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Catheterization delay

I was recently diagnosed with Atrial Fibrillation.  I was put on Dilziatem 120mg 1x and Flecainide 50mg 2x daily.  I was then given a stress test.  After the results, my cardiologist said there was a slight blockage to one of my heart chambers. He said this was restricting the blood to my heart.  He said this only showed during the "stress" part of my chemical test. ( he only administers chemical tests )  
His advice was to get a heart catheterization  to see just what the blockage was.  He then said because I do not have insurance, we could hold this off awhile, while I check into getting some sort of insurance.  He changed my medication slightly taking me off of Dilziatem and giving me Toprol 25mg instead.  He said this was "good for my heart".
I am concerned that the reason he is putting off the catheterization is simply because of the insurance issue.  Am I in any great danger?  He said I should return to my normal activity ( which is fairly active ) as I am a gardener. I am a 61 year old man, otherwise healthy.
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Avatar universal
I really wish I could get some feedback from a medical professional.  To be honest, I do not trust our local "for profit" medical community.  They seem to order tests and procedures, simply for the sake of making money.

This is my life, and I am worried about someone messing around simply for the sake of getting rich off of me, and others like me.  I have been at their mercy since being admitted to the hospital.  It's "don't question my authority" all along.  Nobody willing to discuss anything.
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367994 tn?1304953593
Why did the doctor give you a stress test?  If there isn't objective evidence, insurance will not cover and that is as it should be!  I don't know the future of the medical profession if and when medical treatment is free.
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Avatar universal
Ok, this is what has me confused.  I do not have any pain!  I never had any.  It's simply that the chemical stress test showed this.  I do occaisonally get a little fuzzy in the head, but that's all.  When I walk, or ride my bike, I feel fine.  I don't even get out of breath. He gave me nitro-glycerine in case I had chest pain. I don't know what the Toprol is for exactly, other than lowering my blood pressure.
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367994 tn?1304953593
A stent opens a coronary vessel and as a result the blood flow is increased to an area that previously been deprived of a good flow of blood when the demand increased (usually due to exertion).  Medication (nitrate) also opens (dilates) the coronary vessel and induces a better flow of blood to the deficit area.  Either treatment treats the symptoms (angina) only...does not cure.  You may want to google COURAGE study.  The scientific study concluded in comparison of the three treatments, by-pass, stent implant or medication, the results are the same for life span (no increase nor decrease).  If medication does not relieve your angina, then you may need a stent or bypass.  If medication opens your vessels, and no angina, you may not need a stent, etc.  A diabetic may be an exception as they can have a blockage with no pain (angina)...it may be wise to stent under that circumstance.

I take a nitrate prior to going to the gym (5 years), and I don't experience any angina with the medication.  I have a totally blocked LAD and the circumflex is 72% blocked.  Five years ago, I had a stent implant in the RCA (98% blocked) to help feed the area associated with the LAD.  The LAD developed collateral vessels that naturally bypass the LAD lesion.
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Avatar universal
Thanks for your feedback.  I'm not sure that I understand you though. My worry was that if I don't get a catheterization done, I will be in danger.

You say, you had this problem years ago, but now you don't.  Did you have a procedure done to relieve it, or did you simply do it with exercise/diet?  This is what has me concerned.  Should I be rushing to the hospital, complaining of "pain" that I do not have. So that they do the procedure.  I was told that if I was admitted, they would have to do it.

Originally I was admitted for Afib.  This showed up on the stress test.  It would seem this is unrelated to the other condition.
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367994 tn?1304953593
I pasted my response to your other post that is a duplicate of this post.

" It is true hipernating** or stunned cells can be revived (sometimes with an adequate supply ofblood/oxygen) and the condition is reversed, but in the context of the examination and the comment that there is no evidence of ischemia at rest , etc. probably means that, in a stress test, it was shown that the person taking the test has some narrowing of the coronary arteries that happens during exercise, but will go away when they rest. In other words, it's reversible. Additionally hibernating heart cells causes hypokenisis (impaired contraction).  I had that condition years ago....currently my heart is pumping normally.

The rest and exercise images are directly compared to determine if an area that has good blood supply at rest has a reduction in blood supply at peak exercise.  If this is found, it is called stress-induced reversible ischemia and generally indicates that a significant coronary artery blockage is present.

**Cardiologists have appropriated the word ''hibernation'' to refer to a chronic functional abnormality of the heart muscle due to ischemia, or oxygen deficiency caused by inadequate blood flow. The key feature of hibernation, in contrast with other heart problems such as infarction, is that the hibernation is at least partially reversible when the cause of the ischemia is relieved. Most reported cases of hibernation have been reported in cardiac patients who have undergone bypass grafting. Patients with severe atherosclerosis sometimes experience an improvement in heart muscle function after grafting improves the blood supply, indicating that the muscle was ''hibernating'' prior to the surgery.

Treatment for ischemia such as medication, stent implant or CABG only treats the symptoms and not the disease of CAD.  As the doctor stated if the nitro does not relieve symptoms of chest pain, then the medication is not sufficient or the pain is not related to ischemia.  
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