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11389921 tn?1417798614

Heart Issues or Not?

I have been seeing a Cardiologist due to an abnormal stress test. The test showed atrial flutter with 2:1 heart block. I am almost 37, and I have had abnormal EKGs since at least about 1999/2000 that I know of because of bradycardia. My heart rate is usually in the high 40s to low 50s. I am not an athlete :). I had an echo that was normal with 60-65% EF and only trace tricuspid and pulmonic valvular regurgitation. The Cardiologist did a nuclear stress test that showed EF at 60% but abnormal EKG with NSR, anteroseptal MI. There was a "moderate sized basal and mid segment anterior wall perfusion abnormality of moderate intensity that worsens during stress, suggestive of reversible ischemia. Appeared to be old MI with mild peri-infarct ischemia". I also did a Holter which showed some supraventricular beats, but not much else. I had a left heart cath with EF 65% and only a mild increase in end-diastolic pressures. My arteries were not blocked. Meanwhile, for at least the last couple of years, my ankles and legs have been severely swollen and now will no longer respond to diuretics. I responded much better to fluid restriction, but I am still swollen. I have bouts daily with palpitations, chest pain, difficulty breathing when lying flat and sometimes while just sitting, and a weird dizziness that makes me feel as though I am going to pass out (I have never actually passed out). I have gained about 20 lbs in just a few months, mostly because of water retention. Other than nitroglycerin, I am not on meds. I was taking Diltiazem, but my cardiologist took me off after the heart cath, stating that nothing is wrong with my heart and it's just my Gerd. Because of the palpitations, chest pain, edema, and difficulty breathing while lying flat, I think I want to get a second opinion just in case. My maternal grandmother had CHF, so I am always a little concerned about my heart. My EF is good, but I know that a good EF doesn't always mean you're in the clear. My cholesterol is at 216, so I am making diet changes right now. My blood pressure is usually very good (example 116/78), but I do have occasional rises. Has anyone ever dealt with anything similar with a good EF? What was the issue? This whole thing is starting to baffle me, because everything seems to be good except the stress tests and how my body feels.
5 Responses
976897 tn?1379167602
so it sounds like you had a heart attack at some time in the past and now the arteries are clear? that's absolutely possible.
11389921 tn?1417798614
I figured that since everything looked good on my heart cath, then maybe that wasn't really the case. I would thing they'd be able to see an old MI during the heart cath. They did only do the cath on the left side, so who knows? I just wonder why my doctor would say it's nothing.
11389921 tn?1417798614
Sorry...I mean I would think...
976897 tn?1379167602
perhaps make an appointment to clear up this confusion.
Avatar universal
It sounds like there is something wrong. If you believe that is the case then definitely get a second, third or even fourth opinion. Sadly, it took me four cardiologists to finally get results, and that was after having an MI that the doctor initially tried telling my family was just gi reflux (very thankful for troponin tests). They made too many assumptions about my age and physical condition, and this almost cost me my life.

Doctors are human, they make mistakes just like the rest of us. And with today's "meat market" mentality from management, they rarely have the proper amount of time to do thorough analysis.
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