Hello all,
I am a 23 year old male (I know, too young for this stuff) and I work for EMS. I started to feel palpatations and an irregular heartbeat and put myself on the monitor at work. The result was frequent PAC's....almost trigeminy, with every 3rd beat being a PAC. I became worried because these occurances started to be symptomatic, with me feeling weak and short of breath. I went to a cardiologist who did an echo and a stress test. In the past, I had a 12 lead say I had "borderline ischemia". My echo revealed a low ejection fraction, about 50-55%, and my stress test showed an area in the inferior wall that suggested ischemia. My cardiologist wants to do an exploratory cath. I have to say, I am pretty worried about all this. I am a little on the heavy side, but not overly fat. I am 6'0" and about 250 lbs. I have a family history of heart and cholesterol problems. Anybody have any thoughts on this?

I've had many cardiograms in the past and they've all been abnormal. One also suggested possible ischemia. It was only after I was in the ER in April, that the doctor there suggested that I have an echogram and stress test. I went to the ER because my pulse was very high and I felt faint. I didn't have a heart attack. My stress test was abnormal as well, so the cardiologist sent me for a nuclear scan and echogram. The nuclear scan was normal - EF 70% and the echogram showed some stenosis of the aortic valve - EF 60% (which could be caused by aging). The thing is, in my opinion, is to have a nuclear scan first before going for an angiogram. Here, in Canada, where I live, the doctors are much more conservative - they just don't jump in and send you for an angiogram before other tests are done (unless maybe someone's had a heart attack.) There are many people with abnormal cardiograms - it doesn't mean that they have heart disease. Also, your EF rate is not horribly low.

i had a nuclear scan...that was part of the stress test. thats what showed the ischemia in the inferior wall. 50% is borderline low, but being 23 years old, I should be more around 65%...the computer report of the echo actually said 44%, but the doc thought it was higher

There are many people on this site who've had caths, and are more experienced than I with heart problems. I know it's worrisome and frustrating when something is not right with yourself. Do you have faith in your doctor's opinion and expertise?

Hi shokeyfan,

Often with a low EF (50% should not be a problem!) there is or has been heart muscle damage that impairs contractions. The heart muscle damage is usually due to not receiving enough blood/oxygen.

The area identified with "borderline ischemia" suggests some blockage/blockages. Sometimes the oxygen deprived heart cells are only stunned and fully recover and contractions will improve with restoration of normal blood flow to the area.

A cath will verify the area and at that time, if appropriate, a stent implant. Some areas cannot be stented so a bypass may be indicated as the best treatment. Intervention is usually the recommended treatment for relief of angina (heart induced pain). However, some people wish to be treated medically and follow the condition on a regular basis. PAC's may be a separate problem.

i was told normal is 55-65. My echo post heart attack show mine at 60, so i guess damage to my heart from my heart attack was minimal. I will have another echo done in 3 months