need for cardiac catharization

[jocare]

My Mom is 82.  She is a very young 82.  Everyone thinks she is in her late sixties or early seventies, including her doctors.  In 2004 she had a stint inserted.  She has never had a heart attack, however on her stress test at that time they felt she had blockage.  Hence the chatarization and the stint.  On June 21, 2009 she expericenced left arm pain, a heaviness, she called it.  When it persisted for several hours, I took her to emergency.  They took blood work, EKG, chest X-ray, and a stress test the following morning.  All of which showed nothing, all tests where inconclusive.  They stated everything checked out fine.  The hospital scheulded a catharization for August 5th.  They discharged her.  On August 1, 2009 I again had to take her to the emergency.  Again same condition however the pain went into her chest.  The hospital again took blood and did an EKG.  The head heart doctor of his group stated that no way would he perform a catharization.  He felt strongly that she was experencing acid reflux and perscribed prilosac.  Mom has never had any symtoms for acid reflux.  She has only taken this for two days.  That evening after the first pill,she still felt the same pain and had to take the nitro pill.  Last night she had a pain in the arm again.  But said it was different because it was on the outer side of the arm below the shoulder insteadt of under her arm pit.  So she did not report it to the nurses.  This morning her doctor that inserted the stint made his visit and said the only why to be sure that it is not heart related, is have the proceedure.  I will be talking to him about 4:00 - 5:00 today.  If anyone could assist me on questions to ask or advice as to wether she should have the proceedure or not, I would extremly appreciate it.  Thank you very much.

[kenkeith]

Thrombosis of the UPPER extremities is rare...lower extremities more vulnerable due to gravity, siting, etc .When suffering from deep vein blood clots of the upper extremities, the patient will first notice a large degree of swelling with some pain and loss of range of motion in the arm affected. Untreated it will lead to paralysis for a lifetime.

[ed34]

Has she been given anti clotting agents? Pains in the limbs can be caused by a thrombus forming. Clot busting drugs can be given for this.

[kenkeith]

Usually with relief from a nitro pill indicates coronary artery stenosis causing angina (chest pains, etc) but cannot rule out a esopheogeal disorder.  There can be a condition that causes angina that is heart related and no coronary lesions noted.  The condition is Prinzmetal's and should be suspected by a cardiologist when the pain occurs at rest and/or in clusters, and in the absence of a positive treadmill stress test, as Prinzmetal's is exercise tolerant and can generally only be diagnosed after other forms of cardiac disease have been ruled out.