Clogged Arteries

[lolathechi]

Hi

I was wondering what are the symptons of clogged arteries? Is a stress test used to determine that? If your arteries are begining to clog can this reverse with diet and exercise?

Also they say the vagus nerve is related to a lot of pvcs, if this is so why dont they have a medication that will "relax" your vagus nerve to stop these horrible things??

Thanks so much!

[EchoTech]

Well, the way I would look at it is that you may have, and heavily stress the MAY, have had a heart attack.  If you EF is 60% (normal is 55%) and you feel fine and can do what you want to do, then I would not sweat it.  I was wondering if the gradient you mention is the peak or mean gradient.  If your peak gradient is 18 mmHg, then that is reaaly close to normal.  If you mean gradient is 18 mmHg, then hopefully it will come down some more.  By reducing the graident, you have most likely improved you mortality and morbidity rates, and that is a good thing.  I hope things go well for you.

[upbeat63]

Hello, just wanted to ask a question of you, regarding any earlier post you made about GPs and cardiologists.

Brief history. I had a stress echo done after a 48hr holter showed I was having 24,000PVC/day, about 20% of my heart beats. I asked my family doctor for the echo, because I've had PVCs for 24 years and this was a significant increase. Family dr hadn't recommended anything except toperol. I was concerned about a possible cardiomyopathy

Long story short, she then ordered a stress echo and dopler. But the report was so "lean" that I called the center that did the tests and asked for some information on the measurement of the LV and EF. The tech asked why I wanted to know all this when everything is "normal" (except mild aortic regurge). I said I wanted a  baseline and thought EF was always given with a stress echo. She said no its not and that to review it again and calculate figures more would cost more. I already paid $700 out of pocket for this in addition to $650 for the holter and $400 for my family dr appnts.

So finally, my question. What is standard info to provide in the stress echo with dopler. There was only one sentence I didn't understand it was something about a rate pressure. I have the numbers, but didn't know what if anything it means, and it was buried between regular, normal and other descriptions of heart wall motion-- meaning --tell her to go get a life--...I haven't seen a cardiologist. The report went to my family doctor and they faxed it to me. Is there some bias there? Would I have gotten more info with the cardio? No one seems concerned and I certainly don't want to spend more money to "chase butterflies" when there's nothing there. Thanks for your opinion.

[MinnieM]

Thanks Echotech for responding.

Echo's were done in late 2004 and one in 3/2005.  These due to a heart cath and stent in summer of 2004.  ALL Normal Echo's. EF 60%.

Spring, 2005, A-Fib attack (first one ever). ER conversion to NSR. Normal heart Enzymes in ER.  4 hrs later elevated Troponin (4.3) levels and CK-MB. CK-MB quickly came down.  Troponin took 4 days to hit the normal. Heart Cath showed small blockage in LAD that was not stented in summer 2004 so they stented this even though Cath doctor did not think it was the cause of the A-Fib. Cath doctor called this a "heart Event".  He said no MI but Echo doctor disagrees and is going by the Troponin spill. Cath doctor still disagrees with Echo doctor.  "hatfield and mcCoys"  LOL  

Then post-"heart event" Echo now shows Dynamic LVOT Obstruction due to SAM.  This concerns Echo cardio doc. From a 50 gradient in June, July was 40, August was 30 and in August again, 18 and the other day still an 18mmHG gradient. Echo cardio doc  wants this back to normal ASAP.  Replaced TopolXL with Coreg.  On Plavix also.  A-fib, I heard can cause a spill of Troponin which means some muscle involvement.  Will have another Echo in 10 days to see if Coreg is working.  My feelings is this Echo may never get normal. )-:  I am praying very hard.

[cryingheart]

The symptoms of clotted arteries are the symptoms of a HEART ATTACK OR STROKE. If you are having those symptoms you need to be seen. A stress test is usually not done if doctors are thinking you may already have a blockage. A stress test if positive can indicate narrowing of the arteries as in plaque build up and harding of the arteries.

[EchoTech]

Well, I'm not sure what event you might be talking about.  I'm going to guess you had a-fib and then discovered the SAM.  I'll also guess that they put you on  a beta blocker to help with the SAM.  It sounds like that they are watching to see if it is reducing the gradient which it seem  like it is.  With the same tech doing them month after month, the likelyhood of her seeing them at first and then missing them now are quite remote.  If the pictures were extremely difficult to see, perhaps, but since the tech got the gradients the first three times along with the other two lower ones, that would be stretching it very very far.  In all likelyhood, they are getting the same quality pictures and measuring in the same place they were before and that they are truly measuring the gradient correctly.  They can use a cath to get the gradient, but they'd likely prefer to do the serial echos.  As far as a TEE, the short answer is that a TEE would not be the test of choice for measuring what you need.  There is a reason for it, but it would really be bogging you down in details.

[EchoTech]

I'm not all that great with arrhythmias so I'll give a somewhat educated guess.  Some people feel the skip beats more so than others.  There is  no rhyme  or reason as to who can feel it and who cannot.  I don't have a really good reason for it.  The best analogy I've come up with people and pain tolerance.  There are some cry after a needle stick, while others are like no big deal.  These same people that can't take a needle stick, you could crack a 2x4 board across their back and it won't even stun them, while the other folks crumble like a pile of bricks when you hit them.  Everyone is different in their tolerance, and sometimes it changes over time.  sometimes stress can aggravate the arrythmia, but then you already knew that.