Re: Alternatives to Medication and Surgery

[Diane__0__0]

Posted By Diane on August 03, 1999 at 17:04:00
My husband has had two angiograms, one angioplasty, and a stent installation to treat angina. Following the stent procedure, the chest pains continued but always at rest, never during or after exercise. The first cardiologist seemed to know nothing about care other than his invasive procedures and medication that made my husband feel worse, without relieving his chest pain (Imdur and also the nitro patch). The two stress tests following the stent procedure showed a strong heart with no blockages. Yet, the day after the second stress test my husband was in the ER with chest pains.
We transferred to a second cardiologist, same clinic, and one with an excellent reputation throughout the area. On my own, I had found something called the Prinzmetal variant of angina, which seemed to describe pretty much my husband's symptoms. I asked the second cariologist about that as a possible explanation for the chest pains and he said that it was extremely rare and changed the subject.
Next, I asked for some dietary, exercise, and stress management guidelines that my husband might follow to help his overall cardiac health. Not that I am unaware of what these guidelines are, it was that I wanted a "white coat" type person to stress these things to my husband. With me being the only one to mention concern about proper exercise, avoiding saturated fats, refined flour, etc. etc. I very much needed medical support on this endeavor. To my amazement, this highly-regarded cardiologist informed us that "they" were finding that "it was all in the genes" and that if the genes were good, everything was OK and if the genes were bad, there wasn't much anyone could do about it.
My questions are:
How is the Prinzmetal variant diagnosed?
Is there any meeting of the minds between conventional doctors and others like Dean Ornish, Julian Whitaker, Andrew Weil, etc?  I have never been able to have a meaningful conversation with a doctor about things like COQ10, vitamin E, vitamin B6, etc. etc. but the media is loaded with data, mostly from Europe and other countries, about the wonderful and safe results from supplements. I feel that if I were to wait for my husband's doctors to recommend anything natural, he would be being deprived of considerable help.
Oh, one last thing...I have frequently read about the usefulness of a homocysteine level test at predicting the liklihood of a heart attack and, if the test is positive, the value of supplementing with vitamins B6, B12, and folic acid. I have asked both cardiologists as well as two internists about doing this test on my husband (who, by the way is 74) and they say it is not necessary - then change the subject. Could you give me some information on this?
Many thanks for this helpful service.

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on August 04, 1999 at 08:43:46
Q: How is the Prinzmetal variant diagnosed?
A: Prinzmetal's angina is due to coronary artery spasm in a person with normal coronary arteries.  It may be diagnosed in the cath lab by injecting the coronary arteries with ergotomine to see if spasm can be precipitated. Treatment is with a type of medication called calcium channel blockers. By definition you husband does not have Prinzmetal's angina because he has coronary artery blockages.  However, calcium channel blockers may provide some benefit if your husband has failed other medications.
Q:Is there any meeting of the minds between conventional doctors and others like Dean Ornish, Julian Whitaker, Andrew Weil,etc? I have never been able to have a meaningful conversation with a doctor about things like COQ10, vitamin E, vitamin B6,etc. etc. but the media is loaded with data, mostly from Europe and other countries, about the wonderful and safe results from supplements. I feel that if I were to wait for my husband's doctors to recommend anything natural, he would be being deprived of considerable help.
A: It is true that someone must have a genetic predisposition to develop coronary artery disease, but the environment (i.e diet, exercise, vitimins, homocysteine, etc.) is the other factor necessary to develop coronary artery disease. This is well established medical fact but unfortunately still many doctors do not spend significant time on prevention.  I would recommend seeing a specialist in preventive cardiology or a prevention clinic (i.e. Cooper center in Dallas, Pritkin center in California).
Q:Oh, one last thing...I have frequently read about the usefulness of a homocysteine level test at predicting the liklihood of a heart
attack and, if the test is positive, the value of supplementing with vitamins B6, B12, and folic acid. I have asked both
cardiologists as well as two internists about doing this test on my husband (who, by the way is 74) and they say it is not
necessary - then change the subject. Could you give me some information on this?
A: Homocysteine levels are not considered routine at this point but in some individuals may be helpful.  
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.
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.











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Alternatives to Medication and Surgery Diane 8/04/1999
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Re: Alternatives to Medication and Surgery CCF CARDIO MD - CRC 8/04/1999
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