HEART TESTS

[hazyworld]

TWO years ago the cardiologigt did a nuclear stress test on my heart,it showed very mild heart vessel ischemia,he told me nothing to worry about,since then i have also had a echo gram ekgs,blood work,holter moniter..alls beeen on.I wenr to him yesterday because i keep having pains in my shouklders and behind my breasts and tightness in my chest...i also have severe anxiety...i was put on adderall which is a stimulant on april 7th and of course it raises your heart rate...well my dr listened to my heart and he feels its still ok even thought i have been having this pain...so he thinks its muslesskeltal pain and put me on 800 mg ibprohun..sorry for the spellling...My heart rate had dropped down but i upped the adderall a bit and its back like in the low 100s..dr says he is sure im ok....imscared since he didnt do any tests other than listen to my heart he may be wrong....the pain in more on the left side today,yesterday it was the right side,neck shoulder chest..i guess i have to trust himhe is the cardioligist....and he does know how bad my anxiety is..but those tests were 2 years ago something could have changed..how often do u needd tests like the echo and stress done on heart..should i just relax and believee this is just a pain from tension
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[joanincarolina]

I have no idea how my note made it to my recipient 'hazyworld' from 'hazypain'! As long as she reads the thread it'll be ok. Yes, she is similar to me. Thanks, Joan.

[kenkeith]

Joanincarolina, I thought of your condition and thought it to be similar to your symptoms.  Who is hazypain?

[joanincarolina]

If there is any doubt in your mind that what you feel is chest pain,shoulder, jaw involved then go back to the heart doctor.You are correct that it has been two years since tests and you have angina like signs.It is not worth the risk to second guess this and attribute it to anxiety as the pain will also cause you anxiety.The Cardiac Syndrome X, or heart microvessel dysfunction as KenKeith describes is the condition I have and I have been there with doctors saying it's nothing, altho' in my case I was over-tested. Go back. Be insistent until you are satisfied with an answer. Best Wishes, Joan.

[kenkeith]

Usually, angina (chest pain due to heart disorder) can be seen when the blockage is with the larger coronary vessels.  However, there can be angina related to the occlusion of smaller vessels not easily seen.

For some insight: Recent studies have supported the notion that women with Cardiac Syndrome X(angina and "normal" coronary arteries) actually do have coronary artery pathology involving "microvessels" - the small branches of the coronary arteries that are not visualized by cardiac catheterization.

Most angina (chest discomfort due to insufficient blood flow to the heart muscle) is associated with partial blockages in the large coronary arteries. Patients with angina often have heart catheterizations, in which dye is injected into the coronary arteries so that the blockages can be visualized. Once the blockages are located, they are often treated by angioplasty, stenting, or bypass surgery.

In women with Cardiac Syndrome X, despite the fact that they describe symptoms typical of angina and often have ECG changes suggesting coronary artery blockages, are found to have "normal" appearing coronary arteries on catheterization. These women are often told they are normal, and that their symptoms are due to anxiety, so go away and leave the cardiologist alone.

JOURNAL OF AMERICAN COLLEGE OF CARDIOLOGY (JAAC)  "Coronary MVS and resultant myocardial ischemia were not rare in patients with angina caused by epicardial coronary artery spasm. From a therapeutic point of view, calcium channel blockers are extremely effective for epicardial spasm, but they are reportedly of limited efficacy in patients with microvascular angina (9,10). Physicians should be aware of the possibility that coronary MVS may also contribute to chest symptoms in those given a diagnosis of vasospastic angina and carefully assess the presence or absence of coronary microvessel disease for the appropriate management of these patients"