I am 70 yr old Surgeon, 5'7", 145 lbs, active, controlled diabetes a1c 5.7, had 5 artery bypass in 1995 veins grafts + using left internal mammary artery. I changed my life, exercise daily (at least 20 minutes aerobic daily) eat right and regular Insulin regimen. I consider myself to be healthier than normal and thought I had an excellent heart with a resting pulse of 46 or so. Recently I have noticed some PVCs/or PACs specially when my heart slows down from 130 to 60-70 after exercise and then it stabilizes after a while. I have no arrhythmia or symptoms when my heart rate is up even upto 155 (more than my maximal on Bruce 4th stage). I had a resting Echo with ejection fraction 45%, reasonale LV and very little motion disturbance. Stress EKG to maximal stress (155 BPM my age does not show any ischemic changes on EKG. Resting Tec scan is more or less OK, but shows very significany loss of perfusion after exercise to left side of heart so much so that I got scared. They did not do a stress Echo. No one has paid much attention to my main concern of PVCs. I believe I had some silent damage over a period of years but with my life style I have compensated all and may have a stiff LV. They want me to go thru Angios etc and they may put a stent (where? LIMA?). I am very reluctant for anything like that. I want to stick to my baby aspirin, Diovan 80/day, lipitor 20/day and vitamins and Calcium. Am I being foolish in making this decision and refusing to be cathed? Thanks
Angios? is that the catheter examination of the heart to check for blockage? If so, I've had a couple and one was also done to check my mitral valve function/leakage, best I can remember. I had the first examination when I failed my Nuclear Stress test, they found no blockage in my case, thus no stent needed. The second time was preliminary for heart surgery, may as well do any bypass if needed while the chest is open. None needed.
Not sure this is of any help to you other than to say I had no problems with the procedures or with recovery, really a "non-event" in my experience. I guess that's to your question. I say, why not if there is any chance there is a problem that can be found by that examination?
Overall you appear to be in great physical shape, the EF could be higher, mine is about 60% following mitral valve repair. I will be 70 in June. I suffer from AFib.
Why not have the cath just to be sure!! I did it about 7 yrs ago and it was really cool. I actually stayed awake and watched it. Luckily I didn't have a blockage but the doctor thought i did because of a positive stress test the day before. You mentioned you were concerned about some silent damage over the years, do you ever have angina? I, too, experience PVCs after my hour long workout. During my workout, it is fine....no PVCs or PACs...but about 30min after, it starts and doesn't let up for several hours sometimes. But it is tolerable now....since my Dr. adjusted my meds and added some. I take Lopressor, Norvasc and Cozaar, Zaroxolyn and one for thyroid and menopause. I hope this hopes...let us know what you decide. Best of luck and God bless.
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