Awaiting stress EKG results - Page 2

jrmom1 · 02-23-2008, 07:07 PM

oooh 800 miles, alone , driving, that is stressful
I might rethink that one myself until you have your definitive answer ( the angiogram). Ask your cardiologist what he thinks about the drive

huckfinn · 02-24-2008, 01:00 PM

Goldy

I have been studying your situation for a couple of hours. I got up at 3 am. Basically I have made a few notes pertaining to your current medicine-Atacand. When I hear the term "this medicine takes a load off of my heart", I think about the beta blocker class of medicines. So I had to study Atacand and it's possible side affects, and just exactly what it does.

I tried this specific drug, Atacand, probably over a year ago, after I developed the very common and intolerable side affects of the ACE inhibitors. I had taken them since my heart attack, but amazingly after about 3 years, the side affects started. Coughing and angioedema were the side affects. The angioedema caused my face and airways to swell.

Atacand is one of the newer classes of drugs known as ARBs (Angiotension Receptor Blockers) that block the angiotension II, AT1 receptors in our hearts and really anywhere the receptors are found. They do the same as ACE inhibitors but in a different way.

So I went for almost a year without taking any angiotension blockage medicine (ACE or ARB). I went through all of the ARBs, but could not find one that I could tolerate. So in desperation, I stated back on the old bottle of ACE inhibitors (Altace) I had and so far (6 months) I am ok. I don't have a cough but I still have some swelling in my lower airways, which I watch close.

The reason that I am telling all of this to you is because I am boring

No, I believe that going without one of these classes of medicines last year and longer, allowed my heart to remodel and cause the Diastolic Dysfunction/Diastolic Heart Failure.

Per the pharm literature, ARBs (Atacand) can possibly cause all kind of side affects/symptoms. Bradycardia is one. It also increases your potassium and serum creatinine significantly. Potassium helps with the control of our heart rate, and all muscle movement.

While you are taking Atacand, you need to have a basic metabolic panel blood test periodically, which measures sodium, potassium, chloride, bicarbonate, blood urea nitrogen (BUN), magnesium, creatinine, and glucose. It also sometimes includes calcium.

So I cannot tell if the Atacand affected your stress test. I will make an uneducated guess and say that it did not.

I do not know what you have to do so far away from home, but if it is emotionally or physically challenging, I would put the trip off for sure. It is kind of rare these days to receive a phone call from your doctor, although I have one that will call me and discuss all of my test results. I feel really fortunate to have found him.

If I were you, I would have the angiogram asap. I do not know your doctor, so I cannot determine the urgency involved or emphasized during the phone call. I do know as a general rule doctors do not want to alarm you. They know that this will only make the situation worse. Maybe you could call the nurse and arrange to speak with your doctor again, or have the nurse ask the doctor about when the angiogram needed to be scheduled.

There is nothing comparable to an angiogram when it comes to "searching and seeing" the condition of your heart and coronary arteries. There are many people that waited too long to have, or never had a chance to have an angiogram. I had a friend that I worked with for over 20 years that died of a a massive heart attack 2 weeks ago. He was 57, looked 47, and was the most active man I have ever known. He was a medic in VN.

After having the angiogram, you will feel much better. If nothing is wrong you can rejoice. If something is found, you can still be happy because it can be fixed and you can get your life back. You may still have to deal with FM, but the symptoms of FM and heart disease are so alike.

I have had 10 left side cardiac catheterizations, and 1 right side catheterization. They are a piece of cake. I had a left ventriculurgram during my last cath at the Cleveland Clinic. This is where the cath wire is guided through the aortic arch to the aorta and through the aortic valve. Once there, contrast dye is injected and shows all dimensions and volumes during systole and diastole, movement or lack of and any disease process that could affect the muscle of the left ventricle.

Start eating and put on some weight before the angiogram! Are you still very slim? If so, eat like a pig, lol.

If I can help, CALL ME

Huck

goldyfm · 02-24-2008, 02:05 PM

Thanks Huck. Yes, I have decided to get this out of the way before I tackle the trip and all the work involved there. I am cautious as I am now the age of my father when he lost his battle with heart disease. I am the skinny one of the family and the rest of the family is healthy as horses when it comes to their hearts. I just caught all the familial cholesterol and heart problems. I am a little heavier than I was while working- I hover around the 140's now but I am still okay according to my BMI. I am the skinny one of the bunch but also have a little height compared to my siblings, so I am okay there. I know my lack of exercise due to the fibro fatigue is the culprit.

