Dear Dr T, Following a CABG X3 in Sept 2012 I have had ongoing chest soreness. I had an echo done in the summer which showed slight heart damage and an EF of 50-55%. At my own request I also had a treadmill stress test about 2 months ago and I lasted 18 minutes with chest soreness which didn't get any worse during the test and thankfully the 'result was negative with an excellent level of exercise.' On the bike today during a hill climb I suddenly had fairly bad pain across my chest accompanied by 'skipped beats' every two or three beats (I had the skips before surgery and they have never given me any trouble when exercising) my heart rate did return to the 80's though in about 1-2 minutes and I felt ok otherwise. When I stopped the pain subsided and I was able to carry on with no real problems although my chest still felt/feels sore. I guess my question is as follows: is a treadmill test a good indicator of everything being ok and could the pain today have merely been chest wall pain? I'm 47. Thank-you
I cannot tell whether this latest episode is different from the your previous pains that appear more muscular skeletal in nature, but because this episode appears different recommend another cardiac stress test or a CTCA to rule out a sudden graft failure. Persistent muscular skeletal pains sometimes are the result of painful sternal wires, that (if so) can be easlily removed with a minor operation.
I am 44 female, don't smoke, no BP, no diabetes, no cholesterol. I have always had pvc's but they were once in a while. Since the beginning of 2013 I have them more frequently and sometimes the heartbeat is so painful, it's like a knife stabbing me from inside. The pain radiates to the neck and jaw. I just recently had a mibi stress test. Since my pvc's happen at rest 98%of the time, I didn't have any on the treadmill. The pictures of the heart showed no abnormality. I know that I should be relieved, but I am not. I can't seem to get a clear answer to what exactly causes them. I drink one coffee a day, no soda. I do use an asthma medication though. My twin brother died at the age of 22 of a heart attack with no underlying heart problem. I have also read on coronary spasms which have a similar profile to pvc's, they happen mostly at rest, are very painful, pain can be felt in the neck and jaw, but they can't be detected on a mibi stress test if you don't have on during the test. Do coronary spasms show on an ecg? My next train of thought would be to ask m doctor for a holter. What are your thoughts on this? Without a test, is there a way to differentiate between pvc's and coronary spasms? And are painful pvc's normal? Thank you, any help would be appreciated.
I recently read that 60% of heart attack victims will have a 2nd heart attack. Is there a known reason for such a high rate? Also, is there a timeline in which the 2nd attack is likely to occur? Thank you
In Feb. 2013 I experienced 2 heart attacks, which led to the insertion of 3 stents. Afterward I felt great, cleaned up my lifestyle considerably, however I did not right away. Recently I ve been experiencing angina pains when my heart rate is increased even by simple walking for 5 min. Is there exercise or pharmaceutical treatment, or is more surgery iminent? Thanks
Figure A shows the coronary arteries located on the surface of the heart. Figure B shows a stent-widened artery with normal blood flow. The inset image shows a cross-section of the stent-widened artery. In figure C, tissue grows through and around the stent over time. This causes a partial blockage of the artery and abnormal blood flow.
I recently had pericardial effusion and tamponade.....I was fixed with a drain for 5 days but they did not go in blind. The surgeon cut a 4 inch incision in order to direct the drain and to take a biopsy of the pericardial sac. Its been 3 weeks and now Im having some sharp pains on my left side just under the rib cage. I feel like I have to hold my chest in to ease the pain. Could I have torn something or could it be fluid on the left lung causing the sharp pains?
History: 51 yr. old F, healthy(slightly overweight). Runner/jogger since 1998. Last Sunday during a Half Marathon developed pain in chest left side directly under collar bone did not radiate down arm. Severe nausea, dizziness, lightheaded, & tired. Continued nausea for next 2 hours after race. HR too high the first 5 miles (162-174bpm)slowed down to 154-161bpm. Mile 8 to 13 is when the pain developed and got worse if anything other than a walk was attempted. Have had same symptoms in the past did EKG/Stress Test all was normal (4 yrs. ago). Current Dr. visit same routine EKG/Chest X-Ray & Stress Test (still waiting for results/ appointment). If all comes back normal should I request a visit to a cardiologist to be safe? None of this is normal for me, heart rate has been higher as slower paces, going up stairs sometimes feels like I just did a short sprint, extreme fatigue. But all could be related to something else? Paternal grandfather passed from heart attack under the age of 40 don't know if that makes a difference. My Triglycerides were a little high last testing about 4 years ago more concerned about a possible blocked or partially blocked artery. Thank you in advance for your time.
Your symptoms are very suggestive of angina and coronary artery disease, but why do you ask for an opinion before the results of these tests are available? They will give you a much better answer than anything I can guess from here!
While I don't know of course what is your situation, the most common symptom of a heart attack in both men and women is some type of pain, pressure or discomfort in the chest. But it's not always severe or even the most prominent symptom, particularly in women.
