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Symptoms of Heart failure

My husband is 75. Had calcium score of 750 and agatston score of 1032...2 years ago. He has had no symptoms of heart disease. He rides his bike 1-1/2 miles twice a day without getting out of breath. However he gets out of breath when he has to carry my vacumm up & down the stairs for me. He never used to be out of breath. Could this be a symptom of his heart starting to show signs of the disease? How can that be if he can ride his bike without the tiredness???


This discussion is related to Echo/out of breath.
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367994 tn?1304953593
Yes, your husband's symptoms can be related to coronary vessel blockage.  I don't know the  answer why one activity causes symptoms and another does not...may be the one exertion without symptoms is due to the body has and does compensate adequately for the one activity and not the other.

Your husband should get a stress test.  That would be a test to view blood/oxygen flow through the vessels at rest and then with exertion.  Also, if a person has angina (chest pain with exertion) nitrate medication will open coronary vessels for a better flow of blood and there should not be any pain.  I take a nitrate prior to working out in the gym for the past 5 years....I have some blockage and medication serves me well, and there isn't any noticable progression with medication to regulate blood pressure, heart rate, and lower lipids.
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Avatar universal
He had a stress test 2 years ago...but since he thinks he has no symptoms, he does not want another one until he gets the chest pains or gets dizzy. His test 2 years ago came out fine with no problems. That is why I worry. He is waiting for something to happen before he sees a heart Dr.. he has no chest pain either...so he says. The heavy breathing I recently noticed. But not after riding his bike...maybe because he has really strong legs???. You have some blockage...like my husbands EBT calcium screening scores??? His seem quite bad.
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367994 tn?1304953593
Often older individuals and individuals with diabetes don't experience any symptoms until there is heart failure (silent heart attack is the medical term).  When heart cells do not get sufficient blood/oxygen there can be negrosis of heart tissue and that will impair the heart's pumping phase and heart failure.

I have totally blockage of the LAD, stented RCA and 72% blockage of the circumflex and calcium scoring (Agatston Methode): RCA, 872.2, Left Main 79.0, LAD 215.3 and total is 1207.1.  Calcium scoring is a measurement of the soft plaque within the inner linings of the vessel.  It is this soft plaque that ruptures into the lumen causing a clot that can cause a heart attack.  A high score indicates an increase of probability for a heart attack within a year.  

The buildup of plaque within the lumen causes blockage and inhibits a good flow of blood to the heart tissues.  This condition has less probability of a heart attack from soft plaque  but can cause heart failure.

Strong legs require less blood/oxygen per MET (measurement of oxygen required for a unit of energy) and that may explain no symptoms for the routine activity and symptoms for another less experienced activity.
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Avatar universal
Wow...a heart attack within a year with a high  plaque calcium score???   It has been over 2 years since my husband had that test. Maybe the test was wrong. His GP Dr. doesn't seem concerned...unless my husband is not telling me the whole story. I am glad you seem to be doing good...with nitrate medicine...guess that will happen to my husband sometime when he has some symptoms..  How does one know if it is soft plaque or hard???    My husband says his bike riding is helping his heart grow stronger...hope that is true. I worry it may be bad for him to exercise too much. But what you said makes sense...so maybe it is all OK. I wish he was as concerned as I am for his health!   Are you worried about yourself & a heart attack? Are you under a heart Dr care??? pattisd1
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367994 tn?1304953593
Hard plaque usually exists within the lumen, and there is a risk that some portion could break away and cause a heart attack.  Soft plaque breaks through and ruptures the endothelium lining into lumen causing a clot and a heart attack.  A ct scan views the entire anatomy of the coronary arteries...a cath views the lumen for blockage, but there can ultra sound with a cath angiogram to obtain an image of soft plaque within the walls of the vessel.  There can be vessel stenosis (lumen remodeling, narrowing) with soft plaque as well.

Score calculation:
0. Negative test - i.e. significant obstructive luminal disease highly unlikely
>100. High calcium score - i.e. above average risk of a cardiac event in the next five years
>1000. Very high calcium score - i.e. high risk of a cardiac event.  If I remember correctly, there is a 10% probability for each year.

My lipid profile is very good (doctor said it can't be any better!)  Blood pressure and heart rate is very good.  And I understand when HDL is higher than the LDL lipid profile there can be some reversal of CAD, and my medication has elevated my HDL higher than a reduced LDL.  Doing what I can to reduce the risks fo0r a heart event  provides some relief from any worry about the future...
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Avatar universal
I think my husband should be seeing a heart Dr. instead of his GP Dr.  You seem way more involved in your condition and aware of the tests and what they mean. My husband does not seem concerned since he has no symptoms. Maybe in the future he will be more concerned about the possible problems he is facing. I just worry that it may be after a heart attack instead of before one. I never heard that about the HDL being higher than the LDL would reverse CAD.  I shall let my husband know and maybe he will be a bit more interested in his own health issues if he can actually do more to make it better. Thank you for all the info & hope you stay healthy!!!  P.
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