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Holding off on Catheterization
I was recently treated for Atrial Fibrillation and was put on Flecainide 50 mg twice daily and Dialzetem 120 mg once daily together with a regular aspirin 325 mg.
The Cardiologist wanted a stress test done. I took this last week, and today was told I have a "small area of blockage" in one of the arteries to my heart. He said this is "ischemia" and explained it more or less to me.He said it was totally reversible, and might simply be a false positive. Said it warranted a catheterization, to make sure. He said it only showed up during the stress part of the test ( chemical ) the artery seemed normal during the rest period.
However since I do not have insurance ( it was dropped for pre-existing ) He said we could try medication and see what happens. He took me off the Dialzetem and changed it to Toprol 25mg daily instead. I am still taking the Flecainide and Aspirin. He also gave me nitro 'glycerine in case of chest pain. He said he would like to take me off the flecainide, but I would have to be hospitalized for that. And since no insurance, he would simply keep me on the Flecainide.
My question is. Since he did say a catheterization was warranted. Am I in any great danger by putting this off, due to the non insurance. He didn't say yes or no either way. I am worried about this. That he simply put me on medication since I could not afford to pay the bill. He did tell me, that if I experience chest pain I should take the nitro and wait five minutes to see if it stops. He then said, if it doesn't to call 911 ( obviously ). He said I should not worry, and to go about my normal routine. Does this sound right?
The Cardiologist wanted a stress test done. I took this last week, and today was told I have a "small area of blockage" in one of the arteries to my heart. He said this is "ischemia" and explained it more or less to me.He said it was totally reversible, and might simply be a false positive. Said it warranted a catheterization, to make sure. He said it only showed up during the stress part of the test ( chemical ) the artery seemed normal during the rest period.
However since I do not have insurance ( it was dropped for pre-existing ) He said we could try medication and see what happens. He took me off the Dialzetem and changed it to Toprol 25mg daily instead. I am still taking the Flecainide and Aspirin. He also gave me nitro 'glycerine in case of chest pain. He said he would like to take me off the flecainide, but I would have to be hospitalized for that. And since no insurance, he would simply keep me on the Flecainide.
My question is. Since he did say a catheterization was warranted. Am I in any great danger by putting this off, due to the non insurance. He didn't say yes or no either way. I am worried about this. That he simply put me on medication since I could not afford to pay the bill. He did tell me, that if I experience chest pain I should take the nitro and wait five minutes to see if it stops. He then said, if it doesn't to call 911 ( obviously ). He said I should not worry, and to go about my normal routine. Does this sound right?
It is true hipernating** or stunned cells can be revived (sometimes with an adequate supply ofblood/oxygen) and the condition is reversed, but in the context of the examination and the comment that there is no evidence of ischemia at rest , etc. probably means that, in a stress test, it was shown that the person taking the test has some narrowing of the coronary arteries that happens during exercise, but will go away when they rest. In other words, it's reversible. Additionally hibernating heart cells causes hypokenisis (impaired contraction). I had that condition years ago....currently my heart is pumping normally.
The rest and exercise images are directly compared to determine if an area that has good blood supply at rest has a reduction in blood supply at peak exercise. If this is found, it is called stress-induced reversible ischemia and generally indicates that a significant coronary artery blockage is present.
**Cardiologists have appropriated the word ''hibernation'' to refer to a chronic functional abnormality of the heart muscle due to ischemia, or oxygen deficiency caused by inadequate blood flow. The key feature of hibernation, in contrast with other heart problems such as infarction, is that the hibernation is at least partially reversible when the cause of the ischemia is relieved. Most reported cases of hibernation have been reported in cardiac patients who have undergone bypass grafting. Patients with severe atherosclerosis sometimes experience an improvement in heart muscle function after grafting improves the blood supply, indicating that the muscle was ''hibernating'' prior to the surgery.
Treatment for ischemia such as medication, stent implant or CABG only treats the symptoms and not the disease of CAD. As the doctor stated if the nitro does not relieve symptoms of chest pain, then the medication is not sufficient or the pain is not related to ischemia.
The rest and exercise images are directly compared to determine if an area that has good blood supply at rest has a reduction in blood supply at peak exercise. If this is found, it is called stress-induced reversible ischemia and generally indicates that a significant coronary artery blockage is present.
