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Follow-up#2: LAFB
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Follow-up#2: LAFB

Dear Doctor,

Wow, thanks for the speedy answer.  I'm beginning to resign myself (though very reluctantly) to the prospect that I may never know the cause of my chest pains following cocaine use and whether LAFB was due to minor MI or something congenital. (I don't have a previous ECG).

At this point I'm worried about whether an MI that is "undetectable" may affect my life-expectancy.  Please consider this last set of questions:

1) Is it true that any MI that resulted in myocardial cell death would have left some scarring?  

2) Only an MI that resulted in myocardial cell death and scarring is relevant to my long term prognosis and life-expectancy, right? If there is no scarring, then can we assume that whatever happened will not affect my life-expectancy?

3) Assuming that I suffered an MI, don't there exist "post-hoc" means to detect scarring?  MUGA?  I've also heard of some new technology using MRI to detect direct evidence of MI (as opposed to troponin/CK which are indirect evidence).      

4) My cardiologist says that Troponin I level would show at least some increase even if minor MI occurred, even though blood was taken 4 days (102 hrs.) after event.  Doctor who answered my first posting here says that's not true, given my age (26 yrs).  My Trop. level was low (<.3 NG/ML).  I'm confused--can you resolve or point me to some literature?

Thanks,
Thomas
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Dear Thomas,

Please do not repost on the same day.  Please post under your prior response if possible.

In response to your questions your chest pain was caused by spasm caused by cocaine and this may or may not have caused permanent damage.  If you stop using cocain your life expectancy should not be decreased in view of essentially normal tests.

As far as troponin.  you may look this up through our home page as a serch for additional information.
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