• Findings strongly suggest non-obstructive heart disease.
• With normal angiogram, zero
calcium score, normal echo (EF 65%) and ECG, chances of a life-threatening cardiac problem are very low.
• Persistent symptoms are more likely due to coronary slow flow / microvascular angina or non-cardiac causes (anxiety, GERD, musculoskeletal pain).
Is repeat angiography needed?
• No, not indicated at present unless new high-risk features develop.
Next Steps
• Start/optimize beta-blocker or
calcium channel blocker
• Consider ranolazine if chest discomfort persists
• Do stress test with imaging (TMT-Echo / nuclear) for reassurance
• Evaluate anxiety/panic disorder and GERD
• Lifestyle: daily walk, stress control, good sleep
Health Tips
• Symptoms are real but not dangerous
• Avoid repeated invasive tests without new evidence
• ER visit only if severe chest pain, syncope, or breathlessness at rest develops
Bottom line:
This is not a life-threatening heart condition. Focus on symptom control and non-cardiac causes rather than repeat angiography.