Positive streets test

[JasonRoberts777]

Hi,

I have some questions about heart disease and what to do. Currently changing cardiologist and would like to be more informed about my own case..

Everything started about 5 months ago with sharp stabbing pains on my chest, it feels like needles in the lower left side that last from a fraction of a second to a few seconds and vary in intensity and sometimes occur on the right side of chest.. I can easily identify the location of the pain with finger and tend to press it as to make it go away but since it last only a few seconds it seems  it does.They happen at random times, mostly at rest. They don stop me from doing anything and is the sensation that is bothering more than the pain. I can run Jim, do get tied since I'm not in good shape, but never felt the pain inside like is the heart, mostly feels like it is outside of the rib cage

I'm 33 years old,5'10 240lbs no so active man.  Cholesterol, sugar is normal, High blood pressure is present..

Took a thallium stress nuclear test and came out positive (dr. Was shocked). Doctor didn't give me much reason, nor he go into details on what could be the cause and action. Since I have been having issues with the cardiologist as he is very hard to get, cancel appointments and does not dedicate any time to explain or follow up on his own proposed test. I am currently changing to a new one, but just wanted to get more info and see where I stand.

The stress test was positive and the following is what was found.

"Findings:

Abnormal a small area of diminished perfusion in the anterior wall during stress images noted. There was redistribution in the anterior wall during delayed images.

Impression: a small area of anterior wall ischemia identified
"
I was also send to the stomach doctor and gave me some medication, which "seems" to minimize the pain but after a month I'm  still feel it, also was given antiflamatory pills for muscles as doctor thinks it could be muscle related, but my biggest issue is the positive stress test.

Any ideas on what could be? I heard the stress test isn't as accurate as it seems, I am a large guy though and dr. Did say when there is. Large guy the test may give a false positive..

Thank you for your ideas and advice

[JasonRoberts777]

I had blood test done, EKGs and nothing was never abnormal. Except I do have high blood pressure but the strees test is the one that came positive. I'm starting some new pills (anti-flamatory) for my chest may be that will help since doctor believes it could be muscle related specially that the pain is comes so fast and last just seconds. Not to mention it seems to be outside of the ribcage. I'm having my new cardiologist appointment next week and hope he can better explain. What is going on and what comes next. I certainly feel fine except is very hard to ignore chest pain now that you have so much information on heart disease.

[ed34]

There are really only two other forms of tests available. One is to peek inside your arteries with a ct-angio or to look and see if the cardiac muscle is affected in any way with stress, perhaps using a stress echo scan. If you achieved 96% of your max with no pains, then I would perhaps rule out artery disease. Have they done the obvious? run a blood test to see if you have any infections which could be attacking your cardiac muscle.

[JasonRoberts777]

Ed,

Thank you for sharing your information.  I did do a stress test in a treadmill and lasted 8 minutes on it and achieve 96% success based on my age..now I never had any pains during the test which is even stranger. I can see how the pain is unsettling since it always makes you think that is your heart, but as you mentioned the thallium stress test as far as I have been able to read has a 20% failure rate. Even the dr. Told me that, while my doctor still thinks is the chest muscles, I am waiting for my cardiologist to see me so we can further test what it can be.

Hope you are well and getting stronger every day.

[ed34]

Hi, I can give you some insight into the thallium stress test from my own experience, and from what I have been told by various Cardiologists here in the UK. In 2007 I had a heart attack followed by emergency stenting. When they were inside my coronary arteries looking around, they were shocked at the state of them and the Cardiologist actually said "I'm shocked that you have survived so long". He found the blockage causing the heart attack and stented it. However, it was obvious from this procedure that my Left artery was blocked from the top. My right artery was blocked halfway down. My circumflex artery was the one stented. The circumflex was feeding the left artery, through tiny vessels which had opened up to form natural bypasses, but due to this becoming blocked, those feeds had virtually all closed up and this is why I was in so much pain. My Cardiologist then said "you undoubtably will have some dead heart muscle from this, so we need to establish how much, and its location". I was booked for a thallium test. I went to see my cardiologist after the thallium scan, thinking I was going to be told half my heart was dead or something, but I was shocked, as was the cardiologist, to learn none was dead. The cardiologist said that the thallium revealed excellent blood supply to all areas of the heart, and yet I was still suffering bad angina on any exertion. He explained this by saying "thallium tests are good for backup, for detecting dead muscle, but apart from that I have never been satisfied with anything they reveal". My heart showed no dead tissue, but the scan was basically labelled as scrap for the rest of the information because it didn't reveal what my arteries were really like. I do think however that your symptoms are quite strange for being cardiac related. Believe me, when having heart attack or angina, pressing any part of your chest will not relieve the pain. The heart muscle is generating the pain because it is basically suffocating, short of oxygen, and pressing your chest anywhere will not increase the oxygen levels in your cardiac tissue. If exertion causes your discomfort then it could be stable angina, but if it comes out of the blue, even when seated, it could be unstable angina or chest muscle. I think a treadmill stress test would be far more valuable, and in the UK it is the first test performed, along with an ECG.