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Do I need special Heart Tests at my age?

Question: 
Hi. I am an 80 year old male, in good health. Over the years my BP has stayed in the 120/80 range and my cholesterol readings have also been within range. I have no angina or other heart problem symptoms. I was born with a murmur, which usually is not noted during examinations. While I do have a urologist, dermatologist and allergist, I have not felt the need for a family physician, for many years. Since I just turned 80, I felt that it was time to see a doctor and start annual exams. The questionaire that the doctors office sent me was extensive and asked, amomg other questions, when I had my last ECG and stress tests. I would like to be prepared for my exam and any recommendations, for testing, that the doctor might have.  Considering my age, as one factor and my being asymptomatic, as another, would you recommend any cardiac testing, if I was your patient? Thank you.

Not necessarily. At a healthy age 80, you have already passed many of the hurdles of most of your contemporaries. If you came to my office, you would get a routine physical & history exam, during which I'd try to find anything specific to focus on. Most of this would become clear from your answer in the questionnaire.

Heart valve leak, poor heart function and exhaustion

Question: 
My fiancee is a 48yr old blk male. He has pretty severe IBS and has lost 60lbs over the last year due to the IBS. He is now underweight for his height. Recently he has been having severe fatigue  barely able to go to work and come home and go to bed. He always feels exhausted. Blood work showed his cholesterol was high even though he eats very little due to the IBS. They were going to do a stress test but cancelled when a ultrasound showed his heart is working at 25% and he has a heart valve leak. The Dr. performed a heart cath. which showed no blockage. They still don't know what's causing the leak. The Dr. prescribed Crestor and sent him home for a week. What tests should we be talking to the Dr about?  Why would his cholesterol be high with him being underweight and eating so little? Is the Crestor safe with his history of IBS?

His doctor and you are focusing on the wrong thing, his cholesterol. Crestor is not going to help his heart except maybe in the long run. The issue here is the leaking valve and poor heart function of 25%.

My dad has congestive heart failure

Question: 
My father had myocardial infraction in 2000. Cardiac ECHO in 2010 showed 45% Ejection fraction. Now recent ECHO showed 20% Ejection fraction. The conclusion of Cardiac ECHO report is that Left atrium mildly dilated, Mild basal septal hypertrophy, Severely reduced left ventricular systolic function with severe global hypokinesia, Normal right ventricular systolic function, Grade 1 left ventricular diastolic dysfunction. Last week he has breathing problem, doctor diagnosed congestion in chest and suggest him Lasix ,Digoxin, Aldactona-A. Sir is this a very serious condition??? what should we do??? here is any treatment in medical science to normalize the ejection fraction of heart?? please help me??

Yes it is. Congestion stands for congestive heart failure (CHF), probably as a result of coronary artery disease causing heart attacks:

Very high heart pressures after ASD closure follow up

Question: 
She was operated for ASD and the patch is in-situ as per echo report. She was operated at the age of 23 and both her ventricles were enlarged as per discharge report of the hospital. She undergoes echo every 2-3 months. Is right heart catheterization a treatment or a diagnostic technique? Is there any treatment available for this high pressure. Is this pressure of 110 too high.

Right heart catheterization is a diagnostic tool for evaluation of pulmonary hypertension. Other tests should include various types of lung scans. I have blogged about this several times:
http://www.cardiachealth.org/ca-blog/pulmonary-hypertension-is-it-dang
http://www.cardiachealth.org/ca-blog/i-had-an-echocardiogram-that-show

High cholesterol in a very healthy male

Question: 
I am a healthy 55 year old man, who does not smoke, who exercises, and eats a low fat diet with lots of fruits and vegetables (I have been a vegan for 14 years.)  Nonetheless, probably due to genetics, I have struggled (sometimes unsuccessfully) keeping my cholesterol within normal range.  About a month ago, I received my highest results to date:  Total=274; Triglycerides=151; LDL=191.  My HDL was 53.  Because I was troubled by these results, I underwent a CIMT ultrasound.  My CIMT results were good, indicating an arterial age of 43 years old. Given high cholesterol mixed with a good CIMT result, what would you advise?  Would you still recommend statins for a person in my circumstances?  Thanks!

I suppose you can go either way: healthy 55 yo male, healthy diet, exercise, no evidence of cardiovascular disease, but with a high total cholesterol, HDL almost perfect. Statins are used primarily to reduce your LDL, increase HDL and reduce triglycerides, which in your case means your doctor would treat only the high T.cholesterol. Assuming you wouldn't have side effects, it might be OK to try a generic statin and see what happens.

