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Old 09-01-2007, 01:51 PM   #1
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Location: Tunbridge Wells, Kent, UK
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New user - ? angina but negative tests so far

This is my first time on here. I am 61. About 15 months ago I was getting recurrent chest pains and saw my GP, who found my BP was 200/110. I was put on diltiazem, but the initial dose didn't lower it enough and the higher dose had intolerable side-effects, although the chest pain subsided until November, when it recurred and my BP was 180/106 on medication. I was then put on lisinopril as well and my BP was well controlled, so the diltiazem was discontinued.

I have a lot of risk factors for ischaemic heart disease:
  • Age 61
  • Both parents were hypertensive
  • Just about all of Dad's family had ischaemic heart disease
  • I am overweight, although I have lost 29 lb since November and am no longer obese
  • I store fat around my middle rather than hips
  • I am hypertensive and probably was so untreated for several years - even when I was in my 20s my BP was always borderline/raised
  • I am on medication for high cholesterol
  • My occupation is sedentary
  • I get stressed easily and have depression problems
I started at the gym last week, but then began getting chest pains again and on home monitoring my BP is higher than it was, although only borderline. My GP says I can continue if I take it easily. I find two of the machines quite hard going and can't manage the level my instructor recommended as my heart rate goes above 160 and the machine warns me if it goes above 145 for my age. I had mild chest pain on the exercise cycle. I've had a break from the gym this week, but plan to go back on Monday.

Last autumn my exercise ECG was normal and in the spring an isotope scan didn't show up anything major, but my GP thinks that because of the risk factors and the typical nature of the pain, central pressure, sometimes radiating to my jaw, triggered by exercise or stress, which is relieved by GTN, it is almost certainly cardiac in origin. I have had a heart murmur since childhood, but they cannot identify why. An echocardiogram last year did show mild left ventricular hypertrophy. MY GP says that if it doesn't settle I will need an angiogram, but i'm not keen.

Has anyone else had IHD/coronary heart disease with normal tests initially?
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Old 09-01-2007, 03:06 PM   #2
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Re: New user - ? angina but negative tests so far

I don't know how the medical system in the UK actually works, but if you were in the US, I'd say:

Your GP is probably right.
Get to a cardiologist ASAP.
Don't worry about having the angiogram; in the hands of an experienced cardiologist it is usually a piece of cake (though it does have risks).

It is not at all unusual to have a negative EKG, or even negative stress test and have heart disease. Did you have a nuclear stress test where they "take pictures" of your heart before and after exercise, or just a stress test where they hook you up to the heart monitor and put you on a treadmill?

The nuclear stress test is much more reliable than just the treadmill stress test, but even it can have "false negatives."

In the US, the standard of care is a nuclear stress test before proceeding to an angiogram.

I had a completely normal EKG, but classic angina symptoms (chest pain on exercise, goes away with rest) with multiple risk factors similar to those you mention. My nuclear stress test was abnormal, with a 99% LAD blockage confirmed on the angiogram. (They placed the stent at the same time they did the angiogram).

Last edited by Connie122516; 09-01-2007 at 03:10 PM.

 
Old 09-02-2007, 12:44 AM   #3
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Re: New user - ? angina but negative tests so far

Yes, I has a nuclear scan which didn't show anything significant.
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