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Heart Disease (Expert Forum)
Several Questions After Prior Silent Heart Attack
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Several Questions After Prior Silent Heart Attack
by BabsD, Mar 03, 2003 12:00AM
I am a 38 year old female with a history of a prior silent heart attack. I currently take 81mg aspirin, 25mg atenolol, and 1mg folic acid daily, as well as fish oil capsules and a multivitamin. I was diagnosed after a routine ekg and echo were abnormal, and I had a heart cath that showed the scar from a prior heart attack, but normal coronary arteries and an EF of 50. No cause has ever been determined, although the theory is that it was caused by a blood clot due to birth control pills I had been on.
I get a lot of PVCs, which I was told not to worry about, but I keep reading on this forum that they are only ok if you have a structurally normal heart. What does this mean for me, since I have had a heart attack? Also, my cardiologist tells me that my EF is low normal, but I have read on this forum that an EF of 60 or greater is normal. Who is correct? Is there any way for me to raise my EF? I now exercise 3-4 times a weeks, although I am still 40lbs overweight, and my total cholesterol is 185, LDL 131, HDL 42, Triglycerides 62.
I am scheduled to have my partially impacted wisdom teeth extracted under IV sedation this week, and I am VERY nervous about the sedation. Is IV sedation safe for me? Should I refuse it and just get novocaine? Am I at a greater risk for the sedation because of my prior heart attack? Just how safe is IV sedation? I also have a heart murmur (although my valves are supposedly fine) so I was told to take amoxicillin before the procedure.
Thanks in advance - I really appreciate this forum and look forward to your reply.
I get a lot of PVCs, which I was told not to worry about, but I keep reading on this forum that they are only ok if you have a structurally normal heart. What does this mean for me, since I have had a heart attack? Also, my cardiologist tells me that my EF is low normal, but I have read on this forum that an EF of 60 or greater is normal. Who is correct? Is there any way for me to raise my EF? I now exercise 3-4 times a weeks, although I am still 40lbs overweight, and my total cholesterol is 185, LDL 131, HDL 42, Triglycerides 62.
I am scheduled to have my partially impacted wisdom teeth extracted under IV sedation this week, and I am VERY nervous about the sedation. Is IV sedation safe for me? Should I refuse it and just get novocaine? Am I at a greater risk for the sedation because of my prior heart attack? Just how safe is IV sedation? I also have a heart murmur (although my valves are supposedly fine) so I was told to take amoxicillin before the procedure.
Thanks in advance - I really appreciate this forum and look forward to your reply.
Doctor's Answer
by CCF-M.D.-RCJ, Mar 03, 2003 12:00AM
Babsd,
Thanks for the post.
In regards to the PVCs, it is possible, although not probable, that they could be a sign of enhanced potential for other types of rhythm disturbances. In someone with an EF of 50, they would not warrant treatment unless they were causing symptoms. We have some evidence, for example, that implantable shock boxes (defibrillators) do not improve survival in someone with a heart attack and an EF of 40 or more, provided that the person does not have symptomatic arrhythmias. The EF probably cannot be raised above 50 -- unless you have other medical problems (such as untreated high blood pressure) that could be contributing to your low-normal EF.
I can't comment on the iv sedation without seeing you and knowing what the sedation is. Talk to your doctor about this issue.
Good luck.
Thanks for the post.
In regards to the PVCs, it is possible, although not probable, that they could be a sign of enhanced potential for other types of rhythm disturbances. In someone with an EF of 50, they would not warrant treatment unless they were causing symptoms. We have some evidence, for example, that implantable shock boxes (defibrillators) do not improve survival in someone with a heart attack and an EF of 40 or more, provided that the person does not have symptomatic arrhythmias. The EF probably cannot be raised above 50 -- unless you have other medical problems (such as untreated high blood pressure) that could be contributing to your low-normal EF.
I can't comment on the iv sedation without seeing you and knowing what the sedation is. Talk to your doctor about this issue.
Good luck.
best,
alex
best,
alex