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Heart Disease (Expert Forum)
Cause and affect
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Cause and affect
by arg, Jul 02, 2001 12:00AM
I am a 57year old male who had a heart attack on May 10th, 2001. I had an emergency Cardiac Catheterization and stent that repaired the most recent damage that had blocked my left anterior, descending coronary artery. I was told that I had probably had another heart attack previous to that and there was two adjacent areas that were destroyed. At the time of the heart attack my ejection fraction was 30%. I just had my nuclear stress EKG (stress Sestamibi) and EKG was stable. my ejection fraction was around 35% and I know that it is a different measurement than at cathertization and I am on beta blocker and cumadin (coumadin) that may effect result.
I kind of assume that I am on the right track - that the stented area will handle the flow in the future. I realize that these things can just happen, but I am trying to figure out if I should have been more aware of the possibilities, especially that I have a family history of heart problems.
This possibility of a heart attack has haunted me every day of my life –from the time that I was 14 when my father died of a heart attack. So I was obsessed with the possibility of this happening to me.
At the time of the heart attack I was taking 50mg of VIOX and 80mg of Adderall (adderrall). The VIOX is for arthritis (I have two artificial hips) and the Adderall (adderrall) was for depression and lack of energy. These were prescribed by my primary care Physician and Psychiatrist who have been treating me for the last five years.
My last EKG was three years ago and normal. My current cholesterol was normal and within range and I had been seeing my physician and group of Dr. s on a regular basis and had extensive blood work and physicals by them over the last year and especially over the six week period prior the heart attack where I saw my GP 3 times, a vascular specialist and a Rhumatologist.
In each of these five visits they asked me if I normally had high blood pressure –which I said no and they said that I had white coat syndrome because it registered high.
The reason I saw my GP was brought on by my podiatrist who said he could not get any pulse in my feet during a minor surgery event and who also said that he saw calcification in my veins- he referred me to my GP to pursue this problem. I had been complaining to my GP about energy and fatigue even with 80mg of Adderall (adderrall).
My GP could not get a pulse in the feet and I was sent to a vascular surgeon who could not get a pulse but gave me a Doppler probe on both ankles that registered over 1. I asked if Adderall (adderrall) could have affected the test? They said no. Because I was tired and had low energy my Dr sent me to a Rheumatologist to check for Fibromyalgia.
That night, May 10,2001 I had the heart attack- which I did not report to my Dr. for twelve hours. It came as a hamstring spasm attack. I had had stomach cramps and thigh cramps that were peculiar over the previous weeks. The hamstring spasm was followed by a familiar neck pain that was the same as I had a year ago when I had a bout of neck pain for about 12 weeks.
Last year, I was treated for the neck pain and told that I could do nothing about it but rest. I also got a MRI at that time and was told that I had degeneration of the neck.
question: Could the three years of Adderall (adderrall) have contributed or accelerated my heart condition?
question: Could the cramps mean that I might still have a clot in my system?
question: Was the tightness in my neck a year ago and the key indicator at this heart attack -a form of angina?- Unstable angina -that damaged my heart a year ago with the first real heart attack and then came again with more damage this time?
I kind of assume that I am on the right track - that the stented area will handle the flow in the future. I realize that these things can just happen, but I am trying to figure out if I should have been more aware of the possibilities, especially that I have a family history of heart problems.
This possibility of a heart attack has haunted me every day of my life –from the time that I was 14 when my father died of a heart attack. So I was obsessed with the possibility of this happening to me.
At the time of the heart attack I was taking 50mg of VIOX and 80mg of Adderall (adderrall). The VIOX is for arthritis (I have two artificial hips) and the Adderall (adderrall) was for depression and lack of energy. These were prescribed by my primary care Physician and Psychiatrist who have been treating me for the last five years.
My last EKG was three years ago and normal. My current cholesterol was normal and within range and I had been seeing my physician and group of Dr. s on a regular basis and had extensive blood work and physicals by them over the last year and especially over the six week period prior the heart attack where I saw my GP 3 times, a vascular specialist and a Rhumatologist.
