What comes Next?

[debray55]

After having a pain in left shoulder, that nitro stopped, I was given and EKG. The dr. said it was abnormal and sent me to a cardiac sp. They had me on pletal for severe pain in legs(calf) when walking. Pletal caused my pulse to stay above 112, BP to elevate and generally made me feel out of breath. The Cardiac dr ordered some tests and blood work. Then they call, almost in a panic telling me to stop the pletal. I already had the day before after seeing my reg dr. Then they call back at different times telling me my Echo was abnormal, some blood work was abnormal and then to say the stress test was abnormal, showing some blockage in cornary arteries. I was just wondering what I might be looking at as treatment. I have an appointment on the 12th to discuss treatment but was just curious as to what might be coming next.
Thanks

[rockcityaudiouk]

Hi Debbie,just take it easy until you have all your tests.
Also look at the many different posts and you will see that we are all in the same boat with our tickers as you(more or less).let me know how you are getting on,I agree your cardiologist seems to be a no-nonsense kinda guy!.(That's good).

Just wanted to wish you well and don't feel alone or stressed or scared.
there are so many people going through what we are, I've seen so many clinics full of every age and every type of people here in London.
God Bless and Big hug.
Jon.

[debray55]

Thanks John, I am in the US. I have heard a lot of good reports on my dr also so that helps.
Debbie

[rockcityaudiouk]

Hello Debbie.Your correct about worry,it can really make things worse.(and that's all)
Just go though the procedure and everything will be better.your cardiologist seems to know his stuff.Where are you based UK or USA?just interested.your obviously doing all the right things to protect your long term health.
Good luck .
john.

[debray55]

OK, I found out a few more detals today after seeing my dr. The front of the heart is weak, blood supply going into heart is low, blood being pumped out is low (ejection factor was less that 40) Going for angyogram and possible stents on the 24th of
august. I asked him if this was bad enough to cause me to get short of breath and reach total fatigue very quickly and he said yes. Maybe I am just not getting it. How serious is this? Should I be worried (I'm not because I believe worrying makes all disease worse.)
Thanks
Debbie

[debray55]

Thanks John. I had the full CT, am on the baby asprin and fish oil already. Just waiting for my dr to get back from India. Will see him on the 12th.

Having a pretty bad morning here. Mowed the yard yesterday on the riding mower and I guess the vibration from the mower and hitting a few small dips really did in the lower back. I forget sometime that there are things I really shouldn't do. I have moderately severe disc degeneration. Got up in severe pain, then started having some angina as well then got sick and threw up. I am feeling a tad bit better now tho.

Thanks again for the feedback and info.
Debbie

[rockcityaudiouk]

Hi Debbie,
         I'm so sorry to hear such tragic news about your father and the situation of his death.
I think the best way to go about this now is a full CT Angiography(64 slice or more).
and a very good cardiologist that really knows their job.
I think very gentle exercise is a good idea also maybe take some good fish oils(omacor)for example and also a good whey protein supplement.you may also take a baby aspirin a day(75mg)that will also protect you a little until the CT scan can be done.
also try to cut down on all Carbs.(about 125-150 grams per day max)this will also help take the excess water from your body.
Please inform me of your results and prognosis.
Kind Regards,
John.

[debray55]

Sorry if my post was confusing. First of all, the arteries I was refering to as being ok were the ones in my legs. I assumed they were ok after I had the CT scan and they told me to stop the pletal, that was not the problem.

I don't drink alcohol at all.My BP was a little high 2 years ago and I took lisinopril. It seems to be ok now except for an occasional rise but never really very high.

My ankles do swell and have for about 3 years and I asked the dr. several times about it and all he would say is yep, they are swollen aren't they. I dont know why. And that was the end of it. My abdomen swells also but I had no idea that the two were related.

I have tried to watch my weight and what I eat all of my life. I was diagnosed with fibromyalgia 5 years ago and even before the diagnosis is was hard to get the proper amount of exercise due to pain. I also have disc degeneration  that causes some pain. The more I did, the worse I became.

I think one of the most contributing factors in my case is hereditery. My dad's family (my dad died from CAD/Heart attack, in my car on the way to the dr) and all of his 11 siblings have some form of heart disease, most of them severe to leading to death. I am not trying to sound morbid, nor am I worried about dying from this. I do realize the severity of it but refuse to add the stress of worrying to my agenda.

