Question: I am experiencing achy arms, particularly when walking in cold weather (mostly after eating but other times as well). My PCP thought it was acid reflux, as I have had diagnosis of GERD in the past (also IBS). She gave me nitroglycerin which I didn't use, because the symptoms ease before I return home from my walk. I then made an appt. with my cardio after having more eipisodes of achy arms. Stress test & echo were fine, but dr. said that I could still suffer angina from "small vessel disease" which was diagnosed from my brain MRI in 2008 (there was no difference from an MRI done in 2000 but SVD was not mentioned then. He prescribed a trial of antacid vs. nitro to see which was effective. I haven't tried either at this point since the symptoms are not long-lasting. The confusing thing is that, even though SVD was diagnosed, there was a statement to the effect that "interestingly on the sagittal view, the corpus collosum is bright on flare imaging, a typical pattern for MS. I saw a MS specialist at Cleveland Clinic after the 2008 MRI. He said the gray matter was MS related (a benign type and not SVD). I had some MS symptoms in my 20's, but nothing progressive. I've also had some aura-related migraines recently. Thanks for your help!

Thanks for your brief reply. I appreciate your time and analysis; however, I don't feel that you adequately addressed my concern about small vessel disease. I realize that you don't have the visuals, but would like your perspective about whether the achy arms are angina related based on the SVD diagnosis. Thank you!