Dr TCardiac Risks, Chest Pain, Treatment 1 Comment

I’m 61 and on my last visit to my cardiologist, he wanted to do a heart cath to see if anything was going on in my heart.  I had been to the emergency room 2X in the prior two months with high BP 200/110 on one occasion and 180/100 on the other.  In both cases my heart rate had increased to 120-130 at rest.  The ER found nothing wrong with my heart.  My EKG was normal, as it has always been, and a contrast CAT scan of my chest showed no abnormalities. (BTW, my older brother is treated for the same condition with meds). At my last visit we agreed that I would continue losing weight (I’ve lost 21 pounds.  I’m 6’1″ and 192 now), cut out the fatty food and exercise more.  We would check my blood work in 3 months and consider taking statins.  My HDL is 43, my LDL is 119, my total cholesterol is 180 and my triglycerides are in normal range.  It sounded like a great plan. Two days after my visit I went back to a local ER because my BP and heart rate jumped again.  Again, nothing was found wrong with my heart. The next day, my doctor’s nurse called and said that my doc would really like to do a heart cath to see if I have any issues.  I agreed, mostly because I have a bicuspid heart valve, which has no stenosis and mild regurgitation.  There is no heart disease anywhere in my family and so I expected that he would find nothing. Prior to entering the cath lab, I specifically asked to be awake for the procedure and to talk to my doc before we started.  Neither request was granted as the technicians  knocked me out and I did not get to talk to my doc.  Two hours later, I woke up with a stent in my Circumflex Artery that I did not want nor agree to for 70% to 80% blockage and no chest pains or symptoms. So, now I’m on all the meds, my chest occasionally has pain that it never had before and I’m worried sick about a blood clot and restenosis.    


You certainly have every right to complain: no doctor should perform a procedure w/o a pt’s permission, and it is questionable whether you needed the stent. While you have proven coronary artery disease with hypertension and overweight as risk factors for future heart attacks and/or stroke, your weight loss and excellent cholesterol data would have been reasons for me to focus on getting your BP under better control, helped by continued diet and weight loss: so called “Optimal Medical Therapy” has proven to be just as effective (if not better)!

It is impossible to tell whether these new chest pains are a result of the stent procedure, but they do fail on occasion, so you may need to be re-evaluated to check whether this has happened if your symptoms persist! Please read this post about the subject:

While I written these posts some while ago, these observations continue to be as valid today as when they were written! 

Hope this helps,

Dr T

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