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Heart Damage to Front of Heart
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Heart Damage to Front of Heart

PLEASE HELP.  55 yr old Woman - overweight - HBP for several years/on Diovan & Atenelol..but still BP runs 140+ over 90+. Hypothyroid, and on Armour since Dec.; Synthroid for 8 - 10 years prior.  Have had untreated Sleep Apnea for about 7 years.  Tendency toward sedentary lifestyle...didn't used to be.  Fatigue; chronic tiredness; shortness of breath on exertion; swollen ankles; and sometimes arm pain; and recently areas on my left inside upper leg causing pain (veins/arteries?).  Both father and grandfather (paternal) died of heart attack.  Paternal aunt has suffered heart, thyroid, and kidney issues. About 3 weeks ago, I had what I thought might be a heart attack, which subsided.  Went in to clinic two days later; an EKG and chest x-ray were done.  Both showed within normal limits; no enlarged heart. Ordered a stress test.  This showed fairly normal blood flow through heart; but the Cardiolite scan (?) showed that I have heart damage to the front of my heart.  My GP was vague about this, as to what may have caused this...pretty much said I need to start walking, and 'eating right'.  He is ordering a sleep study.  I'm concerned that 1) he is not telling me what could have caused the damage 2) will I suffer further damage  3) have I had a heart attack or more, and not recognized the symptoms 4) could other things have caused this, like childhood illness?  5) should I have more tests, like an echo cardiogram, or catheterization procedure to see if I have blocked arteries? 6) should I have been put on blood thinner? and 7) should he have referred me to a cardiac specialist??  PLEASE HELP.  
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If heart cells are damaged (can be due to lack of blood flow, heart muscle disease, etc.), an echo can help determine the degree of impairment and location.  An EKG should have picked up on any heart muscle damage, but not very reliable.

The stress test should have disclosed any blockage of vessels by lack of perfusion to the damaged area (you shouldn't need a cath, but a cath is better to discover blockage and if necessary implant a stent)..  If there are any blockages, the lack of blood /oxygen to the area in question can damage the heart cells and sometimes without any symptoms.  That happened to me...damaged cells caused congested (pulmonary and peripheral edema) heart failure were my first symptoms.  But you have symptoms!

You should see a cardiologist.  Its possible there is heart tissue damage and that impairs the heart's contractility causing a low cardiac output of blood/oxy and symptoms of shortness of breath, fatigue, tiredness, etc. Also a family history of heart disorder should alert a cardiologist.  Also, not being in very good physical condition can be a problem by stressing the heart and respiratory system.
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Thank you for your very welcome response, and guidance.  It is so clear now...why am I messing with a GP, when I am dealing with something so important and specialized?  I will plan to see a cardiologist as soon as possible.  Being from ND, you know how very rural our states are (I'm in SD)...Thank you so much for your help.  

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