chest pressure and poor activity tolerance

[bsn]

Over the past 6 months I have been having increasing problems with frequent chest pressure and SOA, particularly with exertion. I have a history of endothelial dysfunction and hyperlipidemia. When this cycle started 6 mo. ago I was diagnosed with HTN (170/110). Currently, I take Lisinopril 20 mg, Verapamil XR 120 mg, ASA 324 mg and Crestor 10 mg.
No pulmonary problems found.
I live on the third floor of my building and now I find it very difficult to climb the stairs. I'm SOA and dizzy by the time I get to my apt. with a HR from 120-160 and it is almost impossible for me to carry anything up the stairs. I also am noticing more fatigue every day. I used to sleep 5 hours a day and was full of energy, now I sleep 8-9 hours every night and I'm completely wrung out by 5:00 in the evening. I am only 41 yrs old and feel like I'm 90.
There is a very strong family history of early heart disease and both of my parents died by age 60 of SCD.
I have had no recent cardiac tests done (it's been 3 yrs since I saw a cardiologist)as due to a lapse in my health insurance my PCP and I want to delay alot of tests until my coverage is in place again. I did agree with this approach 6 mo. ago but now I'm becoming more concerned as the s/s are continuing and/or worsening. I also do not want to be someone who runs to Dr. unnecessarily.

Does it sound like my increasing concern is warranted and would you suggest I seek further tests now? It will be 6 mo. before my insurance will cover any heart related issues.

[CCF-M.D.-MJM]

Hello,

I am sorry to hear about your insurance problem.  This can be a challanging issue and occurs more commonly than you probably realize.

Does it sound like my increasing concern is warranted and would you suggest I seek further tests now?

It sounds like you are having symptoms that could be cardiac related, although a component of your symptoms does not.  With some risk factors (HTN, increased cholesterol, family history), you should probably see someone sooner than later.  It situations like this it is our job to prove that it isn't your heart causing the symtpoms and this usually takes a few tests.  Early heart problems are sometimes reversible and waiting can lead to damage that is not reversible.  You can work with your doctor to try to order the most appropriate and least expensive modalities available.

Good luck and thanks for posting.

[mend]

Can you afford to pay for a visit to a cardiologist?  The tests are expensive, but talk a  cardiologist about your insurance problem.  I have CAD, and your symptoms sound like heart problems to me.   Getting symptoms with exertion is one of the signs.  Also, they are increasing, and you have fatigue.  I  don't want to scare you, but you really need to see someone.  I would not bother with an internist, because they will send you to a cardiologist.  You are young, but I had a friend drop dead at 42.  Don't take a chance.  If I can help you, I would be glad to give you my e-mail.