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How to manage mild chest pain after two normal angiographies?

Q: I have had two angiographies in the past 3 years and both the times coronaries were found to be normal. A TMT done last year was positive. Stress Thallium subsequently also showed stress induced reversible ischaemia ( moderate). In fact I feel mild pain in my left chest occasionally during rest only. At other times, I feel discomfort (not accompanied by pain) in my chest. Kindly advise if I need to go for third angiography and if it is still normal, how to manage my discomfort and occasional mild pain.

A:If your stress thallium at the time of last angiography was entirely normal and you feel the symptoms have increased it may be worthwhile repeating an angiography. It is all the more important if you have other risk factors like diabetes, hypertension, family history, etc. If the angiography is entirely normal then it is labelled as a clinical entity called Syndrome X and medical treatment is required.

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