**Cardiologists have appropriated the word ''hibernation'' to refer to a chronic functional abnormality of the heart muscle due to ischemia, or oxygen deficiency caused by inadequate blood flow. The key feature of hibernation, in contrast with other heart problems such as infarction, is that the hibernation is at least partially reversible when the cause of the ischemia is relieved. Most reported cases of hibernation have been reported in cardiac patients who have undergone bypass grafting. Patients with severe atherosclerosis sometimes experience an improvement in heart muscle function after grafting improves the blood supply, indicating that the muscle was ''hibernating'' prior to the surgery.
Treatment for ischemia such as medication, stent implant or CABG only treats the symptoms and not the disease of CAD. As the doctor stated if the nitro does not relieve symptoms of chest pain, then the medication is not sufficient or the pain is not related to ischemia.
Hi,
Under Florida law they had the right to cancel me. I already consulted with a lawyer. No insurance company in Florida will insure someone with a pre-existing condition without a twelve month waiting period.
Regarding my lifestyle. I up until had been perfectly healthy. My cholesterol was a little high, but within limits according to my GP. I have pretty much always lived a healthy lifestyle in regards to eating etc. I have never smoked. I exercise regularly. I am a retired gardener, so my work kept me pretty much in shape. I am not overweight.
The cardiologist for some reason, prefers chemical stress tests over treadmill. While I was there they gave four people the same test. I saw no treadmill in the room.
My worry was that he said I could go back to my "normal routine" including riding a bike. But then he warned me about chest pain, and said at the first sign I should go to emergency. I felt that the only reason he did not say I needed this now was because I do not have insurance. He said I should "work very hard" at getting it. I think the stress of this, and the local Lawn Nazis is what put me in the hospital in the first place. I have a lot of stress since I moved here. I am also taking care of my 89 year old Mom, who at this time is doing better than me. :-)
Under Florida law they had the right to cancel me. I already consulted with a lawyer. No insurance company in Florida will insure someone with a pre-existing condition without a twelve month waiting period.
Regarding my lifestyle. I up until had been perfectly healthy. My cholesterol was a little high, but within limits according to my GP. I have pretty much always lived a healthy lifestyle in regards to eating etc. I have never smoked. I exercise regularly. I am a retired gardener, so my work kept me pretty much in shape. I am not overweight.
The cardiologist for some reason, prefers chemical stress tests over treadmill. While I was there they gave four people the same test. I saw no treadmill in the room.
My worry was that he said I could go back to my "normal routine" including riding a bike. But then he warned me about chest pain, and said at the first sign I should go to emergency. I felt that the only reason he did not say I needed this now was because I do not have insurance. He said I should "work very hard" at getting it. I think the stress of this, and the local Lawn Nazis is what put me in the hospital in the first place. I have a lot of stress since I moved here. I am also taking care of my 89 year old Mom, who at this time is doing better than me. :-)
I'm sure your head is spinning, you have a lot of decisions to make.
A catherization would be the gold standard to determine blockages. I don't quite understand why the insurance company called it a pre-existing condition if you hadn't been tested for it, so I would challenge that decision. However, if the area of ischemia is reversible, it means that the reader of the test determined that stunned heart cells can be brought back to life through medication, exercise and diet.
I would first question the insurance company and use your State's Omsbudsman, if you have one, to represent your question.
By the fact that you had a chemical cath, I'm guessing you aren't in the physical condition to take the exercise stress test. The fact that you have Atrial Fibrillation indicates that possibly your heart is enlarging (that's just one possibility), which can be serious. Here are some questions; do you need to lose weight, and do you exercise? Do you follow a heart healthy diet? Do you get out of breath easily? Do you smoke?
I'd start at square one and make as many heart-healthy decisions as you can, and get more information about your insurance. Keep us informed.
A catherization would be the gold standard to determine blockages. I don't quite understand why the insurance company called it a pre-existing condition if you hadn't been tested for it, so I would challenge that decision. However, if the area of ischemia is reversible, it means that the reader of the test determined that stunned heart cells can be brought back to life through medication, exercise and diet.
I would first question the insurance company and use your State's Omsbudsman, if you have one, to represent your question.
By the fact that you had a chemical cath, I'm guessing you aren't in the physical condition to take the exercise stress test. The fact that you have Atrial Fibrillation indicates that possibly your heart is enlarging (that's just one possibility), which can be serious. Here are some questions; do you need to lose weight, and do you exercise? Do you follow a heart healthy diet? Do you get out of breath easily? Do you smoke?
I'd start at square one and make as many heart-healthy decisions as you can, and get more information about your insurance. Keep us informed.
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