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Old 12-15-2004, 09:57 AM   #1
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KATIE25 HB User
How do you know when to push for more test?

Hello all!
I need to know what my next course of action should be. My problems started in July of 2003. In September 2003 I had EKG (abnormal no other details), Adenoside stress test (showed decreased uptake on stress and resting part, but was blamed on Molly and Polly (my breasts)), reg Echo (showed nothing) and then Treadmill Stress Echo (showed nothing). However, given my age and what I now know about the dr who read all my test results (he was not my reg cardio and the one time I saw him in person, he told me my only problem was my engine was revved to high, and he didn't need to see me ever again) I think he probablly never even really looked at my tests results and he certainly wasn't present during them. Fast forward to July 2004, I got ticked at this entire practice and took my records to my new heart dr who at least has far better manners. He has reviewed the test results (only the interpretations, not the actual films, the practice wouldn't release those) and thinks that they all look fine so my problems can't be from my heart. My symptoms are episodic and consist of chest tightness, a dull ache between my shoulder blades, ache like pains in my shoulders, neck and left arm usually with nausea and a very weak feeling. If I stop what I am doing and lay down, they usually ease off, but I have had 2 in the past few days that took longer to go away. I am 26 years old and have high blood pressure that is not very well controlled (take 20 mg Lotensin, high cholesteral (controlled with 10 mg Lipitor), sinus tach (mostly controlled with 200 mg Toprol LX (my resting heart rate stayed in the 130's before, and my old cardio had me on 81 mg Aspirin which my current dr says to coninue with. I also take Bextra 10mg (for hand injuries from a car accident), and Lexapro 10mg for stress (my former family dr says it is all in my head and this will stop my "panic attacks", it hasn't). I am also about 50 lbs overweight, but frankly don't have much time to exercise and have no known family history except my grandma was a diabetic. Could it still be my heart with all those tests. My paramedic friend tells me not to play around with it because it sounds like classic angina equivalents to him, but I am under the care of a heart dr, and don't know what else to do. How do I know when to just deal with it and hope it doesn't kill me. I see my cardio tom. Is there anything I can do differently to get him to take me serious. I don't want an angioplasty unnecesarily,and to be honest I think my new dr thinks the risks outweigh the chance that he will find anything, but I don't want a heart attack either, and I don't want to be a statistic. Please help! katie

 
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Old 12-15-2004, 06:35 PM   #2
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NineLives HB User
Re: How do you know when to push for more test?

Katie it helps if you will keep a log of your pain. How it felt. How long it lasted. What helped if anything. Sometimes when a doctor can see a written record I think it benefits you more. It's hard to explain what you felt when it happened days ago or weeks ago. Other than that just be persistent and don't try to lessen your symptoms by explaining them away when you talk with the doctor. Such as I had chest pain but then again I was under alot of stress that day. If you explain it away they will not take it serious either.

 
Old 12-15-2004, 09:01 PM   #3
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Kitten1980 HB User
Re: How do you know when to push for more test?

Did you tell the new doctor what the old doctor's attitude towards you and the tests was? Show him your post with the old doctor's statement about not ever needing to see you again! If the new doctor can only go on the interpretations of tests provided by the old doctor, of COURSE he is going to come to the same conclusion. I would have the new doctor repeat the tests and get his own interpretations. It sounds like you also need to try to get the weight and blood pressure issues under control, and the only way that is going to happen is if your doctor has accurrate information.
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Old 12-17-2004, 07:21 PM   #4
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Re: How do you know when to push for more test?

Katie, you are caught on the horns of an unpleasant dilemma.

With the adosine stress test showing decreased uptake at rest and stressed (apologies to Polly and Molly),. I would push for further tests. The nuclear stress test you had is certainly superior to the usual conventional stress tests, but still not entirely definitive. Coronary angiography may be needed to rule out blockages.

I recently had a nuclear test that indicated coronary ischemia, so the cardiologist strongly recommended an angiogram. I had that, but it showed the coronary arteries (bypasses included) to be clear. So the nuclear stress test can sometimes give false positives.

From what you've described, you could be experiencing angina or even gastric distress.

Has your doctor given you nitro to see if that relieves the pain? If you don't have nitro patches or pills, ask the doctor to let you try that to see if it helps, in which case angina would be strongly indicated.

I have had heart problems dating from a heart attack 30 years ago, and am still plugging away. So I've been on the receiving end of most of the tests available.

Good luck,
Bill

Last edited by Fizzickle; 12-17-2004 at 07:26 PM.

 
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