Q: If I get angina pain because of the spasm of the coronary artery, then what medicine should be taken as SOS? I have been getting these bouts of and on over the past 4-5 years. I have consulted many doctors and have undergone a host of investigations. All investigations (including coronary angiography) have been negative. In my case apart from usual symptoms of angina (chest pain spreading to the left shoulder, arm and neck. The pain also spreads to the lower limb. High levels of B.P. are also recorded. By the time I go to a doctor and an ECG is taken (this has happened at least half a dozen times), the ECG comes normal. How can it be correctly diagnosed? Can high B.P. cause angina pain?

A:Anginal pain does not go below the umbilicus. Your pain is most probably not anginal. Also anginal pains typically happen with exertion and are relieved within a few minutes of taking rest. As you have normal coronaries you are not at risk for heart attacks. Spasms are not common. They are diagnosed by special provocative tests during angiography, but most doctors do not do these tests as some normal people can also have spasms with provocation. Most spasms are relieved by sublingual (under the tongue) sorbitrate 5 to 10 mg. They can also be prevented by calcium channel blockers like amlodipine or diltiazem, which are also good drugs for high blood pressure. Stress tests (exercise treadmill tests or nuclear stress tests) can be done to document decreased blood supply to the heart muscle at themicrotube supply level. If your treadmill test is also normal, it will exclude even this cause of anginal pain that occurs with exertion. I suspect you do not have anginal pain. Your doctor can decide quite accurately after taking a detailed history from you.