possible heart problem?

[starlight620]

I just recently was in the emergency room with chest pain, shortness of breath, nausea-my troponin level went up to 0.04, i have cardiomegaly, prolonged qt interval, and an extensive family history-both parents had heart attacks, father has a AAA, grandfathers had a stroke and thoracic aneurysm,etc.  The stress test came back ok so do you think i have a potential problem or am i being unduly worried?

[kenkeith]

QUOTE: "i have cardiomegaly, prolonged qt interval, and an extensive family history-both parents had heart attacks.... "  

>>>>>>For some insight: Dilated  hypertrophic cardiomegaly may have a long QTc interval.  It can be inherited or a acquired.  The enlarged heart can cause an abnormaility of the heart's electrical system.  The electrical problem is due to defects in heart muscle cell structures and that is causing an abnormality of the heart's electrical system. The mechanical function of the heart can be entirely normal.  The long QT indicates a longer time is required to complete a heart rate cycle apparently caused by electrical impules find some obstruction to pathways of defective heart tissues with cadiomegaly.  

In the ICU some patients with elevated troponin values and nonspecific ECG changes are considered to have suffered an MI (heart attack) and are treated with anti-ischemic, antiplatelet (prevent blood clots), and anticoagulant therapies, whereas others are considered to have an alternative explanation for the troponin rise and do not receive any of these therapies.

"Cardiac troponin T values above 0.04 μg/l were considered evidence of myocardial necrosis and levels of 0.04 μg/l or less were considered to represent no evidence of myocardial necrosis (dead heart cells.)".  Your troponin level is questionable to whether or not there had been a heart attack.

Anytime there is shortness of breath and/or unexplained chest pain requires a more exact  diagnoses and you should be given an explanation.  I don't want to unnecessarily alarm you, but a stress test wouldn't rule out a heart muscle damage from the symptoms you have given (unless an echo was part of the test).  I had almost the same condtion you describe, and went to ER for shortness of breath, etc. and learned I had had a silent heart attack and the only symptoms I had were from heart failure (didn't feel ill). I was given a chest xray, ekg, blood tests, echocardiogram and the echocardiogram was the test that showed heart muscle damage from a heart attack.

An echo would give the dimensions of your heart chambers and walls, whether there is any heart wall movement disorder (damaged heart cells), and normal flow of blood through the heart. Also, it would serve as a reference basis going forward for any future tests. You should ask and receive all medical reports for your records.

Thanks for the question, and I hope I have provided some insight and a perspective that can help you discuss your health condition in the future,.  If you have any further questions you are welcome to respond.  Take care.

[cindy707]

You have done well in knowing your family history altho try to remember that the only part that would effect you personally and it only actually puts you in a higher risk group doesn't mean that it will happen to you is that if anyone in your family has had a heart attack at age 50 or younger....or clotting issues....i don't blame you for being worried ut if you were given a green light it probably won't get any greener...hoefully you saw a private heart doc and not just one at the E,R. their creed is to treat em and street em and refer us out to specialists...good luck