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Thallium stress test negative, but?
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Thallium stress test negative, but?

Greetings,

  On 8-15-08 I was awakened by the perfect symptoms of a heart attack. I had the severe chest crushing pain in the center of my chest, pain radiating down my left leg, breathing wasn't normal, my teeth hurt, I knew I was (thought) having a heart attack but was in denial and didn't want to push the panic button just in case it wasn't. These symptoms lasted approximately 10-15 minutes. Afterwards, I really got light headed and felt pretty spaced out. I felt completely worn out as if I had gone 9 rounds with Mike Tyson and had to lay down. Later that night at work, the chest pain felt as if it were going to start up again, but would only last a few seconds, I also had pain in my left arm and my left hand felt numb. Again i ignored it because I didn't want to push the panic button. That morning I called my Dr's office hoping to get an appointment but they were closed. I had the Dr. on call paged and told her of my symptoms, she asked if I went to the hospital which I told her no and just wanted to come into the office. She advised me to call on Monday (2 days later) for a follow up. I called and she was on her day off and the other Dr. was booked for the week, the receptionest bade my appointment for Tuesday. I saw the Dr., she had me make an appointment with a Cardiologist, who performed a Thallium stress test. I had the test yesterday 8-25-08 and was told today the test came back normal but to see the Dr. for a follow up in a week. Is it possible for the test to be negative and still have a heart issue not seen? I take meds for high blood pressure, high cholesterol, acid reflex and have family history (mothers side) of heart disease. Something caused the heart attack symptoms and I'm just a little conserned. Thank you in advance.
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242509_tn?1196926198
Given you age and obesity and very typical symptoms suggesting an acute coronary event, I would say that no test apart from a negative left heart catheterization would have excluded in my mind the presence of  severe  coronary atherosclerosis. You should know, if this hasn't been told to you yet, not to ignore such symptoms but to seek emergent medical care. This episode could have progressed to a myocardial infarct, and you might have not survived it. A stress test in this setting I feel in inappropriate, as there possibly recently ruptured plaque which may be worsened by stress testing. A left heart catheterization would be what I would suggest irrespective of stress test findings.
5 Comments
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Avatar_m_tn
How old are you?  male or female?   how much do you weigh?   have you ever smoked?   what are you cholesterol numbers?   do you have a family history of heart disease?    was your stress test and EKG completely normal?   are you sure?  did you get a copy of the records?   did you have an echocardiogram?
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Avatar_m_tn
Oh, and it's possible you may need to wear a portable EKG for some time to monitor these chest pain/lightheaded events.  and you should have a chest xray.
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Avatar_m_tn
Hey Rob,

    Thanks for the response. I'm a 45 yr old white male, 240 pounds (30 over), have never smoked, social drinker at best, Cholesterol numbers are mid 200's, down from almost 600, EKG was normal, no echo was performed and most of my family on my mothers side has heart disease. Hope this helps and thanks. KniteNblue
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Avatar_n_tn
Sorry you are dealing with this, I hope you get some good information soon with the cardiology follow up.  I would write your Q;s down so you are focussed during your appt with the cardiologist.  I am sure you will get some good suggestions from the forum Dr and participants.

Meantime, next time you experience these symptoms, make sure you PRESS the panic button and call 911.  You are the classic profile for someone to have a heart attack and will get worked up very quickly in the ER, even if it turns out to be gas or heartburn, you are better off knowing that, than having undetected heart issues.  Your cholesterol numbers alone would suggest that its quite possible you have some issues with plaque in your arteries.  

If I was in your shoes, I would be asking the Dr if a cath would be a worthwhile procedure to evaluate your heart more closely.  Or maybe one of those heart scans?

I do know how it goes though, I had a cardiomyopathy (and subsequently a PE in 2005/2006) and was in heart failure.  I ignored significant symptoms for 5- 6 wks before bringing it to my PCPs attention, after going to see him for back pain. If I had acted sooner, maybe I would not have had the PE.

Best wishes and feel better soon.

Fionajnz      

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