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Heart Disease (Expert Forum)
another stress test?
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another stress test?
by LImom, Jul 17, 2006 12:00AM
Brief summery-ablation for svt in 2000,bicuspid aortic valve w/insufficiency,64 slice ct scan said severe narrowing of LAD so I had a cath that said I was fine. This was last Sept. Since then I was diagnosed w/esophageal spasms treated with nitro-bid,used nightly,I have been fine since Sept with this. A couple weeks ago during a very stressful day at work I started getting bad chest pain again,so I found an old rx for nitro-spray and used this,it helped. Iwent to see my doc about this and she did ekg which showed change and sent me to cardio. The cardiologist wants to do a stress test. My question is,Is it possible for my heart to have a blockage with the clear cath? Does the stress test show anything other than blocages? I really hate to start all this testing again, would you have sent me for another stress test or gone another route? Thanks for your time.
Doctor's Answer
by CCF-M.D.-MJM, Jul 17, 2006 12:00AM
Tough question. I am sorry to hear you are going through this. These are always difficult cases.
Is it possible for you to have clean coronaries and have a positive stress test 6-12 months later? Unfortunately yes, but this is rare. When people have a heart attack or unstable angine, that is often caused by a clot forming in the artery. These arteries can sometimes be perfectly normal angiographically prior to the event. It is also possible that you have coronary spasm -- this is also improved with nitro.
a stress test isn't the wrong thing to do, it is a judgement call. If the stress test is negative, it might be reasonable to put you on therapy for coronary spasm -- nitrates and calcium channel blockers.
I hope this helps. thanks for posting.
Is it possible for you to have clean coronaries and have a positive stress test 6-12 months later? Unfortunately yes, but this is rare. When people have a heart attack or unstable angine, that is often caused by a clot forming in the artery. These arteries can sometimes be perfectly normal angiographically prior to the event. It is also possible that you have coronary spasm -- this is also improved with nitro.
a stress test isn't the wrong thing to do, it is a judgement call. If the stress test is negative, it might be reasonable to put you on therapy for coronary spasm -- nitrates and calcium channel blockers.
I hope this helps. thanks for posting.
