Heart Health: Risks After Normal Coronary Angiography

Coronary Angiography

I would like to ask if having undergone a coronary angiography a year ago with no abnormalities, no calcification, and no stenosis still poses a risk for cardiovascular disease.
Recently, I have been experiencing persistent pain in my left shoulder, along with back pain and neck pain.
I have tried rehabilitation and muscle relaxants, but the pain persists, and I have a dull ache in my back.
I am currently taking lipid-lowering medication, which I have been on for four months.
Could this possibly indicate a heart issue? Thank you, doctor!

Ming, 50~59 year old female. Ask Date: 2024/05/31

Dr. He Dongjin reply Cardiology

Hello, a year ago you underwent coronary angiography which showed no abnormalities, no calcification, and no stenosis.
While the risk of developing cardiovascular disease remains low, it is still present.
You are experiencing pain in your left shoulder, back, and cervical spine.
Some individuals may experience this side effect from lipid-lowering medications.
It is advisable to stop the lipid-lowering medication for observation.
Changhua Hospital cares about your well-being.

Reply Date: 2024/05/31

More Info

Understanding heart health and the risks associated with cardiovascular diseases is crucial, especially after undergoing a coronary angiography that showed no abnormalities. While a normal coronary angiography indicates that there are no significant blockages or calcifications in the coronary arteries at that time, it does not entirely eliminate the risk of developing cardiovascular diseases in the future.
Cardiovascular disease risk factors include a combination of lifestyle choices, genetic predispositions, and existing health conditions. In your case, you mentioned that you are currently taking lipid-lowering medication, which suggests that you may have elevated cholesterol levels, a known risk factor for heart disease. Even with a normal angiogram, factors such as age, family history of heart disease, hypertension, diabetes, and lifestyle choices (like diet and exercise) can still contribute to the risk of developing cardiovascular issues.

Regarding your recent symptoms of left shoulder pain, back pain, and neck pain, it is essential to consider that these symptoms can arise from various causes, including musculoskeletal issues, nerve compression, or even referred pain from the heart. While it is less common for heart-related issues to present solely as shoulder or neck pain, it is not impossible. In some cases, individuals may experience atypical symptoms of angina, which can include discomfort in areas other than the chest, such as the shoulders, arms, neck, or back.

Since you have been experiencing persistent pain despite rehabilitation and muscle relaxants, it is advisable to consult with your healthcare provider for a thorough evaluation. They may recommend further diagnostic tests, such as an electrocardiogram (ECG), echocardiogram, or even a repeat stress test, to assess your heart's function and rule out any potential cardiac issues.
Additionally, it is important to monitor any changes in your symptoms. If you experience new symptoms such as shortness of breath, increased pain, or any signs of a heart attack (like chest pain, sweating, or nausea), seek immediate medical attention.
In summary, while a normal coronary angiography reduces the likelihood of significant coronary artery disease, it does not completely eliminate the risk of future cardiovascular events. Your current symptoms warrant further investigation to ensure that any potential heart issues are addressed promptly. Regular follow-ups with your healthcare provider, maintaining a healthy lifestyle, and adhering to prescribed medications are key components in managing your heart health.

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It is recommended that you discuss the above situation further with your attending physician to determine if any additional examinations are necessary. Thank you, and wishing you good health!