Your MRI findings are very common and often relate to normal aging, high blood pressure, or cholesterol. To protect your blood vessels, doctors typically manage risk factors using daily low-dose aspirin or cholesterol-lowering statins (like atorvastatin), alongside lifestyle changes. For your lightheadedness and chest sensations, it is important to have your heart evaluated by a doctor to rule out cardiac issues. They may check for blood pressure drops when you stand. Depending on their findings, treatment might include staying hydrated, adjusting current medications, or prescribing treatments for heart rate or acid reflux. Please seek immediate medical attention if your chest symptoms become severe.