An abnormal heart shape in a young man

Question: 
Hello I'm searching for information on the heart. My son age 24 has just been sent back to the states from Afghanistan from his job.  After his smallpox vaccination he began having chest tightness and rapid heart rates. He was medically advise to return home and see his primary doctor and a cardiologist. He has seen the cardiologist and he has ordered a echocardiogram and has him on a heart monitor. He seen his primary doctor today and had some X-rays done. The doctor has explained that the X-ray is showing that the heart is enlarged on his right side and also that he has found that his heart is in an odd shape instead if the rounded form of a normal heart his is actually has a v shape on the right side and it extends about 3 or more inches pass the regular size of a normal heart. I have seen the picture of the Xray and it literally looks v shaped some what like < this but more opened.  His doctor was straight up with him that he has never seen anything lime that and was very glad that my son has already seen a cardiologist. Can you help explain what this is? Please! Thank you

I cannot possibly comment on these findings w/o specific information, but an enlarged heart in a young man suggest either a congenital defect or a cardiomyopathy, best evaluated next with a cardiac ECHO and other tests. Since he has had an ECHO already, there should be a lot more information available than what you have given me.
Please read more here and come back to me when you know more:

I am afraid to get hypertension

Question: 
I am wondering what's the best way to lower Blood pressure. I had a normal blood pressure checked before and I am afraid to get hypertension. Are there any foods I should eat rather than medications? Thank you.

I am wondering what's the best way to lower Blood pressure. I had a normal blood pressure checked before and I am afraid to get hypertension. Are there any foods I should eat rather than medications? Thank you.

Safe Heart rates in Marfan Syndrome

Question: 
Can you tell me what is a safe heart rate for someone with Marfan syndrome during exercise? I have seen 100 bpm suggested, but that is quickly reached even while walking. I seem to be able to do very little exercise at all beforehitting this limit.

Where did you read this? You are quite right, a heart rate of 100 BPM is very easily reached without much exercise and you cannot live your life like that. The presence of Marfan Syndrome doesn't mean you are disabled, it means you are at risk for some of the vascular complications of Marfan's. Although most patients with Marfan's eventually develop some cardiac and vascular complications, this is best followed with regular check-ups at a center with experience in this disease. Meanwhile, your doctors should consider Beta blockers.

Can seizures cause heart failure?

Question: 
My husband has had seizures for thirty years and suddenly died of a heart failure Aug.9, 2010, could his seizures had weakened his heart throughout the years?

It is unlikely your husband's seizures had much to do with his heart unless there were rhythm problems demonstrated during an attack. It is more likely that your husband had a problem like coronary artery disease (CAD) in addition to his long-standing seizure disorder. You can check here whether he was at risk for CAD:
http://www.cardiachealth.org/risks-benefits/cardiovascular-risk

Swollen feet after a sunburn many years ago

Question: 
When I was 26, I got a severe sunburn on my feet.  Later that day, they started swelling and got small red “pinprick” size spots; no blisters.  They swelled so big, I could barely wear flip-flops.  My doctor back then gave me hydrochlorothiazide (I believe 25 mg).  The swelling went down.  When I turned 29, they started swelling again, with no apparent cause/reason.  My current doctor says it is pitting edema and has added 5 mg of lisinopril.  This only temporally fixes the swelling.  I have also tried compression stockings and elevating them, but that doesn’t really help either.  Because of the sunburn, the skin is very sensitive to sunlight (they feel like they are sizzling) and the red “pinpricks” return periodically.  It is also painful to wear shoes all day because my feet get hot and that makes them hurt as well. They are very stiff feeling and painful when they swell.  I am also getting small groups of spider veins on my feet and near my ankles.  Sometimes there will just be a small puffy area (about the size of an apricot) near my ankles.  On a side note, I recently dropped a can of soda on one of my feet and now it swells more than the other one (my doctor doesn’t seem to be worried about that, but I think it is a problem). I am now 30 and getting tired of having this happen; it’s painful and looks gross.  They doctors I have seen don’t seem to take my concerns seriously.  They simply say there is nothing they can do.  I am in relatively good health.  I am 5’10” and 160 lbs.  My blood-pressure is naturally low. I also take 112 mg of levothyroxine.  I also only take the hydrochlorothiazide and lisinopril (separately) when the swelling occurs.  Thank you

While the sunburn surely caused a local injury at the time, that injury should have healed a long time ago. Therefore it seems to me the cause of your edema has yet to be found. The most common local conditions that cause edema are varicose veins and thrombophlebitis (inflammation of the veins) of the deep veins of the legs. Problems with your heart, liver or kidneys may also cause peripheral edema. If blood tests have excluded your heart, liver and kidneys as a source for your edema, you need to look for local problems with either the veins or lymphatic system in your legs.

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