Another contributing factor was smoking. Although I never had smoked at all before I was 46 years old. I smoked for 8 years. I had tried to quit several times over the past 3 years with no success. I just did not have enough will power. I did quit on July 14th of this year. I know it sounds early to say I quit but have not had any so I really dont think I will go back to it. Other than actually knowing that it was killing me it was quite embarrasing to go to the cardiologist and have to tell them yes I smoke a pack a day. So, I quit.

As for exeercise, I now have a machine that causes no impact and is basically a glider (gazelle) That I can use and it does not add to my pain.

At this point I am just hopeful that when they get through with treatment, I will feel better and have more energy so I can actually do some of the things I enjoy.

Thank you so much for your information

Debbie

[rockcityaudiouk]

Hello,hope your feeling a little better?.I was wondering if you could clarify what you mant by"Good to know those arteries are ok"?.nothing in my post said that so I need to clarify that.I will list the following points that may be easier to understand rather than a long post.
1.the only way to examine your coronary arteries are with A coronary cathertization(a thin tube is placed into your heart and they look at an x-ray machine while shooting dye into your veins.OR  CT 64 slice angiography.(which is safer) but, obviously then they cannot put Stents to hold open your veins,if they should need to.
2.your point of cramping of the calf,do you have swelling?As the body becomes overloaded with fluid from congestive heart failure, swelling (edema) of the ankles and legs or abdomen may be noticed. so check that out as well.
3another helpful diagnostic test is a blood test called a BNP or brain natriuretic peptide level. This level can vary with age and gender but is typically elevated from heart failure and can aid in the diagnosis, and can be useful in following the response to treatment of congestive heart failure.
4 Depending on the underlying cause of congestive heart failure, potentially reversible factors should be explored. For example, in certain patients whose congestive heart failure is caused by inadequate blood flow to the heart muscle, restoration of the blood flow through coronary artery surgery or catheter procedures (angioplasty, intracoronary stenting) may be considered. Congestive heart failure that is due to severe disease of the valves may be alleviated in appropriate patients by valve surgery. When congestive heart failure is caused by chronic, uncontrolled high blood pressure (hypertension), aggressive blood pressure control will often improve the condition. Likewise, heart muscle weakness that is due to longstanding, severe alcohol abuse can improve significantly with abstinence from drinking. Congestive heart failure that is caused by other disease states may be similarly partially or completely reversible by appropriate measures.
5.also watch your diet,cut out sodium,junk food and don't drink alcohol at all.
Hope I have helped..keep strong ,Kind Regards,John.

[debray55]

Thanks John. They did tell me that the amount of blood being pumped out with each pump is low (this was on the echo)but I don't have a number.

I read about the pletal and figured that was exactly why they had me stop it. I found it odd that they would even put me on it if they even suspected CHF. They knew something was going on. Maybe they figured I really needed it for the legs. That was the only test that came back ok.
Good to know those arteries are ok. Thanks for the info. I am not really distressed over the news, actually relieved to find out what was wrong, so we can hopefully fix it.

I was wondering if the probs I am having with cramping of the calf when walking could be caused by the heart problems??

Anyway thanks for your info and taking the time to respond

[rockcityaudiouk]

Hello,Sorry to hear this very distressing news,I will try to help as far as my limited knowledge goes.Pletal,Generic Name: cilostazol and several of its metabolites are inhibitors of phosphodiesterase III. Several drugs with this pharmacologic effect have caused decreased survival compared to placebo in patients with class III-IV congestive heart failure. Pletal is contraindicated in patients with congestive heart failure of "any severity".So they may have panicked and thought that you may have congestive heart failure.(that may not be the case however)If your doctors suspect blockages they will do what is called  A coronary catheterization it is a minimally invasive procedure to access the coronary circulation and blood filled chambers of your heart using a catheter. It is performed for both diagnostic and interventional (treatment) purposes.If that then shows blockages you may then be stented(small wire like mesh's)implanted into the coronaries to keep them open.
Without knowing your results from the Echo its hard to say for sure what's going on,it would be good to know your current ejection fraction.(EF)you may want to ask them that.
the main thing is though,is that your now under good medical care and the problems have been found.your also lucky enough to be in a country that uses the latest technology and expertise you have the most excellent medical prognosis due to that fact.
good luck and please keep us posted.
God bless you.
John.