Vascular spasm; antiphospholipid antibody syndrome

[kd]

I have what has been diagnosed as premature atherosclerosis.  My coronarys are clear but my carotids aren't.  I have PVD and a MVP 3+/4 regurgitation.  They didn't know why I had the atherosclerosis.  It started showing up in 1994.  Since that time I have had an endartarectomy (which closed up in short order), multiple TIAs, 2 mild strokes since last Sept., etc. etc.  On my last trip to the hospital, they basically said don't come back because there is nothing we can do until you have a massive stroke because you don't have clots and you don't have a hemmhorage.  And I KNOW they can't do a whole lot after you have a massive stroke.
  Last week my PVD specialist said something about vascular spasms and that might be the cause of a leg problem I had last year instead of a clot.  I can't find much about vascular spasm.  Since you deal with the vascular system, can you tell me a little bit about it?  What causes it?  Can I control it?  Could it also be causing the atherosclerosis? the TIAs? Can it increase the MVP problem?
  This week, my PCP tells me that (after much searching) I may have antiphospholipid antibody syndrome.  Will that cause atherosclerosis?  Will that increase the MVP problem?  There used to be calcium around the aorta and now the MV is also collecting quite a bit.  Will the antiphospholipid antibody syndrome affect that?
Thanks.
kd

[CCF CARDIO MD JMF]

DEar KD,

Your medical problem is quite complex and your problems stem from multiple interrelated problems.

First lets start with the MVP.  If you truly have 3-4+ regurgitation you need to be evaluated for consideration of a repair of this MVP before it impacts poorly on your heart function.  As MVP becomes more severe, it may cause atrial fibrillation or an irregular beating of the heart and this alone may predispose for an increase risk of stroke.

As far as premature atherosclerosis.  This is very common and is caused by a combination of risk factors including smoking, cholesterol and family history of genetics.  You should have your physician address each of these potential causes for early atherosclerosis.

Antiphosholipid antibody syndrome is a disease process in which your body developes particular antibodies that cause you to be more suseptible to clotting and thrombosis.  This should be handled by a specialist.

I would recommend a second opinion to review all your cardiac conditions as well as your clotting abnormalities.  I would recommend a consult to a hematologist and/or cardiologist.

[NO NAME]

WHY, when the places to post is to limited, is this person allowed to post their questions 2 times?  ONce here at the heart forum and the exact same question at the neurology forum.  So many people have wanted to ask questions and haven't been able to because of lack of space.

[kd- to Dr. JMF]

Thanks for your response.
Part of the confusion about the premature atherosclerosis is because I have never used alcohol, cigarettes, or drugs (other than what was prescribed).  The link with a family history is also very small.  I am 48.  The earliest any member noted vascular problems was in their late 60s-early 70s.
I've been to see practically every specialist known to man and had many blood tests.  My cardiologist doesn't feel he can do anything with my heart because it will trigger a stroke.  The left ventricle is getting larger but is high normal (from low normal last year).  He said surgery in another person would have been done 2 years ago but the other problem says "wait."  That was why I wondered about the interaction with the antiphospholipid syndrome.
I don't have a hematologist but my PVD specialist said he had the same qualifications.
The vascular spasms still remain a mystery.

Thanks again.  I have basically been told there is nothing left to do except have a massive stroke.  Even the angiograms create TIAs.  It is hard.  I have an 11 year old son.  Your support is welcomed.
kd

[kd to no name]

I am sorry I took up too much space.  I understand how you feel.  I have been trying to get on the neuro page since before Sept. and this one sporadically since it changed from many responses to a few.  Unfortunately, my problem spans both areas and often the specialists in each area give differing information that can be used to bring about a new outlook.  
I never expected to reach one, much less both, today.
This is a fatal condition.  The atherosclerosis is moving rapidly.  It is affecting my ability to eat.  I am no longer able to drive.  I have difficulty walking upstairs.  And the drs at the ER don't even treat me because they say there is nothing they can do that isn't being done.  The cardiologist won't do surgery because of the vascular problem.  The vascular surgeon won't do surgery because of the heart problem.  Do you know how it feels when you have a young child who has his own neurological problems to know that you may not be around past a couple of years?
So, yes, I feel sorry that I took advantage of the openings from the standpoint that there are so few.  But, no, I don't feel sorry I grasped at the straws I was given.  
If you look closely, you also notice that the two messages are not exactly the same.  Some parts are but there are changes to meet the site.
I hope you get on tomorrow.
kd

[Barbara]

kd  dont be sorry , you do what you have to do and take all the space you want to . GOD bless you and and know he will be with you and see you through this .

[Sandy Stidham]

I am not sure if the condition that you are discussing here is what I am looking for information about or not.  I do not know the medical term for my condition, but I do know that my doctor said that the artery on the left side of my heart is having spasms, and he has never seen nor heard of this in a 42 year old woman.  I have chest pain every single day, caused by the spasms.  Please let me know if this is in the same line as your condition or not.  Thank you!

[kd re: longstanding MR]

I'm sorry, but your symptoms don't sound like mine.  I'd have liked to have helped.  Luckily, my spasms - if they are spasms - have occurred every where but my heart. (Knock on wood.)
I wrote a long message earlier but my husband turned his computer, which is connected with mine, off and it erased the message right in the middle of the "send."
However, one thing that I have learned is to get a second or a third opinion when your Dr. starts talking about things not happening in a certain age range.  The exceptions are just too frequent.
Good luck and if you find anything on vascular spasm, let me know.
kd