Myocardial Bridge - right test?

[juliemg]

My doctor did an echocardiogram while I was resting/ lying down. My heart is supposedly OK and "pliable" (exceptionally for my age 54) .
My problems are when I'm active.  Shouldn't a "stress echocardiogram" have been done to determine how the myocardial bridge affects the functioning of my heart?

[grendslori]

Hi Julie, I've just read your posts and wanted to know: What did the doctors tell you a Myocardial Bridge is? You sounded so frustrated in your last post. Stabbing pains in the middle of the chest are not usually heart related; most everyone, at one time or another, has experienced stabbing pains like you describe; it doesn't mean anything. The SOB could be caused by many different problems. A cardiologist can get a pretty good picture of heart function off of a regular echo, they aren't going to want to put you through a stress echo unless they really think you need one. Stress tests of any kind aren't much fun. Have you had a stress test done?

[kenkeith]

Yes, you should have had a stress test.  There is a congenital anomaly where heart tissue covers the vessel, and as a result when heart cells are activated during the contraction phase, there may be undue pressure causing the vessel to narrow at the site of the vessel's bridge.  This effect happens during systole (pumping phase) when blood is pumped into the system's vessels. But blood is circulated to the heart during diastole (resting phase).

A stress test would be able to image the perfusion of blood during the exertion part of the test and then the perfusion during the resting phase.  The result would give an indication of the amount of oxygenated blood received by the heart during diastole.

The bridge wouldn't effect the functionality of the heart, but it could explain any chest pain.  Left ventricle functionality refers to adequate pumping of oxygenated during systole, and if LVEF is preserved there would not be any SOB that would relate to the heart, and an OK and pliable heart indicates the filling phase (diastole) has adequate capacity.

[juliemg]

Hi,
       My chest pains/breathlessness don't happen just "every now & then".  They happen several times an hr (when I'm active and sometimes when I'm sitting & watching TV).
        What is SOB?  It can't mean the same as what I think of my cardiologist.  He doesn't tell me anything except.. the Myocardial Bridge is not serious... you've had it all your life and it never bothered you before...".  He wouldn't explain any of my test results (angiogram echocardiogram- both while resting... or the 24 Hr Holter Moniter results).  He just says to "it's not your heart ... it must be a lung problem" and shrugs me off.
    My very first test was at PC doctor's  was a Treadmill stress test.  I lasted 3 1/2 minutes out of the 10 it was supposed to last, before they insisted on stopping it (I had severe chest pains and was breathless). They didn't like what they saw on the EKG.  I said I could keep going (as I put up with worse at work 10 hrs/day), but she said "no way".  That's when she sent me to a cardiologist.
    I have been flu-like sick (nausea, severe fatigue, continued abdominal problems since my partial (uterus) hysterectomy Dec 07.  Then I started getting short of breath and chest pains on walks of about 3-4 blocks. The last 6 months  the breathlessness and chest pains happened on shorter & shorter distances.  Now I can't walk 50' without the stabbing (mid) chest pains and breathlessness.  I have to walk real slow to cover any longer distances, and still have to stop & rest for a minute or so to relieve the pain..  I can't sweep more than 10', or ride a bike even 1/4 mile. I'm living life in slow motion just to get thru the day.
   I'm on a waiting list to see a Lung Specialist for earlier then the March 26 appt. I have.  I'm hoping they will explain test results and be sure i get the "right" tests.
   Thanks much for you replies and help

[juliemg]

Hi,
My cardiologist has pretty much written me off.  I'm hoping the Lung Specialist (don't have one yet) will do all the right tests, including sending me the the "right" heart doctor, if need be.
   I can't believe my frequent stabbing chest pains are not serious.  Since it is affecting all of my activities (which are severely limited.restricted now).  Is there any other type of doctor I should see to figure this all out?
Thank-you