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Nuclear Stress + Angiogram + Asymptomatic


I apologize for the length of this post.

A summary of my tests: I went in for a physical and my EKG was abnormal. I then had an echo done and it was discovered that I had mitral valve prolapse, but normal blood flow. A stress test was ordered (abnormal) and then a nuclear stress was ordered (also abnormal) and there was evidence of a "mild to moderate" blockage. My doctor recommended that I have an angiogram done.

Here's what I'm struggling with.

I'm 39 years old and I have always been extremely active---high level soccer (not recreational) up until about 2 years ago and now I'm a competitive grappler--if you could see what I do to train, you would think I was crazy--I have no problem doing an hour plus of aerobic and anaerobic exercise (with short breaks of course). My resting hear rate is about 60, and the stress tests were no issue, and I had my heart rate up to 180 with relative ease. I have never had any symptoms, no chest pain, tightness, etc. EVER IN MY LIFE. My cholesterol has always been good (or at least not elevated) and I've really had no serious health problems ever. My father had a heart attack at about 70, but he bounced back and I feel he may outlive me right now. All of my closest relatives have lived long, relatively healthy lives (e.g. no one died of a heart attack at 50).

My doctor is obviously recommending an angiogram to rule out/in a blockage, but I just cannot understand how this is possible. I'm terrified of the angiogram and its risks, and the possibility of a stent just doesn't compute (my father was 70 when he got his stent, how am I possibly getting one at 39?!)

Part of me wants it to be a blockage so that I will finally have a definitive diagnosis. If it's not a blockage, then what could this be? I asked my doctor and he said if that's the case, the "mystery continues".

I don't know what I'm looking for here. Advice, words of wisdom, encouragement. Anything.

Thanks for reading.
5 Responses
63984 tn?1385437939
I highly recommend you have an angiogram.  Believe me, the risks of the procedure are minimal, to say the least.  You will be given anti-anxiety meds before the procedure and will be largely out of it during the procedure.  The difficult part is keeping your leg or arm still afterwards, they use arteries in either limb to gain access.

An angiogram will either rule in or out a problem.  If there is no problem, you will have a baseline to compare if you have problems down the road.  If you have a problem now it will be identified.

I've had at least a dozen angiograms without an incident, you will be fine.  Don't worry about family history at this point, just clarify the problem and precede from there.  Given your workout regime, often time people take supplements, etc.  I'd stop those supplements, I've been there and done that.  

Keep us informed.
Avatar universal
Angiograms are low risk.   Stents are another matter in my opinion and should only be used in certain circumstances.   Life style changes, for patients who adhere, can do more than stenting to deal with some forms of blockage as you entire body is affected as opposed to just the stented location, but that is likely to be controversial here... Look up the small studies by Drs Ornish and Esselstyn on how lifestyle changes can slow down or cause mild regression of heart disease associated with arterial blockage.  They are on YouTube as well.

As for heart disfunction, there are many problems which do not have anything to do with arterial blockage so you need to be perfectly clear about what your condition is, and an angiogram can help with this.

As someone into fitness I think this video by a cardiologist  (Dr O'Keefe)who is a life long fitness advocate will be relevant to you.   Research has caused him to rethink how much exercise makes sense in the context of heart health, so now he is an advocate of moderation..

Avatar universal
Thank you for your words of wisdom and advice.
Avatar universal
Thank you too. That video was eye opening.
Avatar universal
I had the angiogram done the other day and it was exactly as you described. The end result was that there were no blockages and that the nuclear stress test was a false positive. To say that I am relieved is an understatement.

Thank you again.
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