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Question:

Can a person have chest pain with so little blockages? 

Hi, I am 46 female with CAD. In 2005, I had double bypass with a block in the left main. In 2005, I had a stent put in because it was said the LIMA graft failed to mature. My latest cath showed the LIMA is better. I do have diffuse disease of the LAD with blockages being 30 percent, also 30 percent in the circumflex. I was told the 30 percent in my right coronary is no longer there. I have been having chest pain with arm pain, neck pain and pain in both arms. Also feeling sick to my stomach with chest pain. SOB at times, too, feeling like someone knocked the wind out of me. I had an upper GI with a little gastritis, a lung function test, stress test, cath are all normal. The cath just showed nothing new. I have read on a cath that uses ultrasound but I hear that it is used only if the blockages are not sure. I had a high sensitivity C Reactive Protein test and it was 23.3. Can it be possible that the blockages are higher than thought or the possibility of small vessel disease? Can a person have chest pain with so little blockages? Thank you.

submitted by Chris from Illinois on 1/19/2013

Answer:

by Texas Heart Institute cardiologist, Roberto Lufschanowski, MD  

Roberto Lufschanowski, MDDear Chris: Your case is obviously complex and, although your e mail is very appropriate, it is not fair to give you an opinion. One test that might give more information is an MRI with adenosine. Ultrasound of the coronary arteries is very useful for decision making but in somebody like you, with multiple lesions, difficult to do and not without risk.  

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Updated January 2013
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