Ive just received a copy letter from my cardiologist which talks about my 'reversible ischaemia at the apex.' How do i interpret the word 'reversible'? I would like to think it means its fixable but i somehow doubt that! The wording, as ive mentioned before, then goes on to say 'the extent and severity of the abnormality is limited and hence the likelihood of future cardianc events is relatively low.' Thanks

Sporti,

The meaning of "reversible ischemia" isn't quite "fixable" but more like "temporary" or "induceable". It means a shortage of bloodflow that is temporary and a result of stress; when the stress is removed, so is the ischemia.

A case of "irreversible ischemia" might be a lack of blood caused by a blood clot...a heart attack because the blood clot causes a permanent cessation of bloodflow..

Reversible ischemia is usually, in layman's terms, angina caused by exercise that stops when the exercise stops. Uncommonly it can be silent, without pain, that shows up as a downsloping ST segment on an ECG.

Refresh my memory, do you have pain on exertion?

Thanks Lenin for your information. I find that quite reassuring and am grateful for your reply. My problems started with slight chest pressure when i was out walking especially noticeable in freezing weather. I would never describe it as painful just a strange sensation which came on quite quickily and then disappeared completely when i stopped walking. I was also breathless- unusually so. It would have been very easy to make excuses for this chest pressure and carry on regardless. As my GP said there is probably 20% of the over 50 population walking around with this and not even know it. Didnt think that was very helpful! but thats what i was told. I guess when im at the Bon Jovi concert tomorrow i better stand still!

Following on what Lenin has said, if you have ischaemia it means your arteries around the heart and perhaps elsewhere in your body are not in great shape. They are narrowed, and/or hardened, and have plaque buildup.

You might need to make some lifestyle changes - diet, exercise, weight loss, stopping smoking, and reducing stress (where they apply) - to prevent the disease progressing. (It is a progressive disease in most cases.)
In addition your blood cholesterol might be high and need medication to lower it to a safer range.

The extent to which the ischaemia can be reduced or eliminated is something the jury is still out on. However, there is no easy cure. Good cardio exercise, together with the factors mentioned above may, and I repeat may, prevent the progression. The symptoms you mention are only a few of several that occur with ischaemia. You need to take it pretty seriously and get good cardio advice.

I dont know what more lifestyle changes i can make. Since having ovarian cancer in 2003 i have lost 28 ilbs, (which makes me a size 12 in the UK a USA 10)i have never smoked and i have the very occasional drink. I walk my dog 40 mins a day - i swim 20 lengths of a 25 metre pool 3 times a week. In that respect there is no more i can do. I have just started lipiril because my cholestrol is 6 and my cardiologist wants it at 4. My cholesterol is according to the cardio and nephrologist heriditary not dietary. Im seeing a highly thought of cardiologist here in the South of England and my thallium myocardial perfusion scan was overseen and read by a Professor of Nuclear Medicine and Cardiology so no mistakes, hopefully, would be made by the normal technician as often happens with this kind of test. My cardiologist has told me to carry on with my life as normal and that unless i get further angina problems i will not be needing an angioplasty. I have to trust him and hope that the tablets keep on working. Of course i take it seriously but when you have had cancer and other problems you have to rise above your fears. Keep well.

Sporti,
Did you spell Lipiril correctly?
Or did you mean Lipidil (fenofibrate) or Lipril (lisinopril, in India.)

So then you and your cardiologist agree that you have angina, though slight, and that you will watch and wait and treat it with medication? If that's the case, then consider adding a statin drug to your regimen.

That ache on walking into the cold is, in my book, one of the GOLD STANDARDS for angina. :D

Hi Lenin - Yes i am on a statin 10 mg. I think i must have got the spelling wrong. My cardio says i have mild angina and the tablets will help. So far so good with my walking and up my house stairs. The test will certainly be when the weather is freezing again. He said that an angioplasty is too intrusive at this point but a wait and see approach is the order of the day and i see him in 3 months or before if i have worsening problems. Im on aspirin- 3 bp tabs and one statin.

