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Old 08-07-2011, 03:15 PM   #1
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cdar HB User
Stree Echo Abnormal - Angiogram Negative

Some history , Dec 2010 ER for chest pain, diagnosed angina, costochrondritis, aortic calcification of the aortic arch with tortuosity. Have asthma and the very beginnings of emphysema.
8/02/2011 Stress echo showed mild mitral and tricuspid leakage, premature atrial contractions, akinetic basal to mid inferior walls, ischemia. Angiogram 8/05/2011 negative.
Cannot get cardiologist to listen. Have chest pain 2-3 x day, with cold/clamy sweating, nausea, light-headedness, pain extends into center back and left arm and back of neck. He justs says it is stress. I have been running and swimming two miles each day, getting my weight down from 458 to 224. On a smoking cessation program, but now I cannot even do regular housework or my favorite - gardening. I am not stressed, not much bothers me. Not being able to do my normal physical activity is bothering me. Someone suggested I ask for a sleep apnea study instead of persuing the heart issue. I do have
severe episodes of waking choking for breath and my oxygen level will be 77% even on 4L oxygen at night. I am not sure where to go next.

 
Old 08-08-2011, 02:30 AM   #2
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Re: Stree Echo Abnormal - Angiogram Negative

First of all, I'm not a doctor, and I'm certainly not a cardiologist.

It sounds like your body has been through a lot of change lately, and that can stress out your body, even if you don't actually feel stressed. When does your chest pain occur? Does anything make it better or worse? As for your breathing troubles at night, it does sound like sleep apnea, and a sleep study sounds like a good idea, regardless of whether or not you continue to pursue your heart issue.

 
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Old 08-08-2011, 12:59 PM   #3
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Re: Stree Echo Abnormal - Angiogram Negative

Quote:
Originally Posted by fallingsky656 View Post
First of all, I'm not a doctor, and I'm certainly not a cardiologist.

It sounds like your body has been through a lot of change lately, and that can stress out your body, even if you don't actually feel stressed. When does your chest pain occur? Does anything make it better or worse? As for your breathing troubles at night, it does sound like sleep apnea, and a sleep study sounds like a good idea, regardless of whether or not you continue to pursue your heart issue.
Chest pain occurs a couple times a day, at rest, getting more severe. I walk slowly, or pace trying to control my breathing. Takes about 15-20 mins before it eases. Wake up at night last two nights with extreme chest pain.

 
Old 08-08-2011, 03:13 PM   #4
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Re: Stree Echo Abnormal - Angiogram Negative

A few more questions for you, cdar.

When did this chest pain start?
Does it feel like the pain you had before? (angina, costochondritis)
Does if feel the same every time it happens?
What does it feel like, and where on your chest does it start?
Does it change when you change positions, take a deep breath, or press on the area that hurts?
Do you have any medications prescribed to you, either that you take on a daily basis or take as needed? If so, what are they for?
How is your heart rate and breathing when this happens?

 
Old 08-09-2011, 08:41 AM   #5
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Re: Stree Echo Abnormal - Angiogram Negative

Started in Dec 2010, getting more frequent and stronger. Starts with burn in center of chest, spreading to sharp crushing pain in left chest spreading to left arm and up to back of the neck. Get clamy & sweaty, and very dizzy. Worse than before. Same each time. does not change with position, or breath. I only take Symbicort 160 twice a day. When pain is active heart goes from 72 to 176, oxygen falls from 94 to 77-88.

 
Old 08-09-2011, 09:12 AM   #6
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Re: Stree Echo Abnormal - Angiogram Negative

Quote:
Originally Posted by fallingsky656 View Post
A few more questions for you, cdar.

