Re: Angina and oxygen level

Posted By Tina on March 22, 1999 at 19:47:14:

In Reply to: Re: Angina and oxygen level posted by CCF CARDIO MD - DLB on March 22, 1999 at 09:40:18:







Hi, I'm a 40 year old female. I have been told I have angina and I take nitro pills when I have chest pain. I also have emphysema and asthma. My doctor recently sent home an oximeter to record my oxygen level over night. It went to 83 and stayed in the low/mid 80's most of the night. My lowest heart rate was 40, the highest was 157. I was sent for a sleep study and it showed that I had sleep apnea. My oxygen level fell as soon as I laid down before I fell asleep so I don't think the sleep apnea is the only reason for it. I asked my doctor about treatment and he said none was needed, I should just lose weight. I'm concerned because I have read that low oxygen levels are hard on your heart. Since I already have angina/ischima (the doctor has called it both, are they the same thing?) couldn't the low oxygen level hurt my heart more, could it be why I have chest pains in the first place? Would you recommend any treatment for a patient with low oxygen levels and angina? Thanks,
Tina




Dear Tina
As a first step, your sleep apnea should be treated. You should go to a doctor who is a sleep specialist. Lung doctors (pulmonologists) sometimes have this sort of training. If you have asthma, emphysema, and sleep apnea, you should be seeing a lung doctor anyway. Most likely you will need to be fitted with an oxygen mask at night to keep your oxygen levels from getting that low. Oxygen levels of the sort you describe are bad for your health and could cause permanent damage to your heart. In particular, it can cause heart failure. In fact, you should be evaluated for any damage on your heart already.
I am not sure how the diagnosis of angina was made in the first place. I do not believe in prescribing a medicine (nitro pills in your case) for a symptom without knowing the cause. You should also be evaluated by a cardiologist.
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.




Thank you Doctor, The doctor that sent the oximeter home with me over night, and sent me for a sleep study, is a lung doctor. The numbers I had given you were the reading from having the oximeter overnight. I received a copy of my sleep study test results today and I think the numbers might be a bit better. Most of it makes no sense to me but it does say that my slowest heart rate was 73.6 bpm, fastest heart rate was 116.4 bpm, my oxygen, was at times, as high as 91.2 but still stayed low a good part of the night.
My Internist is the one that gave me nitro because I would have pain in my chest that I thought was from struggling so hard to breath at times. He gave me a prescription and told me to use them during the pain until I had my Thallium stress test, the test showed ischemia  and all he really said was to use the pills when I needed to. He will ask me about the "angina" from time to time but that's about it. If I don't need them, could they cause damage? Usually just one stops the pain, occasionally two.
I do have a question about something on the sleep test. There is a section for "Heart Rate Summary"
What are Bradycardia events and Tachycardic events? I had no Bradycardia events and 16 Tachycardic events during this section of recording.
Is that good or bad? Thanks again.
Tina