Yes I also was tried on 3 other heart meds, but could not tolerate. Procardia made me a nervous wreck, and the other two (Cozaar and Nifedipine) gave me a persistent cough. I have acquired a cough now, I am sure from my smoking and to add to that was intolerable. I have become concerned as I am experiencing some chest discomfort daily now. I was having some exertional chest pain and SOB but now it is becoming more routine than I would like. It was my revelation of this to the doctor that prompted the Stress test and I am sure it is probably a blockage or COPD related. I know that with my other heart issues, it is not wise to delay workup and repair if necessary. I have been under some extreme stress the last few years and I am sure that has not helped with my heart issues either.

Do you know if a Cardiologist with Nuclear credentials would perform the angiogram? Am I right that an angiogram is the same as what was commonly known as a heart cath? I am a little concerned as I had an uncle by marriage who died during a heart cath and a uncle by relation that died one day post cath. It really weighs heavily on your mind, knowing someone personally who reacted to the procedure itself. I know that it is likely that these deaths may have occurred even in the absence of the procedure, but it is unnerving to know the possibility so personally.

Well I will be calling tomorrow as I know that even though the heart valve issue is stable at the moment, any additional factors need to be addressed to ensure that I have the best chance possible in the event a valve replacement comes my way in the future. I am sure that a weakened heart would not be optimum to withstand the rigors of cardiac surgery/repair of any kind. Thanks for your comments and support.

Oh yes, I had a chem panel in January that was normal!

huckfinn · 02-24-2008, 08:45 PM

Hi Goldone

Yes, an angiogram is done via a heart cath or cardiac catheterization.

Here is the deal.....I would not have it done on an outpatient basis. I did before and regreted it. It should be done where that if something were to go wrong.....It can be fixed, right? If they find a blockage >70% closed, they will want to stent it. If so, only use a drug eluding stent (DES). You will get immediate relief afterwards and it may save (have saved) you from a heart attack. If they want to do bypass surgery, try to resist until you are clear minded and have time to think. You have to sign a form giving them the right to insert a stent prior to the cath, if the policies have not changed. Of course you could talk them out of a stent, but I wouldn't.

You hit the hospital doors at early 30

. You will do the regular insurance junk. Next you go to a room and wait to be called back to another room where you get your gown on and an IV started. It could be a long wait, because someone may get ahead of you because they are in a very bad shape. Finally they will come and get you. They will slip you a tad of valium. Then when you get to the cath lab room, you will freeze your buns off, lol. Ask for heated blankets! These cath lab teams are a bunch of jokesters. They know how scared some people are.

Then the RN will inject you with a mixture of Versed and more valium. The Versed makes time go by really quick and causes amnesia, so you want remember what happened. I always do though. They want you consciously sedated, but still able to help them, say by coughing when they tell you to, or holding your breath. If you are still way to conscious, TELL THEM!

The doc will make a tiny, maybe 1/4 inch incision after giving you numbing medicine. The location will be high (really high) on the inside of your right groin, if women have groins....The doc will insert a small sheath for the cath wire to glide through your femoral artery, up your abdominal aortic artery, past your aortic arch and down into your left main and RCA. One side at a time. They will inject contrast dye into the left main and then take pics of the dye with a fluoroscopy camera (nuclear camera). They can even advance the cath wire down inside of your LAD or left circumflex. If you wear specs, keep them on so that you can watch the monitor. Where there is no dye, there is a blockage. Ask for a cd of the angiogram to take home with you. You may need it to show another doctor.

The whole thing is over in a blink of an eye. You cannot drive for a week, and your leg may be sore. You activities are also limited and you cannot lift over maybe 5 or 10 lbs. When you go back to your hospital room, you will have to keep your leg still for a few hours

. You will spend the night. I start walking as soon as they say that I can, and I believe it really helps the soreness down the road, not to mention a blood clot, which you will have to watch for. This type of blood clot would not go to your heart or brain, it would just head for your toes, lol, but would not make it. It would cause pain and change of color. They can find them fast with ultrasound.

Goldy these docs do these all of the time. I really cannot understand how your family members ended up, unless they were in a small hospital with an inexperienced Interventional Cardiologist.

Any extra weight will be good for you.

Yours Truly,

Huck

goldyfm · 03-01-2008, 09:34 AM

Catherization was done Wednesday and all turned out well. No blockages severe enough for stents or angioplasty at this time. I suppose the chest pains are due to other health issues. I can breathe easy for now. Thanks all for your concern and support.