When did this chest pain start?
Does it feel like the pain you had before? (angina, costochondritis)
Does if feel the same every time it happens?
What does it feel like, and where on your chest does it start?
Does it change when you change positions, take a deep breath, or press on the area that hurts?
Do you have any medications prescribed to you, either that you take on a daily basis or take as needed? If so, what are they for?
How is your heart rate and breathing when this happens?
Angiogram shows "moderate elevation of left ventricle end-diastolic pressure. EF 60%"

 
Old 08-09-2011, 12:03 PM   #7
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Re: Stree Echo Abnormal - Angiogram Negative

Normal EF ranges from about 50 - 70 % Your cardiac function is good. With your angiogram result it sounds like your heart is doing pretty well. The akinesia on your echo may indicate some old injury to your heart muscle, but the fact that your EF is 60% means that your heart is pumping well. While you shouldn't ignore cardiac causes of chest pain, you may want to start exploring non-cardiac causes. Chest pain does not automatically mean something is wrong with your heart. It also doesn't necessarily mean it's just stress, but there may be a better explanation for why you are experiencing this pain.

 
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Old 08-09-2011, 01:13 PM   #8
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Re: Stree Echo Abnormal - Angiogram Negative

Sleep study and mammiogram scheduled for next week. Angiogram report recommends "medical management" whatever that means. Thank you for your help.

 
Old 08-10-2011, 08:34 AM   #9
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Re: Stree Echo Abnormal - Angiogram Negative

Update: Diagnosed with Moderate Diastolic Heart Failure.

 
Old 12-07-2012, 03:55 PM   #10
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Re: Stree Echo Abnormal - Angiogram Negative

10/17/2012 Fourth Cardiologist, went to Loma Linda Heart Hospital. Turns out I have three vessel obstruction not visible on angiogram. I have been diagnosed with Ischemic Heart Disease and diastolic dysfunction. Waiting more tests for further follow-up. No wall motion in both basal inferiir and mid inferior walls.

 
Old 12-09-2012, 10:47 AM   #11
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Re: Stree Echo Abnormal - Angiogram Negative

What does "three vessel obstruction" mean? I too had a negative cardiac catherization, but also have chest pain and an abnormal echo that showed basal inferior wall hypokinesis. Doctor does not seem too concerned, but I am, as I have symptoms every day.

 
Old 12-10-2012, 09:35 AM   #12
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Re: Stree Echo Abnormal - Angiogram Negative

Three arteries have Obstruction (blocked to varying degrees.. Not in the normal areas, did not show on angiogram in 2011. I was told I was fine because of the angiogram results. Apparently this is common in women and until it gets really bad, they cannot see it on angiogram.

 
Old 12-11-2012, 01:33 PM   #13
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Re: Stree Echo Abnormal - Angiogram Negative

How were your blockages finally found at Loma Linda? Have you had treatment? If so, what?
I am having chest pain every day, shortness of breath, lightheadedness. I had an abnormal echo (basal inferior wall hypkinesis). Then had a myocardial perfusion scan, a CT scan, a cardiac MRI, and finally the cardiac catherization. All they will say is that I do have "mild" hypokinesis and a reduced ejection fraction (now at 53%), but that all my symptoms could not come from such a "mild" condition. I was put on a very low dose ACE inhibitor and sent on my way. But my symptoms are not getting better. Some days I can barely function.

 
Old 12-12-2012, 09:09 AM   #14
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Re: Stree Echo Abnormal - Angiogram Negative

Quote:
Originally Posted by karina29 View Post
How were your blockages finally found at Loma Linda? Have you had treatment? If so, what?
I am having chest pain every day, shortness of breath, lightheadedness. I had an abnormal echo (basal inferior wall hypkinesis). Then had a myocardial perfusion scan, a CT scan, a cardiac MRI, and finally the cardiac catherization. All they will say is that I do have "mild" hypokinesis and a reduced ejection fraction (now at 53%), but that all my symptoms could not come from such a "mild" condition. I was put on a very low dose ACE inhibitor and sent on my way. But my symptoms are not getting better. Some days I can barely function.
Echocardiogram with contrast. Look for a cardiologist who specializes in womens heart disease. I am on amlodipine, isosorbide mononitrate to control my heart rate and nitroglycerin for angina while deciding on bypass surgery or not.

 
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