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A 40-year-old female asked:

I get angina symptoms but the doctors say that my heart is fine. small vessel disease showed up in stress test, cta, x-ray, echo and ekg. i have 10 lesions in my brain and theyre trying to rule out ms but would they miss svd in mri?

4 doctor answers6 doctors weighed in
Dr. Mark Rasak
Cardiology 33 years experience
Depends: The brain i assume was evaluated with the cta and MRI with contrast. The heart with a stress test . Not sure from your question if a cta was done of the heart. If your having on going chest pain but tests look ok , then arterial spasm , small vessel dz, non cardiac sources should be ruled out. Can't really tell what tests were done for your heart vs brain. ? What type of stress was done etc.
Dr. Tracy Lovell
Rheumatology 21 years experience
See below: Consider being checked for antiphospholipid antibody syndrome which is a clotting disorder which could explain some of your symptoms. If you have had blood clots or miscarriages in the past, you definitely need to be checked.
Dr. Rama Garimella
Cardiology 33 years experience
No: Small vessel disease typically not seen with any of the above tests. Sometimes we can see in angiogram. Sometimes it is more of a clinical diagnosis.
Dr. Shahin Tavackoli
Cardiology 23 years experience
No, if done correct: Both stress test with radiotracer (nuclear stress test) and cardiac MRI with contrast can have findings that correlate with small vessel disease. If a nuclear stress test is definitely positive, the CTA negative and the person has typical anginal symptoms; they more likely have small vessel disease than anything else. Chest pain on a treadmill remains the most reliable indicator for true angina.
Dr. Umesh Patel
Dr. Umesh Patel commented
Preventive Medicine 42 years experience
Dysautonomia Syndrome causes many different symptoms alleviated by avoidance of stimulants, ensuring hydration, using magnesium, omega fish oils (www.cardiamin.com, use code: CMC), ultra-low dose beta blockers e.g. propranolol 5 to 10mg two to three times daily and SSRIs e.g. citalopram 5 to 10mg daily. Read Dr. Ronald Hoffman’s book (www.Amazon.com) and visit www.dysautonomiainternational.org
Jun 21, 2015

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Last updated Nov 1, 2020

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