A very close friend of mine is a pilot. During exercise in Feb. he experienced some shortness of
breathBreath alcohol test
Breath holding spell
Breath odor. It was time for his annual flight physical and the
EKGAtrioventricular block, ekg tracing
Ecg
Exercise stress test showed some irregularities and he subsequently underwent
angiographyAortic angiography
Arteriogram
Cerebral angiography
Coronary angiography
Extremity arteriography
Fluorescein angiography
Left heart ventricular angiography
Lymphangiogram
Pulmonary angiography
Renal arteriography
Right heart ventriculography which indicated
partialPartial (focal) seizure
Partial thromboplastin time (ptt)
Thyroid gland removal occlusion of at least one coronary artery. I believe it was the LAD but I'm not quite sure on that.He returned for placement of two
stentsAbdomen - swollen
Brain herniation
Chronic persistent hepatitis
Coronary artery stent
Hyperemesis gravidarum
Lyme disease - chronic persistent
Stent.
He just recently had
ThalliumThallium and sestamibi stress tests stress test done. Apparently the cardiologist recommends "no further treatment", but his regular flight physician told him that the test did reveal ischemia, and the cardiologist earlier had told him a small area of his heart had been damaged. Neither doctor mentioned Myocardial Infarction.
He continues to have shortness of breath with moderate exercise. He says he has never experienced any pain. Of course, his license has been suspended and it does not appear he will be able to get it back mainly because the term "ischemia" was used in the test report. Also, he just told me that at the time of the flight physical, they had found his triglyceride levels elevated into the 500's and put him on Lipitor.
My question is: 1)Is it possible to have this ischemia and heart damage, and NOT to have had an MI? 2)What are the chances of him having an MI in the future? 3)If he has NOT had an MI, what are the indications for his future health with this history and the untreated ischemia? I am very worried about him.
Thanks, Pat M.
If there is heart damage, that usually means MI. Ischemia does not mean an MI, just a risk of future MI. I am concerned that he has symptoms of shortness of breath with exercise and ischemia on a thallium, with a history of two stents. Generally, I would recommend a repeat catheteriztion for that sort of patient and, from the information you provided, it is not clear to my why this is not being done.