A bit worried. CAD/Angina even when blood results appear to be fine?

[no_fate]

hey all, this post is rather long. please take the time to write me an answer.



The past years I have been quite sedentary, especially the last one where I still suffered
from agoraphobia. I'm over that phobia now so i'm getting out more and i'm (trying) to get back in shape.

Until 6 months ago I was still eating a lot of saturated fat and way too much sugar!
I am 23,5years old at the moment. I am a little underweight but nothing serious.


My symptoms:
----------------------
I suffer from a very mild yet pronounced widespread pain in the left side of my chest,
the left side of my neck, the back of my left shoulder, my left upperarm, left forearm, left wrist, left hand and it ends in my left fingers.

I have quite a lot of PVC's (at the moment i think it's around 10% of total heartbeats).
I have had 3 short events of what I think were NSVT or SVT, but I could never have them recorded on an ECG so i'm not sure what it was.


The tests on my heart I have had
-----------------------------------------------
In 2009 I have had 2 stresstests and 2 echo's done.
Nothing abnormal was seen, except for the quite frequent PVC's.
They gave me a BetaBlocker for that, which I no longer take due to side-effects.
2 months ago I had a bloodtest done, and the doctor said my cholesterol was perfect.
My bloodpressures have always been normal when doctors measured it.


The question that is plaguing my mind:
----------------------------------------------------------
Despite the tests I have had...

COULD I STILL BE HAVING SERIOUSLY CLOGGED ARTERIES THAT HAVE NOT BEEN DETECTED?

[no_fate]

the answers i was looking for.
thanks a lot! :)

[ed34]

"COULD I STILL BE HAVING SERIOUSLY CLOGGED ARTERIES THAT HAVE NOT BEEN DETECTED?"

Well the truthful answer is yes. For a whole year I had chest pains and throat discomfort from exertion and yet every time I had an ekg it was normal. Echo scans were normal. Nuclear stress tests were normal. I had an exercise tolerance test, and even though I was in a lot of pain they insisted I carried on. They diagnosed me as having some kind of stomach problem and I was given medication to reduce my acid levels. The pains I had in my chest were like a pocket knife being twisted between my ribs. I really believed it was a pulled muscle. I suppose it was like a bad stitch, the kind you feel sometimes when running. When I relaxed, the pains would disappear again. A year later it was heart attack time.
So, from knowing about what clogged arteries would do to your heart, you can easily establish if there is a problem. You have to remember that a Doctor cannot feel what you feel. If your arteries are clogged, then your heart would not receive enough oxygen for exercise. Even walking up a flight of stairs would have an effect. If you feel a lot of chest discomfort from exertion, and it disappears when you relax, I would insist on further tests. Something like an angiogram or nuclear scan. If however you feel no distinct discomfort on exertion, then I wouldn't worry. For example. Go for a 30 min walk and make sure this includes walking up a slight incline at some stage. You should breathe heavier so dont let this alarm you, but you shouldn't get any chest discomfort (unless you get a normal stitch). I'm talking about a gentle walk, not a marathon. If you have clogged arteries, the incline will give you problems no matter how slight it is.

[globalhiking]

Hi,
To answer your question - The only way to physically see if you could have clogged arteries is either with a EBCT (Electron Beam Computerised Tomography) uses X-rays to create high quality images of the heart and coronary arteries.) which actually detect coronary calcium,

http://www.medic8.com/healthguide/articles/ebct.html

or an angiogram.

About having "seriously clogged arteries" - Usually an exercise stress test is quite reliable but not perfect. It is why it is important to know about sensitivity and specificity. For exercise stress test it is as follow -
"The sensitivity of exercise stress testing ranges from 23 to 100 percent, and the specificity ranges from 17 to 100 percent". - There is good explanation of what it all means at this link, where the quote was taken (if you further info let me know)

http://www.aafp.org/afp/990115ap/401.html

Also if the corronary lesions/blockages are too low, the test is not useful  -
"Particularly difficult to detect is evidence of fixed stenoses with collateral blood flow, as well as low-grade (less than 50 percent) stenoses. These abnormalities may not produce sufficient impairment of blood flow to affect the ECG. - (this quote comes from the same link).

PVCs can occur in otherwise healthy people w/out causing problems, but if you have an underlying heart problem they can be dangerous.
So at this time it is advisable to discuss with your Dr if he thinks that you might have an underlying heart problem.
You did not mentioned if your electrolytes were ok - low/high Potassium; low Magnesium; low Calcium levels can all cause PVCs.

Why did your Dr put you on BBlockers? Did you have a rapid heart beat? BBlockers do not help with PVCs, and your BP is normal, so I don't understand why it was prescribed to you.

An antiarrythmic like Procainamide (Procan) is what is needed if your Dr thinks that those PVCs need to be put under control.

Also did you have any blood test done for Homocysteine and CRP (C-reactive Protein).
CRP is an indicator of inflamation, and new studies state that inflamation is more of a predictor of heart disease than Cholesterol.
You did not mentioned Triglycerides - Were they normal?

Your Dr might not be too keen to do an angiogram as it is invasive and carry its own riks, but the EBCT is non invasive, so he might be more willing to prescribe that.

Lastly, I'm just curious to know if you have any neck/spine problems? The pain on the left side could be due to some degenerative problem/pinched nerve (I don't know your age?).

I hope you find this information useful :-)

[no_fate]

nobody?