DVT-Warfarin-Angina

[samkel]

Dear Medical Experts:

Brief background:  I'm 48, 6'-1", 250lbs, body fat around 22 percent (waist minus neck size).  

Health issues:  During March '10, steep ramp up of monthly bicycling mileage from 240 miles to 700 miles left me with sciatic nerve issues the result in my opinion of the piriformis muscle contacting the sciatic nerve. After the second attack, sought treatment at a spinal sports med clinic.  

During this period, traveled to Australia from US Pacific Coast.  Two months after Australia trip and six weeks after epidural injection, began cycling conditioning on stationary bike.  Stretching after a stationary bike exercise session released clot that caught behind my right knee.  Scan of legs showed old clots and new clots in upper right thigh and lower leg.  Begin treatment for DVT: heparin until Warfarin build up in blood with INR 2.5.  

This brings me to now.  I'm still taking Warfarin.  Recently, I've noticed an increase in upper chest discomfort during stationary bike exercises.  The discomfort begins about 10 minutes into a warm up session.  I slow down enough for the discomfort to go subside and keep efforts on the low side to avoid having that pain.   Once into the cycling session, I can increase efforts, but can feel that level upper chest discomfort.   Now and then, just before it's time to take the Warfarin meds, I notice an irregular heart beat, say, every sixth beat is slightly delayed.  Warfarin brochures indicate irregular heart beat and upper chest discomfort as possible side effects.  

Last week at three month checkup, discussed upper chest pain, CT scan conducted that day.  Waiting to be scheduled for stress test.  

Does my situation sound like blocked arteries OR side effects to be expected from Warfarin treatment?  I'm beginning to think the sciatic nerve issues and DVT issues may be unrelated to the recent upper chest discomfort and that I may have blocked arteries.    

Any thoughts?

Thanks,

samkel

[CCFHeartMD11]

The symptoms you are describing could be related to blocked arteries, but could also be related to a pulmonary embolus, or blood clot that went to the lungs. It sounds like your doctor is taking the appropriate steps to evaluate both -- the stress test to look for signs of blockages, the CT scan to look for clot in the lungs. I wouldn't blame the warfarin for the side effects until the other, more important, possible diagnoses have been ruled out.

Another thing -- if you didn't have a workup for the etiology of the blood clots when you were first diagnosed, this might not be an unreasonable thing to do, especially if your current symptoms turn out to be related to blood clots.

[samkel]

A related discussion, DVT-Warfarin-Angina was started.