Re: Possibly an unusual case.

Posted By CCF CARDIO MD - DLB on November 25, 1998 at 12:00:20:

In Reply to: Possibly an unusual case. posted by Paris Roussos on November 25, 1998 at 11:36:52:






: I've never had a doctor take me seriously on this perhaps
: because of the exercize tolerance I've had. Although
: not exercizing much now, two years ago I was playing
: racquetball 3 to 5 hours daily and lifting weights
: afterwords. Doing this 4 or 5 days a week. Then 35 years
: old. During this time and for the previous 8 years it was
: common for me during times of psychological stress to have
: pain radiating down my left arm which would increase to
: the jaws if the stess was not relieved. Sometimes this
: accompanied chest discomfort or pain. The pain was mediated
: by stressful thoughts to such an extent that meditating
: on the same negative thoughts would bring increased pain and
: ceasing would allieviate the pain. About 2 and a half years
: ago I discoved by accident that niacin seemed to alleiviate
: the pain. Recently, I was hospitalized for acute chest pain and
: released when cardiac enzymes were found to be normal and the
: doctors had heard of the exercize tolerance. They told me it
: could not have been a heart attack. I told the assigned physician
: about the niacin and he did not even know what niacin was.
: Because of this I did not return to him for evaluation.
: I took high levels of certain nutrients before going in to the
: emergency room and don't know if this could have effected the
: enzyme tests or perhaps preserved me.
: Has anyone heard of anything like this before?
: Please advise.
: Paris Roussos
Dear Paris
Frankly, there is nothing so unusual about your case. The niacin and nutrients would not affect the cardiac enzyme blood-work, nor would they affect chest pains coming from the heart. I do not know why the niacin helps your symptoms; I suspect it is just a coincidence. Personally, if you were my patient, I would get an exercise stress test on you, even though the likelihood of your having coronary artery disease is low.
I hope this information is useful. Information provided in the heart forum is for general purposes only.  Only your physician can provided specific diagnoses and therapies.  Feel free to write back with further 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.
Could it be that the niacin acts as a vasodilator? I was told this by
a cardiologist.
Dear Paris
Niacin can certainly cause vasodilation and flushing of the skin. This vasodilation would not occur in the coronary arteries. If your cardiologist really believed that the niacin was causing significant vasodilation of your coronary arteries and thereby relieving your chest pain, he would have ordered a stress test to evaluate your symptoms.
I hope this information is useful. Information provided in the heart forum is for general purposes only.  Only your physician can provided specific diagnoses and therapies.  Feel free to write back with further 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.