Sporti,
From what you have said your physical condition and lifestyle is well-controlled.
If you can swim 20 lengths of your pool any angina can, from what I know, only be slight. Swimming is a particularly tough exercise for anyone with cardio problems. I certainly could not do it and I am not overweight and exercise regularly.
I would like to ask how you pull up after those 20 lengths - is there any discomfort or chest pressure?
With me I have always had a moderately high cholesterol (around 6) that I can only attribute to an heriditary affect, although both of my parents were, as far as I know, free from any major cardio problems and lived into their 90s.
My cardioligist was a little puzzled by this to say the least.
If you have had an angiogram or thallium isotope test they should be able to see the condiition of the arteries and can probably identify the particular one (s) that causes the discomfort. That really closes the loop in the diagnosis.
With my exercise I can work my stepper and keep on working without any real discomfort. I can finish puffing quite hard, but without any discomfort. However when walking sometimes even the gentlest slope can cause chest pressure - well before the level where I need to puff. It must be the way the different muscle groups work.
Keep Well.

Sporti: have you considered supplements (fish oil, niacin, high dose vitC) that are known to contribute to heart health/healthy arteries?? What about EDTA chelation therapy? Is it available where you are? These are both strategies I am using to support the prevention of restenosis after an angioplasty/stent placement 5 weeks ago.

Do some searching on these approaches; you may find something useful.

Ken

Thanks Beefsteak and Ken289 for your helpful replies. Beefsteak funnily enough i have never had a problem when i am swimming. Yes i have to stop for a breather every two lengths but i have never had chest discomfort when swimming. Do you know why that would be? It takes me 35 mins to swim the 20 lengths and i feel fine when i get out. In fact when i get home my bp is always down to 130/70. My cholestrol is 6 and i have to get it down to 4 by medication. Mine is also heriditary. I had a thallium nuclear stress test the results of which I posted in another thread. Yes walking is my problem too god knows what would happen if i ran. It seems a lot better at the moment so i am hopeful.

Ken289 i havent considered supplements but you have made me interested so i will do some research. What do you take? and do you have to discuss them with your cardiologist? What is EDTA therapy?

Thanks for all your help. This Board is such a wealth of information - thanks

Sporti,
You can possibly get your cholesterol down without medication (or down further without further medication) with a low cholesterol diet - avoiding cholesterol-containing foods such as dairy products, meats and fats is a start. Beans esp. soy bean is also effective although most soy milks contain little soy bean (they are a rip off imo) - soy bean powder is much better. Flaxseed oil, pomegranate juice, and cranberry juice also help.You can read about this elsewhere. Naicin can interact with statins so be careful there.
Beefy

Sporti:

You said: "Ken289 i havent considered supplements but you have made me interested so i will do some research. What do you take? and do you have to discuss them with your cardiologist? What is EDTA therapy?"

I have quite a shelf full of bottles (and a good monthly charge to keep them filled--yet the alternative is much more expensive).

The heart (no pun intended) of my program revolved around fish oil (omega-3s) and vitamin c. I also try and keep lots of antioxidents in the blood stream (which the vitC does) but add to that Grape Seed and Green Tea extracts, plus one VitE per day.

You might check out http://www.**************.com/ for info on high dose vitamin C chemistry.

Just do a google search on "EDTA chelation therapy". The top two ones are related to Quack Therapies and the second one is a defense of the therapy. I myself don't care about the arguments as I used it 11 years ago and was successful in prevent reblockage of angioplasty back then (I also started fish oil and careful dieting). I also think the focus becomes too much on the EDTA which is carried in a liquid "cocktail" of various antioxidents, primarily magnesium sulfate. The EDTA part of it may or may not be a factor, but I know my arteries like the concentrated antioxidents they get during the 2 hour infusion. Check it out as one more variable to consider as you try to push the odds in your favor.

Hope this helps,

Ken

I guess the site administrators have some rules (and lists) about sites which are acceptable to share and those which are not. I do not want to run afoul of any etiquette rules. Perhaps you can just do a google search for "Linus Pauling vitamin C therapy" and see what you find.