chest pain high cholesterol

[sckeet]

hello everyone i am a 26 year old male history: smoke heavily pack a day 13 years alcohol 1-2 times a week very

heavily 5+ drinks blood pressure is usually 130/80 but at times as high as 160/112 i had my last exam done 6 months ago it showed elevated liver enzymes high cholesterol and very

high triglycrides i also have gerd lately i have been getting these sharp shocking pains in the left side of my chest where my heart is i went to the emergency room they did the ekg test the blood test to check the heart for enzymes and took a picture of my heart everything came back normal what can these pains be? does the tests they ran able to detect clogged arteries or heart disease?

[Bob_D]

Yes, the pain might be an indicator of occluded coronary arteries, although you are rather young for that. The EKG can detect certain signs of heart disease but is limited. To check for clogged arteries, an angiogram is the definitive test. If you are continuing to experience the pain, you may want to pursue heart tests other than the EKG (such as an echocardiogram, stress test, angiogram, etc) with a cardiologist.
You have probably been informed that elevated liver enzymes are a serious matter.
Also, 130/80 is usually considered pre-hypertension. You may want to consider some lifestyle changes.

[madjlp]

"Shocking" pain is not "typical" for angina though anything is possible.  Given that you're 26, Drs are going to want to run less invasive tests than an angiogram (and frankly, Drs will almost always run less invasive tests first unless there's diagnostic evidence of ischemia or heart attack that requires quick action - you didn't have those indications on your ER visit - ie - I assume they ran blood work including Troponin, checked your Oxygen Saturation  (that little infrared clip that goes on your finger) and put you on an ekg monitor which would likely have shown ekg changes in the event of a cardiac event/distress) - stress test is the most common and allows for a direct view of the heart's function under stress while also indirectly yielding an idea of blood flow (ie - blood flow is reduced and contractility may be impaired in the setting of coronary artery disease).  I don't think much of regular stress tests in terms of measuring CAD (though they do give cardios a solid view of how your heart is functioning, valves etc) however nuclear stress tests are relatively sensitive for CAD (like 85% sensitive for CAD - but that's only for 70% blockages I believe) and CTA (coronary angiogram) are very sensitive for plaques - supposedly like 97% sensitive depending on the facility.  Essentialy modern medicine does not yet have a quick easy test to accurately look at coronary arteries except for the CT Angiogram and that test is expensive, involves radiation and is still somewhat stingily prescribed.  Frankly, in your case, you probably need to go see a good general practitioner, find out whats going on with your liver, QUIT smoking and try to curtail your binge drinking (alcohol stresses the liver which results in higher cholesterol, trigs etc).  The negative ER visit is a good sign and people on this board can definitely empathize with how difficult chest pains are to deal with (whether diagnosed or not) - after you see your Dr for a follow up come on back and we can try to help you undestand whats going on

ps - you mentioned they took a "picture" of your heart in the ER - I don't know if that means you had an xray, an echocardiogram or a CT scan - but the fact that it came back clear is positive regardless..

[sckeet]

hello everyone thank you very much for the responses i went to my doctor and got the lipid tests done my results hdl 23 ldl 200 trigryclerides 233 also my live enzymes are elevated 135 75t i am not familitar with cholesterol however i understand my levels are high can anyone tell me how high my levels are considered?

[Bob_D]

Depending on the number of risk factors you have, the usual maximum targets for LDL are (from zero to multiple risk factors) 130, 100, and 70.
Anything above 150 for triglycerides is considered out of range.
Anything below 35 for HDL is considered dyslipidemic.
Your combination of high LDL and low HDL is particularly problematic.

[sckeet]

would my cholesterol numbers put me at high risk for heart diesase?

[sckeet]

what is the highest ldl and triglcyrides go up tp?

[sckeet]

i meant to say go up to?

[Bob_D]

The main risk factors for heart disease are usually cited as male gender, age older than 55, and family history of heart disease. Those are the ones you can't control. The ones you can control include weight, blood pressure, cholesterol, smoking, and alcohol use. Your elevated cholesterol would be considered a risk factor  
There's a lot of good detailed information at the web site for the American Heart Association on the specifics of heart disease risk factors.

[NTB]

Hi. If I were you, I'd make sure I'm taking good amounts of antioxidants, especially vitamins C and E. A recent report says that the damage to arteries from heavy drinking is caused by acetaldehyde, which is a breakdown product of alcohol. It's a free radical which can be counteracted with antioxidants. So you can get some protection that way.

Smoking also depletes vit C.

[Bob_D]

I'm going to have to respectfully disagree with poster NTB here. While I wish it were not so, a meta-analysis of clinically significant studies of antioxidants over the past forty years published in JAMA in 2007 indicated that antioxidants are not effective in preventing or mitigating any disease process.

[sckeet]

thank you everyone for your replys i still would like to know if anyone can tell me what is how high ldl can go up to? mine was 200 can it go up to like 1000 or is 200 highest same with triglycerides thanks again

[NTB]

Hi, Bob. Your point is noted - and you made me go and look up what criticisms there were over that meta-analysis. I suppose the main one would be that through the selection of what studies were included (e.g., studies in which no one died were not included), then what the meta-study is really saying is that people who are seriously ill with cancer or advanced heart conditions etc. don't get better (or get any benefit) from taking a vitamin pill.

In fact, there was some evidence that taking a supplement like vit E alone might be harmful. I don't do that anymore, just to be on the safe side.

But, primarily I'd have to reply that taking supplements to counteract a demonstrable deficiency (as from alcohol and smoking) would be altogether a different story anyway. Similarly, saying that alcohol (and smoking, IIRC) produces a large burst of acetaldehyde - and that C & E can quench that free radical - I'd think that specific situation lies outside the bounds of that meta-analysis that you mention.

I can relate my own experience when this fall I had a headache for three weeks straight (which coincided with my sudden onset HTN). The headache was gone within 24 hours of starting magnesium.

But then you can say that antioxidants are not the same as minerals, and you'd be right :)  The body can't make minerals, but it might be able to manufacture some antioxidants. So it can go round and round. I myself do not believe that supplements are miracle workers... except maybe when a person has a big deficiency.

Anyway, I do appreciate the type of back and forth discussion, because that's how we learn. Thanks for your observation. You might be right after all.

[sckeet]

can anyone answer my question avbout how high ldl and triglyceride levels can go up to?

[Bob_D]

I don't know what the theoretical maximum is, but I have read that some people with familial hypercholesterolemia or hypertriglyceridemia have total cholesterol as high as 500 and TG's as high as 2,000.

[sckeet]

ok i went to the emergency room the other night because of chest pains they put me on a ekg machine and said everything looked fine they concluded it was acid reflux when i was discharged i was given a copy of the ekg and told to give it to my primary doctor the paper says "sinus rhythm with 1st degree av block non specific t wave abnormality abnormal ekg" what does all this mean is there something wrong here?

[sckeet]

my cholesterol is 200 triglycerides 233 ldl 136 hdl 24 is this bad?

[NTB]

well, it's not good - especially, I'd think, the low HDL

you can find what are called "guidelines" at the American Heart Assoc for starters

TRIs should be under 150, e.g.