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Heart Disease (Expert Forum)
Vague heart problems
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Vague heart problems
by Susie404, Feb 23, 2003 12:00AM
My GP noticed something odd in an impromptu office EKG, slightly abnormal T waves. I went on to a cardiologist for stress test, echo, and some non-dye computer test after the stress test. Cardiologist determines the lower left chamber of my heart is not working quite right, but cannot say quite why. He recommended an angiogram which I am reluctant to do, having the complications of lupus and genetic facio-scalpulo-humero MD. A pulmonary doctor tested my lung function and although it isn't great, the numbers weren't that bad. I am a heavy long time smoker, female age 53, with possible genetic hyperlipidemia - I have large eye area xanthelomas. That is untreated at this point.
I have considered the newer alternative to an invasive angiogram, that close cat type scan that can predict heart disease via calcium depsoits, but I understand it cannot see soft tissue blockage? Would this test be of any value for me?
My symptoms have included bouts of difficult breathing, low oxygen levels with a head and lung cold that resulted in ER visit and treatment six months ago, and the use of Advair inhaler which has worked very well preventing any shortness of breath.
As a child, I was said to have MVP. To make matters worse, I am a heavy coffee drinker due to the fatigue of the above mentioned systemic and muscular diseases.
Do you think I be scheduling an invasive angiogram or getting a second opinion?
I have considered the newer alternative to an invasive angiogram, that close cat type scan that can predict heart disease via calcium depsoits, but I understand it cannot see soft tissue blockage? Would this test be of any value for me?
My symptoms have included bouts of difficult breathing, low oxygen levels with a head and lung cold that resulted in ER visit and treatment six months ago, and the use of Advair inhaler which has worked very well preventing any shortness of breath.
As a child, I was said to have MVP. To make matters worse, I am a heavy coffee drinker due to the fatigue of the above mentioned systemic and muscular diseases.
Do you think I be scheduling an invasive angiogram or getting a second opinion?
Doctor's Answer
by CCF-M.D.-RCJ, Feb 23, 2003 12:00AM
Susie404,
Thanks for the question.
At the CCF, our workup for dysfunction of the left ventricle includes an angiogram. Coronary artery disease is extremely common in the the US and is the primary cause for heart failure. Coronary artery disease is best evalutated by an angiogram.
Lupus increases the chance of developing coronary artery disease. In fact, coronary artery disease is much more common in lupus patients than age and gender matched controls. Given that you have lupus, continue to smoke, and perhaps have hyperlipidemia, the probability that your left ventricular dysfunction is from coronary artery disease is quite high. Lupus can lead to heart failure by other routes as well, including myocarditis, pericarditis, and pulmonary hypertension.
The decision to seek a second opinion is up to you. Rarely does this lead to a worse outcome -- but it can. Particularly, when a patient has made up his/her mind about what they want to do and are seeking second (and third, and fourth opinions, etc) to "rubber stamp" his/her decision. This case can be illustrated by the Reggie Lewis story.
Good luck.
Thanks for the question.
At the CCF, our workup for dysfunction of the left ventricle includes an angiogram. Coronary artery disease is extremely common in the the US and is the primary cause for heart failure. Coronary artery disease is best evalutated by an angiogram.
Lupus increases the chance of developing coronary artery disease. In fact, coronary artery disease is much more common in lupus patients than age and gender matched controls. Given that you have lupus, continue to smoke, and perhaps have hyperlipidemia, the probability that your left ventricular dysfunction is from coronary artery disease is quite high. Lupus can lead to heart failure by other routes as well, including myocarditis, pericarditis, and pulmonary hypertension.
The decision to seek a second opinion is up to you. Rarely does this lead to a worse outcome -- but it can. Particularly, when a patient has made up his/her mind about what they want to do and are seeking second (and third, and fourth opinions, etc) to "rubber stamp" his/her decision. This case can be illustrated by the Reggie Lewis story.
Good luck.
