Heart Disease Expert Forum
I am so worried
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I am so worried

Hello Doctor,

My husband had a heart attack one year ago in July. He has passed a stress and thallium stress within six months prior. This attack hit the lower back of his eart with minimal damage but he did have two stents put in.

About a month ago he was in the hospital for chest pain, had a complete cardio workup including a mylo-view stress, passed that with flying colors and was dxed with acid reflux. Two weeks later he had arm pain, his b/p was 60/21, I called the medics they said he was in heart block,but went into another heart attack. He was flown to a large medical center near us, they did the cath but were unable to open the stent and he ended up having by-pass.He also suffered a mild stroke during the cath. The surgeon said he saw very little damage to the right side of his heart and his heart is very strong. He said he could not believe how well the surgery went and how fast his heart came back, whatever that means.

He never shows any symtons,no SOB, tiredness, nothing just the creases in the ear lobes. I know you do not put much stock in this, but I saw this twce with my husband. He is 68, physically fit but a strong family history of cad.

Right now his b/p is running high the top number is in the 150's sometimes the 160"s. I called the cardio's office and they increased his meds. these med he was on before and they never worked for him. I tell the RN. that but it is like talking to a wall. The home care R.N. called the cardio due to the B/P also she heard a small amount of edema in his lungs, no meds were perscribed for that. I am just so frustrated and do not understand how he can pass these tests when his cad is so bad.

I just do not know what to think, should we find a new cardio, was something missed on the test. How are we suppose to know when he is blocked? Now I frightened about a stroke also, but I know that is a risk factor with a cath.

Sorry this is so long, I just need to vent and wanted yur opinion.  
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Hello,

I am sorry to hear about your frustration and understand your concerns.

I just do not know what to think, should we find a new cardio, was something missed on the test.

I can't really tell you if something was missed, but is possible to have a heart attack despite a normal stress test.  Stress tests are very good at finding blockages that are causing decreased blood flow to the heart.  If the plaque ruptures in a coronary artery, the blood flow is acutely obstructed and there does not necessarily have to be any pre-existing disease in the area of the artery.

If you feel like your concerns are being ignored, consider getting a second opinion.  I agree that blood pressure control is very important!



How are we suppose to know when he is blocked?

If you are having sympoms, please leave it to your doctors to try and help you decide.  Home diagnosis can be dangerous.  I am not asking you to stop being proactive, just try to self diagnose and treat. When the symptoms sound like a real blockage, I usually take my patients directly to cath.  I do this when I am so convinced the chest pain is cardiac in nature that a negative stress would dissuade me from doing the cath.  I may still order a stress to determine the distribution of ischemia, but would still do the cath.  I do exercise or chemical stress tests if I suspect it could be coronary disease, but am looking for data to support my hypothesis.


Now I frightened about a stroke also, but I know that is a risk factor with a cath.

Stroke is a relatively rare complication of heart caths -- although that is not comforting if it is your family that had the stroke.  The most important thing now is maximum risk factor modification:

Aspirin
consider plavix
Statin like lipator, zocor, crestor, etc.
blood pressure control (ACE inhibitor, beta blocker)
diet, exercise

Good luck and thanks for posting.
8 Comments
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Avatar_n_tn
I don't have answers for you, Line, but I will pray for your husband and for you!

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Avatar_f_tn
Nick, God Bless you.

Thank you so much for taking the time to post. I believe in the power of prayer greatly and appreciate your concern and your prayers.

Thank You, Linda
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Avatar_n_tn
Hi Linda,  Im sorry to see what you and your husband are going through. It is very tough. I also understand your frustration with the cardios etc. They do not seem to realise we are all different and do not always present with the exact symptoms or react to medication exactly as seen in txt books. I would say, if you have doubts about your husbands cardio, then find a new one. Go with your gut feeling because they are not always right.  I hope you find the answers you are looking for. Best Wishes. 8)
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Avatar_n_tn
Don't burn any bridges, just go for a 2nd opinion armed with all the tests/reports.  You may find he was right and want to return or you may find that you like the 2nd dr. better and want to stay put.  It doesn't hurt to have a 2nd opinion and it's a situation that would make me want to get one.

My experience in the past is sometimes it takes a 3rd opinion and there was one time where many drs. just couldn't agree (some said a and some said b).  That was frustrating!
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Avatar_n_tn
When I say I understand your frustration. I actually do. I am 39 and suffered 2 heart attacks. First one at the age of 30 and send one 4 months ago. First time I had 3 bypass. This time 5. And I had doctor who wouldn't listen. even 1 month prior to my second heart attack, my doctor wouldn't listen to much. Always doing ECG and increasing nitro dose (isosorbide), so I fired him, took my business else where and I am happy, cos they found out I had all 3 of my blocks closed up ( 2 of them 100% one 99%). Thus the 5 bypass and now I am fixed up untill next one. Oh by the way I am not really over weight. my BMI 23.4%. And total cholestoral 149.

Good luck to you and Allah bless you.
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Avatar_n_tn
Hi,
What were your risk factors if you have low cholesterol and body weight?
Are you male or female?
Thanks.
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Avatar_n_tn
Even though my total chol was good, however my LDL/HDL ratio was bad, I smoked, by born - narrow coronary arteries and family heart disease history (which I didn't know until I had heart problem)
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