Three weeks ago I start having chest pain, shortness of breath, light headed, and dizziness. I went to my medical doc who referred me to a cardiologist. I was examined, failed the stress test, and was scheduled for a heart cath. After the heart cath my cardiologist said my arteries were clear, my heart was good, but a muscle in the back of my heart was having spasms. The cardiologist prescribed nitro for the pain or spasms. I'm afraid of the nitro if i'm not having a heart attack but yesterday the spasms started and today I'm at home because of the pain/spasms. I'm not sure what to do? I'm not even sure what a heart muscle spasm is I can't find any information? Is it serious?
(Image from Mayo Clinic)
I assume it was spasm in a coronary artery. The condition is called Prinzmetal's Angina. NTG is an appropriate treatment.
hello, i am 37fem with 3 kids. lately i have been experiencing odd pains in my chest/back(occasionally and scared it's angina.
specifically, started few weeks ago, i went for my pap test and got nervous when waiting i started feeling like "water" running in my chest and i believe i had acid reflux. then on friday, i was on the bus with my kids and i started having pains like bruising up in my chest , got scared but tried to brush it off. yesterday i was washing my terrace when i had pains again in my chest, then all day my chest (esophagus) and neck area hurt but not at the same pain level. got to sleep with a terrible migraine woke up ok i decided to exercise in my treadmill, was feeling fine fine fine but after i finished and got off i had pain in my upper back no other feeling whatsoever. i did some jumping jacks etcc. and felt a bit of pain again when i sit down it went away. i know this is the description of angina but could it be my esophagitis? i neglected my meds and diet all winter and have been taking my meds again for about a month now. could it be angina with normal to low cholesterol/high hdl very low triglykerides , negative heart disease in family etc...?
i had no other symptoms except in the morning when i woke up i had a burning tongue. i am of normal weight don't smoke or drink, stay away of sugar and fatty foods and exercise as much as i can with 3 kids. no edema anywhere. as i am writing this i am very very scared !!!
i have hashimots thyroiditis, gastritis and esophagitis , mild mitral prolapse, had a heart check up last year, was given the all clear.
would be grateful for any info.
It is unlikely to be your heart or angina, but with your history of GI problems, I suspect another problem such as esophageal spasm may be an issue. This can only be resolved with an examination and appropriate testing.
Chest pains in the middle and nausea. I wake up some nights sweating, heart racing and skipping beat and stomach pains and nauseau. I get light headed and just don't feel right in my chest area with chest pangs and generally discomfort in the chest area.
Time to see your doctor! At your age (46 years) these symptoms could have many causes and be related to these palpitations, or an underlying heart problem (or nothing serious). Without a consultation and testing there is no way to diagnose whether you have a problem that requires treatment, or whether these are related to early menopause.
I have a 80% blockage of my ramus branch of the coronary artery. I was initially hospitalized in the Kaiser Permanente Hospital in Sacramento in 1/1996 with chest pain and it was determined I had a LBBB. Since that time I have had 5 heart protocols after complaining of chest pain. My Dad, a patholgist, kept telling me to keep after it because it appeared nobody was believing me. Finally, in 11/2011 I was catheterized and a 80% blockage was found. Due to its small caliber it could not be stinted or survive angioplasty. I have been on Ranexa. I am not getting worse, nor am I getting better. I have type 2 diabetes totally controlled. I also have myasynthia gravis also controlled and Low T. My whole family is doctors. I was a USAF pilot and I also lettered in HS and College Football. Altough my height and weight is out of proportion, I look exactly like my Dad and Uncles look and none of them were athletic nor did any of them die of heart disease and all lived into their mid 80s. I have never smoked or used illegal drugs and was always acive. Unfortunately perhaps, I have a high pain threshold and on several occassion I have continued to function with serious wounds and disease until forced to stop.
I trust my current cardiologist, and he has indicated that no other method would have found my blockage. He also has told me that my prior heart protocols were invalid as my LBBB would have made them inaccurate. I also went over this data with my first cousin, the senior pathologist at Cincinnati General or whatever it is called now, and he also confirmed this. My problem is that being a former veteran and exposed to Agent Orange, the VA is giving me an Effective Date of the day of my heart catheteriztion in 12/11.
Their definition of cornonary heart disease specifially includes angina which I have been complaining about for many years.
Nobody called it angina until the catheterization.
My first question is, with a small caliber artery blockage, what are the chances of a heart attack?, and second, why can't my complaint of chest pain be called angina? My dad passed away 10 years ago or I would be asking him. He also was a VA consultant. I feel sorry for vets who have do deal with the VA without help.
An 80% obstruction of the ramus branch of the circumflex coronary artery means you have coronary artery disease, but not necessarily that your chest pain is angina, caused by this blockage. For that, other tests such as a stress test are necessary. Considering this lesion was discovered in 2011 and the ramus is as small as described by you, the volume of blood that flows through is also very small and therefore unlikely to cause much trouble even now, and an even less likely reason for angina since 1996.