Chest Pain

[karing1]

Hi,
I am a 32 y/o AA female who has had chest pain off an on for years.  Recently I developed chest pain with SOB.  My PCP sent me to a cardiologist.  My cardiologist did a echo and it showed tricuspid and mitral valave regurgatation.  He then wanted me to have a cardiolyte stress test done and it showed a reversible anterior wall defect.  The curretly have me on a beta blocker and I am scheduled for a cardiac cath.  I am very worried I am an active young , married woman with 2 little girls.  Could this mean something very serios?

[Fionajnz]

Its a good thing to follow up with the cath and get all the information you can while that is done.  Aside from pulmonary hypertension which is definitely something to try to rule out while the cath is done, which means asking them to do a right sided cath in addition to the left sided cath, ensure though that they do a thorough work up of your iron levels and stores BEFORE the cath.  Not that it will make a difference to the cath itself and any results, but it could tell you if anemia is contributing to the SOB.  Severe anemia can cause SOB as can things like asthma, so a pulmonary work up is also worth thinking about.

I have a hx of cardiomyopathy, pulomonary issues incl an embolism and severe anemia, it makes it very hard to figure out what is happening when I get SOB....after going through cardiac testing again, in the last mth or so, which showed some minor drops in function, the hematologist found that I was severely anemic again, so am headed for another course of IV iron.    I also have 3 young kids (1, 4 and 7) so I totally understand the level of concern you have.  

Wishing you all the best and a great outcome.

Fiona  

[Cleveland Clinic]

The chest pain and the shortness of breath is what worries me the most.  It is statistically unlikley that you have coronary artery disease based on your age, but I have seen once or twice before in someone as young as you.  The anterior wall defect may be real and if that were the case you might need a procedure or an operation to fix it.  I am assuming that the valve regurgitation is not severe, at which point, in case the defect is real, this could be fixed with a simple procedure.  I am suspicious, though, that the defect may be a false positive, and that your catheterization will be normal.  Still, however, the shortness of breath must be further investigated.  On the echo, what was the RVSP?  It is usually a numer reported in mmHg.  Also, as a suggestion, if the left heart catheterization does not show any CAD or any other problems, then you should consider having a right side catheterization right after to measure the pressures in the lungs and on the right side of heart to rule out pulmonary HTN.  How far did you go on the stress test and did you develop shortness of breath at that point as well?