### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am 53 yrs old and at age 47 I had a mild heart attack with 1 stent placed in the RCA.  Now in the last few months I have been having what my Dr calls angina. I have been taking Imdur for this but in the last month or so I have been having more episodes as many as 20 a day.  I had chest and arm pain thursday for about an hour that did not go away so i went the the ER and then to the cath lab for heart cath but my Dr said everything is fine, so what could be the cause of the pain that I am having? Any suggestions as the where to look next.

### output:

Hello welcome to Chat Doctor. Since you have got yourself evaluated by an angiography and your doctor has cleared you from the heart side, means that the stent is working well. Angina can be caused by microvascular ischemia, which means the smallest vessels of the heart arteries are having blocks. These blocks cannot be seen by angiography nor can be scented. The treatment for microvascular ischemia is antianginal, statins and anti platelets. You need not worry because it won't cause you any health issues. Other causes if chest pain here should be excluded. Like hyperacidity can mimic chest pain of cardiac origin. Please take a course of antacids for 14 days and see if your pain abates. Another cause can be Costco Chat Doctor.  This inflammation can be contained by using anti-inflammatory medications like diclofenac and ibuprofen. Next Vito levels should be checked. Bit D deficiency can also cause rib pain, bone pain fatigue. Please check your It D levels and take correction for it D of they are low. You have a low probability of this pain originating from cardiac causes. So please continue taking tour cardiac medications and along with it take antacids, diclofenac and It D correction as advice. Wishing you good health. Regards