Hello; Went to my prim doc today and he told me he strongly believes that I have Autonomic dysfunction and wants a tilt test. I see my Cardio on Mon. Lets see if he agrees. Thanks for your replies :)
Aaack, darned Autocorrect! Where it says "... Aminophylline, which acts as as a vasodilator, as does into...,". I had tried to type NITRO, but Autocorrect thought "into' was a better word. Grumble.
Good point, Ed. I would like to add, though, that Syndrome X is now a bit more specific than a bucket now. It is well documented that women are more often diagnosed with it than are men, which is not a mere sexist statement; we ladies are much more sensitive to pain than guys are. There is even some evidence that the tendency towards the symptoms of Syndrome X is genetic (this can all be found in pubmed articles).
However, the standout finding in heartenough's report was the note that she had a positive response to the injection of aminophylline, which acts as a vasodilator, as does into. I would bet that this finding is what pointed her original cardio in the direction of vasospasm.
This brings to mind a situation I had a year ago, and to say the least it shocked me, but it was resolved. Syndrome X is basically a bucket where Cardiologists put patients which they cannot explain. Anyway let me explain what happened to me and how the problem was resolved, then you can mention it to your cardiologist. If he wants proof, I am willing to message you my full details and cardiologists name. I was in tremendous chest pain and went to the hospital where they ran a battery of tests which were all negative. Even the blood troponin was negative, but they must hold you there so the test can be repeated after 12 hours. This time it came back positive. I was taken to the angio suite and my arteries were up on the monitor in minutes as usual. This time however, the images were identical to the ones taken a year before. They just couldn't seem to find the answer and were about to finish the procedure when I just said the magic 3 letters FFR. The Cardiologist to my surprised said it was a great idea and he put the special device onto the catheter tip. This device is like a mobile blood flow rate sensor and it gets passed down each artery. If blood flow reduces for some reason in a specific point down an artery, the screen shows the drop off. Half way down my left rear artery, the drop off was incredible, almost to zero. This was fascinating because the artery looked normal on the screen, with no restrictions. Anyway, he applied a stent and it increased the rate. Lowering the device further, there was another huge drop off, below the new stent, so he added another one. This time the flow rate was great all the way down and my symptoms stopped. The lining in your artery is like glass, but if there are microscopic irregularities then they won't be seen on the monitor. However, they can cause huge amounts of turbulence affecting the flow. My cardiologist said "If I hadn't seen it, I wouldn't have believed it". If I hadn't whispered those 3 letters, then I would be in that bucket of unexplained. They don't use this device in normal investigation procedures which is kind of silly. Perhaps you should raise this as a possibility with your cardiologist. Even though you could see no restrictions, I was in absolute agony. Yes my troponin was elevated after 12 hours, but it was only a small amount considering the pain I was in.
Thank you for replying, I will see my primary today hopefully I can ask all these questions also my original Cardio on Mon. I'm not willing to just dismiss all these symptoms knowing that my workups prove that it is getting worse.
Unfortunately, the lab reports you have offered are too complex for lay people to offer medical advice about. It would be a good idea to post your questions in Medhelp's Heart Disease Expert Forum, where a doctor will eventually answer you in detail.
That said, I believe it would be a good idea to google this:
Cardiac Syndrome X
You will probably find helpful and reassuring information in reading about this condition, particularly since your first cardiologist felt that something like it might be involved.