Hypertension, angina

[Colin__0]

Posted by Colin on May 26, 1999 at 09:49:34
I am a white male 6'1", 280, 46 years old.  My heart rate at rest for the past few years has been 70 - 75.  My BP has ranged from 140/95 to 160/95.
About 8 mos. ago, out of the blue, my heart rate soared to about 125 at rest for about 5 minutes.  I had been experiencing some difficulty breathing and tightness in my chest after climbing stairs or a 40 - 50 minute walk. I went to my GP and my BP was 180/110.  He  put me on 50 mg Atenolol.  I experienced heavy fatigue/exhaustion. He reduced the prescription to 25 mg.  after 3 mos. my bp was 160/100.  I had a subsequent experience of heart racing to about 125 at rest which  lasted about 3 hrs., with extreme anxiety/perspiration. Two weeks ago I went back to my GP for a checkup.  My bp was 180/100.  We discussed my contining chest tightness after walking or stair climbing.  He sent me to a cardiologist.
Yesterday I went for my visit.  He took my vitals (180/100)ran an EKG, discussed family history and my history.  He concluded that I have "some" coronary heart disease and probable angina.  We scheduled a Thalium stress test for next week and a chloresterol screening so that he could determine the extensiveness of the problem and put me on a program for improvement.
Now my questions: What is the difference between a treadmill test and a thalium treadmill stress test?  What does "some" coronary heart disease mean?  What questions do I need to be asking?

Posted by CCF CARDIO MD - MTR on May 26, 1999 at 14:20:54
Dear Colin, thank you for your question.   From the information you've provided, I'm worried that you may have coronary artery disease (CAD).  CAD is also called atherosclerosis and causes blockages to form in the coronary arteries.  These blockages can limit blood flow to the coronary arteries to cause chest pain during periods of stress (exercise or high blood pressure).   A family history of premature CAD in relatives younger than 55 years old, diabetes, high blood pressure, smoking, and high cholesterol levels all contribute to the development of CAD.  Your BP is too high and needs to be aggressively lowered to around 130/80.  Your cholesterol levels should also be checked and high levels should be treated.  An ECG treadmill stress test is the standard version of a stress test where you exercise on a treadmill while your BP, heart rate, and ECG are continuously recorded.  A thallium stress test goes one step further by imaging blood flow to your heart with a radioisotope called thallium during an ECG stress test.  A thallium stress test is more accurate than a routine ECG stress test.  After you receive your thallium results, you should ask your cardiologist about further procedures that may be indicated, how your BP will be treated, and whether you need to take a cholesterol lowering medication.  

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.