Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Heart Disease (Expert Forum)
Chest Pain, PVC's and Mixed test results - confused on what to do?
Answered by
Cleveland - OH
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.
Chest Pain, PVC's and Mixed test results - confused on what to do?
by halpme, Oct 13, 2006 12:00AM
Hello.
I'm 35 years old. Total Cholesterol 215 (working on that) ldl 135. HDL 58. No significant family history.
Blood pressure is slightly raised, but spikes under stress. On Altace, and now Toprol XL (For PVC's).
I've had chest pain, primarily in the center of my chest during stressful situations for a year now. This even resulted in a trip to the ER in February. Stress Cardiolite test was passed.
I continue to have chest pain, and developed PVC's. Chest pain mainly during stress, PVC's all the time. Though both diminish during exercise. I did NOT have PVC's a year ago, strips at my physical are nul.
I subsequently passed a stress echo in June, at 17 mets.
However, the PVC's have gotten worse and a recent blood test showed that my HSCRP was over 4 - which is above the 3.0 high risk cut-off. My regular CRP however was .5.
My doc wants to run the hscrp again, and if it comes back high run another cardiolite stress test. I'll admit the pains and PVC's have me quite worried, but other than the HSCRP nothing points towards a problem now right? I've passed 2 tests under stress.
Toprol XL 50 was RX'd for pvc's, it takes the edge off.
Here are my questions.
1. How much stock do you put into the HSCRP? Particularly when I have passed a cardiolite test in Feb, and Stress Echo in late June?
2. I get chest pain when stressed, or sometimes at rest - IF this was true CAD wouldn't it come on during exercise also?
3. Can the high hscrp be treated?
4. Is baby aspirin in order?
5. Are there other tests I should consider?
I'm 35 years old. Total Cholesterol 215 (working on that) ldl 135. HDL 58. No significant family history.
Blood pressure is slightly raised, but spikes under stress. On Altace, and now Toprol XL (For PVC's).
I've had chest pain, primarily in the center of my chest during stressful situations for a year now. This even resulted in a trip to the ER in February. Stress Cardiolite test was passed.
I continue to have chest pain, and developed PVC's. Chest pain mainly during stress, PVC's all the time. Though both diminish during exercise. I did NOT have PVC's a year ago, strips at my physical are nul.
I subsequently passed a stress echo in June, at 17 mets.
However, the PVC's have gotten worse and a recent blood test showed that my HSCRP was over 4 - which is above the 3.0 high risk cut-off. My regular CRP however was .5.
My doc wants to run the hscrp again, and if it comes back high run another cardiolite stress test. I'll admit the pains and PVC's have me quite worried, but other than the HSCRP nothing points towards a problem now right? I've passed 2 tests under stress.
Toprol XL 50 was RX'd for pvc's, it takes the edge off.
Here are my questions.
1. How much stock do you put into the HSCRP? Particularly when I have passed a cardiolite test in Feb, and Stress Echo in late June?
2. I get chest pain when stressed, or sometimes at rest - IF this was true CAD wouldn't it come on during exercise also?
3. Can the high hscrp be treated?
4. Is baby aspirin in order?
5. Are there other tests I should consider?
Doctor's Answer
by Cleveland Clinic, Oct 13, 2006 12:00AM
, Oct 13, 2006 12:00AM
Thanks for the post.
1. How much stock do you put into the HSCRP? Particularly when I have passed a cardiolite test in Feb, and Stress Echo in late June?
All test must be interpreted in the context of the patient. I dont use CRP very much as a first line screen. In someone with other risk factors such as weight, and cholesterol I would address those before ever checking it. In a 35 year old, whos risk of having a significant event is already low and with negative stress test even lower....I wouldnt check it at all. If you keep repeating test, the odds of getting a false positive will eventually happen, I would not pursue a 3rd stress in someone with your risk profile.
2. I get chest pain when stressed, or sometimes at rest - IF this was true CAD wouldn't it come on during exercise also?
It most likely would. Honestly, with your exercise capacity and negative evaluation i would be looking elsewhere for causes of your chest symptoms.
3. Can the high hscrp be treated?
Through basic risk factor modification.
4. Is baby aspirin in order?
No. Some may disagree, but your risk of having a coronary event is low so using aspirin for primary prevention really isnt indicated. I would however focus on cholesterol and other risk factor modification
5. Are there other tests I should consider?
Without meeting you and checking your whole history I cant tell you. I would probably not pursue much more than a blood pressure check, and cholesterol in someone your age. For palpitations an echo and holter could provide other helpful information.
good luck
1. How much stock do you put into the HSCRP? Particularly when I have passed a cardiolite test in Feb, and Stress Echo in late June?
All test must be interpreted in the context of the patient. I dont use CRP very much as a first line screen. In someone with other risk factors such as weight, and cholesterol I would address those before ever checking it. In a 35 year old, whos risk of having a significant event is already low and with negative stress test even lower....I wouldnt check it at all. If you keep repeating test, the odds of getting a false positive will eventually happen, I would not pursue a 3rd stress in someone with your risk profile.
2. I get chest pain when stressed, or sometimes at rest - IF this was true CAD wouldn't it come on during exercise also?
It most likely would. Honestly, with your exercise capacity and negative evaluation i would be looking elsewhere for causes of your chest symptoms.
3. Can the high hscrp be treated?
Through basic risk factor modification.
4. Is baby aspirin in order?
No. Some may disagree, but your risk of having a coronary event is low so using aspirin for primary prevention really isnt indicated. I would however focus on cholesterol and other risk factor modification
5. Are there other tests I should consider?
Without meeting you and checking your whole history I cant tell you. I would probably not pursue much more than a blood pressure check, and cholesterol in someone your age. For palpitations an echo and holter could provide other helpful information.
good luck
I did a basic calcium score test - it was zero.
I guess my worry is soft-plaque. My echo was good, other than my LV wall being 12mm, which was the cut-off for normal. I used to exercise quite a bit.
750 Ventricular events, 4 supraventricular results.
Max VE hour - 75
Mean - 31
Thanks.