Heart Issues H-FABP

[marcusm]

Hi,
Currently freaking out... stuck in Japan had very mild chest discomfort, shortness of breath, dizzy for about a week. Went to see the doc today, all normal incl. EKG apart from LDL and H-FABP.
Since researched and found that my LDL is average for British but high in Japan (go figure) but what's really freaking me out is the H-FABP, apparently a good predictor of death!
They didn't do a quantative test only pos or neg, so I know quantity is important but I am still freaked out. Doctor is recommending go straight to a angiogram.
Could do with some advice as stuck in a foreign country with limited communication. First doctor seemed to get off on the drama the second (when I went to the wrong hospital later) didn't seem so worried and said wait til tomorrow.
Thanks

[marcusm]

Thanks very much for your reply.

The initial H-FABP test freaked me out but then I've been to a second hospital who don't use it and instead did a C-Reactive and Troponin which were negative. Not to say the test may not be useful but it wasn't a quantative test which is more useful, from what I understand just a positive indication

I've also had a stress test and cardiac echo which were also negative. My blood pressure was more accurately checked and was 131/92. The symptoms have also now gone.

The doctor recommended we monitor the situation and watch my diet and do exercise before re-evaluating in 3 months if symptoms return then decide to do a standard angio or CT angio.

Thanks again for your input, it's most helpful when far away from "known" medical care.

[Jonathan D. Rich, MD]

Hello and welcome to the forum.

In the US, we do not use the H-FABP test.  However, in Japan they use it as a marker for evidence of having had a possible heart attack.  It will be difficult for me to fully advise you given the limited information at my disposal and your current situation in Japan.

However, given the symptoms you experienced, coupled with the elevated H-FABP, a coronary angiogram does not sound unreasonable.  It is a relatively safe test and if you indeed do have a big blockage in one of your arteries, they can fix it right there on the spot with a stent.  Dont know what your travel situation is but you certainly do not want to be stuck on an international flight having a heart attack!

Of course, make sure you feel comfortable with your doctor and that you are in a reputable institution.  You may want to ask the cardiologist whether a "noninvasive" assessment of ischemia would be reasonable first to determine the need for angiography.  However, again, based on the information your described (chest pain and SOB with an elevated H-FABP), this certainly can not be ignored.

Wishing you all the best.

Dr. Rich