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Anticardiolipin antibodies

I am a 36 year old female with Undifferentiated Connective Tissue Disorder.  Recently I have been experiencing chest pain. My rhemotologist ran some blood tests and sent me in for an ecg and echocardiogram.  The blood work shows that I have the presence of anticardiolipin antibodies and elevated glycoproteins.  The ecg notes short P-R intervals and shows mild pre-excitation was present.  The echocardiogram shows minimal posterior buckling of the anterior mitral leaflet with mild mitral regurgitation and trace tricuspid regurgitation.  My doctor told me I am at a higher risk for stroke or heart attack and advised me to take one baby aspirin a day.  He referred me to a cardiologist but seem unconcerned.  The cardiologist can't get me in for a week and I'm still experiencing some chest discomfort.  What does all of this mean and should I be concerned?
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214864 tn?1229715239
No it wouldn't Andy. Not unless it had previously damaged some area of your heart, which would then show as some abnormal wall motion, in some area. Echos aren't given to test for coronary artery blockages.
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Avatar universal
Thank you for the information.  One other question...  Wouldn't a blockage show up on the echocardiogram?
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214864 tn?1229715239
Sure you should be concerned. I have found some information about your condition, which as you know is associated in a strange way with Lupus and Rheumatoid Arthritis. This association is not clear and is not agreed upon by research scientist, but there are antibodies that are common among these diseases.

People diagnosed with the antiphospholipid syndrome (APS) have the anticardiolipin antibodies and elevated glycoproteins. Doctors in Israel are wondering if all people with coronary artery disease have these anticardiolipin antibodies and elevated glycoproteins.

It appears from reading the literature that you are at risk for heart attacks and strokes. Your chest pain could be caused by a blockage(s) in your coronaries. I am sure that your cardiologist will schedule you for a nuclear imaged stress test. This will show either good blood flow (perfusion as they say) to your heart muscles or lack of blood flow to your heart muscles.

A positive result of the test and associated chest pain (angina) will usually require a cardiac catheterization, for an angiogram. This imaging will determine for sure if you have any blockages. The cardiac caths are a piece of cake :) I tell everyone that I have had 10 and they do not hurt at all. Maybe you want have to have one, but an angiogram is the "gold standard" for imaging blockages in the coronary arteries and estimating the percentage of the blockage(s). There are also other very important test or measurements that can only be done during a cardiac catheterization.

I would list references for the information below, which is not copyrighted, but my post would be deleted.

Keep in touch and best of health to you. Remember that if you suspect that you may be having a heart attack, chew 2 adult aspirin and call 911! (AMA recommendation)

Jack

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Antiphospholipid Syndrome

Antiphospholipid antibodies are the hallmark of the antiphospholipid syndrome which is characterized by thrombosis. There are currently data supporting an association between these auto antibodies and atherosclerosis as well. Human studies suggest that anti-cardiolipin and anti-β2-glycoprotein-I antibodies are elevated in patients having coronary artery disease compared with controls. Anti-cardiolipin antibodies are also associated with typical chest pain, significant coronary artery stenosis on angiography and prediction of myocardial infarction.
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Summary

The antiphospholipid syndrome (APS) is a thrombophilic disorder characterized by the combination of arterial and venous thromboembolic phenomena, recurrent fetal losses and thrombocytopenia. This prothrombolic state is associated with the presence of antiphospholipid antibodies (aPL), such as anticardiolipin antibodies (aCL) and lupus anticoagulant (LA). It has been commonly known that β2-glycoprotein I (β2-GPI) is a major antigen for aCL induced in patients with APS. Other blood coagulation-related proteins, such as prothrombin, annexin V, and kininogens, were also shown to be targeted by autoantibodies derived from the APS.
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Undifferentiated Connective-Tissue Disease

History: Patients may present with systemic symptoms, such as fatigue, fever, or weight loss, preceding any organ involvement. The most common symptoms include arthralgias, unexplained or undifferentiated polyarthritis, Raynaud syndrome, mucocutaneous manifestations, and sicca symptoms. It is unusual for a patient with undifferentiated connective-tissue disease (UCTD) to have major organ involvement. However, patients may manifest many signs or symptoms observed with other connective-tissue diseases as described in the potential features listed below.

Skin - Malar rash, digital skin ulcers, purpura, alopecia, skin tightening, urticaria, or photosensitivity
Eyes - Dry eyes, conjunctivitis, or ocular inflammation
Salivary glands - Dry mouth or salivary gland enlargement
Reticuloendothelial - Lymphadenopathy or splenomegaly
*Lungs - Dyspnea, orthopnea, cough, wheezing, or pleuritic chest pain
*Heart - Angina, atypical chest pain, dyspnea, orthopnea, dependent edema, or pericarditis
*Vascular - Raynaud phenomenon (exaggerated vascular response to cold temperatures leading to episodic color changes in the skin of the digits), history of arterial or venous thrombosis, history of frequent miscarriages, or vasculitis
Gastrointestinal - Anorexia, dysphagia, dyspepsia, abdominal pain, vomiting, nausea, hematemesis, melena, jaundice, or diarrhea
Genitalia - Urethral discharge or dysuria
Muscles - Muscle weakness, muscle pain, or history of myositis
Joints - Arthralgia or arthritis
Nervous system - History of seizures, neuropathy or altered mental status
Physical: Physical findings can be limited or may involve many organs. The potential physical manifestations of UCTD are best described by organ systems.

Skin - Telangiectasia, purpura, petechiae, digital ulcers or scars, sclerodactyly, acroscleroderma, calcinosis, malar rash, discoid rash, erythema nodosum, erythematous knuckle pads, periungual erythema, alopecia, heliotrope eyelids, subcutaneous nodules
Eye - Conjunctivitis, scleral-episcleral disease, uveitis, iritis, or keratoconjunctiva sicca
Salivary glands - Xerostomia or salivary gland enlargement
Reticuloendothelial - Lymphadenopathy or splenomegaly
Lungs - Rales, wheezing, pleural effusion, or pleural rub
*Heart - Enlarged heart, murmur, pericardial rub, dependent edema, arrhythmia, or abnormal P2 sound
*Vascular - Acrocyanosis, absent pulses, arterial and/or venous thrombosis
Gastrointestinal - Hepatomegaly, gastroesophageal disease, esophageal dysmotility, or malabsorption syndromes
Genitalia - Ulcerations, rashes, or discharge
Muscles - Muscle tenderness, muscle atrophy, or proximal muscle weakness
Joints - Joint tenderness, swelling, effusion, synovitis, or deformity
Nervous system - Cranial nerve palsy, peripheral motor neuropathy, sensory neuropathy, entrapment neuropathy, psychosis, or personality change
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