Reader: I have had two angioplasties and a heart attack in 2004. Some months ago, I had a nuclear stress test and pulmonary test. They said both heart and lungs are pretty good. I still get out of breath so easy and am dizzy a lot. I take nitroglycerin every now and then. It takes away the slight pain and heavy feeling that I get in my chest. My shoulders and neck both ache after using my arms a lot. I take 12 prescriptions, including insulin.

Hope you might give me some insight into my problem. Both my parents and all grandparents died of heart and/or related problems.

Dr. Zipes: From your description, you definitely have obstructions to blood flow in your coronary arteries that have caused your heart attack and probably the "slight pain and heavy feeling," as well as the ache in your shoulders and neck after using your arms a lot. This discomfort sounds like angina, which is due to the heart not getting enough blood flow. The angioplasties you have had were procedures to open up the clogged arteries. The fact that the nuclear stress test is "pretty good" is a helpful sign that the obstructions are not too significant at present. You need to be sure that all your risk factors are under control, the point I made to the other reader.