, remember such patients with a borderline laboratory findings need periodic follow up. So, I put you on a follow up list. After every eight weeks, you need to go for the tests written below. Upload the reports for my opinion. I will preferably suggest you to choose the best laboratory for blood work, so that nothing is left undetected due to false technique of the laboratory. Your Hepatitis B and C test is negative in reports. But, the reports are done on the kit and false negative fluke test results are very common with that method. I will prefer you to go for ELISA (enzyme linked immunosorbent assay) viral screening of the liver. I have written the tests below which you need to go for. Your weight loss is due to the lifestyle modification not due to any disease. There is no suspicion of cancer. In cancer the results are many folds high and you need not worry. Avoid alcohol, even the one or two episodes too. It is not good for your liver. Some medications also cause increased liver enzymes. So, we have to look after it periodically. Try to adjust your sleep habits in a rhythmic way. Sleep at the same time every day. There is almost no risk to the heart based on all the reports seen throughout our discussions.


Investigations to be done:

Go for these tests after six weeks and upload the reports. The tests to be done are CBC (complete blood count) with ESR (erythrocyte sedimentation rate) and differentials, HBSAg (hepatitis B surface antigen) and anti-HCV (by ELISA), serum electrolytes, LFTs (liver function test), RFTs (renal function test), thyroid profile and ultrasound abdomen.

Preventive measures:

Avoid smoking, if you do.

Regarding follow up:

Revert back after six weeks to a cardiologist online.

Thank you doctor,

Here are my remaining reports for vitamin D and vitamin B12, which seems insufficient. Please advice. Also, I will upload the batch of reports after six weeks as you suggested along with ELISA of both Hep B and C. Can you please tell me why you suspected the hepatitis B and C, especially B? I have not done any unprotected sex for many months. Also, I would like to try Liv 52 DS for my liver. Shall I? What dosage I need? Kindly suggest. I have not been having any fever since last few years. I do not even remember when I had last so I guess it would be a minimum of three to four years back. Is it not a bit unusual? As people usually got at least one to two fever each year. I get a mild cold sometimes that even does not warrant any medication.A few days back, I reached my home at night 9 PM after driving for almost 2 hours; I saw my mother was checking her BP by her digital home BP machine. I just checked mine and the result was a bit shocking. It was 150/92 mmHg and my heart rate was 110 beats per minute. I never checked mine till that day. So, I decided to check it again. The next morning, it was 110/75 mmHg and the heart rate was 76 beats per minute. The same night my BP was 145/85 mmHg. What to do?

#

Hi,

Welcome back to icliniq.com.

I have gone through your reports (attachment removed to protect patient identity).


The Probable causes:

Yes, you have significantly low vitamin B12 and also your vitamin D is too low. I suspected hepatitis because your symptoms look like that. But, it does not mean you really have hepatitis. Let us wait for the ELISA reports. If someone has unprotected sex with a hepatitis patient six months back, it is possible to have symptoms today as after six months we say it has become chronic disease and also in six months body defends against the infection and tries to wall it off. If failed in doing so, the symptoms appear after a lag period. Also, it is necessary to screen you as you live in an area where viral hepatitis is prevalent and every sexually active person should have to be tested on a little clinical suspicion. Liv 52 DS a herbal supplement is claimed to be good, but the benefits are not scientifically proven by much of the research. If you want, then take once a day and not more than 2 to 4 weeks. If you do not get a fever, then no problem. It is not mandatory that you have to get the fever for sure. You are lucky if you do not get sick much. Yes, it is good to keep an eye on your blood pressure. But, digital blood pressure monitors are totally a flop and are just for a reference. It can never give the exact reading. I recommend you to get yourself checked with a mercury sphygmomanometer. Mercury machines are accurate for blood pressure monitoring.

Investigations to be done:

When you repeat other tests, repeat vitamin B12 and D levels too. I suspected them to be low in you. Start the suggestion given below and repeat test to see if these are working well for you.

Treatment plan:

Apply sunscreen lotion (U-Veil SPF-60) and daily go out in sunlight for 10 to15 minutes with sunglasses on. It will help make vitamin D in your body. Take fish and meat in the diet. It will help you get back to normal levels of vitamin B12.

Preventive measures:

No alcohol, cigarettes and sedentary lifestyle.

Regarding follow up:

Revert back after six weeks to a cardiologist online.


Was this answer helpful?

 | 

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!



Related Questions:
Kindly explain the abnormality present in my coronary CT angiogram.

.. here to help you. I have studied your report (attachment removed to protect patient identity). One of your arteries is not following the normal anatomical course as in other people. However, this is a normal variant as is not going to harm you.   Read full

Chest pain since 15 days. ECG & TMT reports are normal. What could be the problem?

Hi doctor, My husband's eye got hurt with my finger accidentally. Now his eye hurts and can barely open. There is a red spot on the white area of his eye. What do we do? Please help.   Read full

Can chest pain have other reasons than heart attack?

Hi doctor, My husband's eye got hurt with my finger accidentally. Now his eye hurts and can barely open. There is a red spot on the white area of his eye. What do we do? Please help.   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read


PCOS and Liver Problems
The hormonal imbalances in polycystic ovary syndrome could cause liver diseases. Read the article to know the relationship between these medical conditions.  Read more»
Inferior Alveolar Nerve Lateralization Technique
The inferior alveolar nerve lateralization technique is a surgical lateralization technique to reposition the nerve. Read the article to know more about this.  Read more»
COVID-19 and Ebola: Similarities and Differences
This article gives a comparison and broader overview of the outbreak of the two deadliest diseases that showed a greater incidence over the last two decades.  Read more»

Ask your health query to a doctor online?

Ask a Cardiologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.