In each of these five visits they asked me if I normally had high blood pressure –which I said no and they said that I had white coat syndrome because it registered high.
The reason I saw my GP was brought on by my podiatrist who said he could not get any pulse in my feet during a minor surgery event and who also said that he saw calcification in my veins- he referred me to my GP to pursue this problem. I had been complaining to my GP about energy and fatigue even with 80mg of Adderall (adderrall).
My GP could not get a pulse in the feet and I was sent to a vascular surgeon who could not get a pulse but gave me a Doppler probe on both ankles that registered over 1. I asked if Adderall (adderrall) could have affected the test? They said no. Because I was tired and had low energy my Dr sent me to a Rheumatologist to check for Fibromyalgia.
That night, May 10,2001 I had the heart attack- which I did not report to my Dr. for twelve hours. It came as a hamstring spasm attack. I had had stomach cramps and thigh cramps that were peculiar over the previous weeks. The hamstring spasm was followed by a familiar neck pain that was the same as I had a year ago when I had a bout of neck pain for about 12 weeks.
Last year, I was treated for the neck pain and told that I could do nothing about it but rest. I also got a MRI at that time and was told that I had degeneration of the neck.
question: Could the three years of Adderall (adderrall) have contributed or accelerated my heart condition?
question: Could the cramps mean that I might still have a clot in my system?
question: Was the tightness in my neck a year ago and the key indicator at this heart attack -a form of angina?- Unstable angina -that damaged my heart a year ago with the first real heart attack and then came again with more damage this time?
Doctor's Answer
by CCF-M.D.-CRC, Jul 02, 2001 12:00AM
Dear arg,
question: Could the three years of Adderall (adderrall) have contributed or accelerated my heart condition?
A: Adderall (adderrall) is a combination drug of dextroamphetamine and racemic amphetamine. This is an addictive drug and I would highly question its long-term use for treatment of fatigue. I don't think it caused your heart attack but amphetamines can lead to a increased adrenergic state which is not good for your heart. Please consider consulting another internist in your area to see about getting off this drug. Don't try to stop taking it by yourself.
question: Could the cramps mean that I might still have a clot in my system?
A: Cardiac pain may occur anywhere from the neck and arms down to the abdomen. If the pain is burning in nature and is brought on by exertion then I would suspect a cardiac cause. If it goes away with nitro this is another indication that it is cardiac in nature.
question: Was the tightness in my neck a year ago and the key indicator at this heart attack -a form of angina?-
Unstable angina -that damaged my heart a year ago with the first real heart attack and then came again with more
damage this time?
A: Possibly. Again I would urge you to seek the consultation of an up-to-date internist in your area. The ABIM (American board of internal medicine) can give you the name of a diplomate in your area.
question: Could the three years of Adderall (adderrall) have contributed or accelerated my heart condition?
A: Adderall (adderrall) is a combination drug of dextroamphetamine and racemic amphetamine. This is an addictive drug and I would highly question its long-term use for treatment of fatigue. I don't think it caused your heart attack but amphetamines can lead to a increased adrenergic state which is not good for your heart. Please consider consulting another internist in your area to see about getting off this drug. Don't try to stop taking it by yourself.
question: Could the cramps mean that I might still have a clot in my system?
A: Cardiac pain may occur anywhere from the neck and arms down to the abdomen. If the pain is burning in nature and is brought on by exertion then I would suspect a cardiac cause. If it goes away with nitro this is another indication that it is cardiac in nature.
question: Was the tightness in my neck a year ago and the key indicator at this heart attack -a form of angina?-
Unstable angina -that damaged my heart a year ago with the first real heart attack and then came again with more
damage this time?
A: Possibly. Again I would urge you to seek the consultation of an up-to-date internist in your area. The ABIM (American board of internal medicine) can give you the name of a diplomate in your area.
