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Hello everyone, I am a 24 year old male without a known history of coronary artery disease
I will give some background to help my bmi is 22, I'm an ex smoker (8 packet years) and I have no family history of sudden cardiac death. I have a non immediate family history of afib and coronary artery disease (all affected were smokers or heavy drinkers, which happened at a late age). I have a panic disorder and obsessive compulsive disorder, and am suspected to have SVT (AVNRT) I've had the following tests within the last 12 months:
stress test with a result of 11 mets
numerous ecg's nil changes except for early repolarization
blood pressure between 90/60 and 120/80
holter monitor with isolated atrial and ventricular ectopic beats
numerous chest X rays
3 week event monitor with one recorded run of presumably SVT or sinus tachycardia at 190bpm
negative electrophysiology study at multiple sites with programmed ventricular stimulation at up to 3 extrastimuli
at the right ventricular apex (The EP had explained that it may have been because I was under anesthetic that they were unable to induce the SVT)
negative Felcainide challenge
and I am due for a table tilt test and possible magnetic resonance coronary angiography soon
My question is, as I had went to an emergency room one night,
there was an elevated high sensitivity troponin t level test.
It initially showed an elevation of 50ng/L, but after a serial troponin it had returned to <5 ng/L
The emergency doctor had discharged me, but I haven't had a chance to ask my cardiologist about what exactly this means. I know that this hospital in particular has a notorious reputation for bad care of patients, so I am somewhat concerned that they had let me out without following proper protocol. To add, this was quite a while ago.
Could I have experienced some kind of coronary event? or could it have been caused by something benign?
I am quite concerned about this as I have had frequent chest pain, which when I have returned to another hospital with a similar complaint, troponin t levels have been normal, no significant ecg changes were found, and I was discharged with musculo-skeletal pain and GERD.
Any help regarding this would be highly appreciated.
High sensitivity Troponin is the regular trop test except that lower values are considered positive. Since the repeat test was negative the first test is likely to be a false positive, since troponin levels do not decrease in a few hours or even days.
Hope this information helps.
Given the cornucopia of tests that have been taken to ensure it isn't cardiac, should I be concerned? I have been having chest pain, and left arm pain. they both wax and wane throughout the day, I've also noticed that some of the pain can be exacerbated upon palpation, but not all of it. I've asked my cardiologist/ep doctor (1 of the best cardiologists in NSW, if not Australia) If I should get a coronary magnetic resonance angiography, and he doesn't think it's necessary (also due to the fact that it is needed all the time, as there isn't many of these machines in Australia). Unfortunately This has left me without an adequate explanation as to why I'm having persistent chest pain, and because of this I've arrived that emergency room multiple times since my cardiologist appointment, only to be told "there's no Ischemia and you're not having an MI, go home and contact your general practitioner). Every doctor has agreed that it is highly unlikely to be ischemic due to my low risk profile. I should also mention that I'm going to the gastroenterologist in order to rule out anything gastric or esophageal going on, as advised by an emergency doctor.
what on earth should I do? can it all really be that coincidental and my symptoms are just manifestations of a a mystery non cardiac etiology?
I've performed stress tests on myself to see if I could exacerbate the chest pain, but I always get mixed results. any help with this would be highly appreciated.
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