more tests

[ed34]

My GP has written to my Cardiologist stating my shortness of breath after the recent 5 stents in my LAD. I also get
quite strong throat angina/mild chest pains if I walk upstairs. I can lift very heavy objects with no problem and walk on a flat surface with no problem. I can now also breathe cold air with no symptoms. Just one flight of stairs however kills me. On Wednesday I am due an echocardiogram (again) and I see my consultant on thursday.

Any input from anyone as to what can cause such shortness of breath caused by one flight of stairs? and yet I managed to carry a huge fridge freezer through the house yesterday without any symptoms. It also seems odd that I can walk on a flat surface with no problems but as soon as there is an incline (no matter how slight) BANG, in come the symptoms.

I am back on beta blockers which tend to mask the true severity of the situation, I know it feels much worse without this medication.

My guess is that the right Coronary artery blockages are causing problems. Everyone has concentrated on the left side but I am guessing this accounted for maybe 25-50% of the problems.

[Flycaster305]

Thank you both very much.  
As it has been explained to me, when one has an MI there are 'stunned' cells surrounding the area of dead heart cells, and if one is fortunate, these stunned cells can be revived with good drugs, just as Coreg, which has a wonderful success record.  That's one of the reasons, I'm told, that the EF can be increased.  However, recovery includes other factors, the main one being daily exercise.  My Cardiologist insisted I do aerobic exercise daily as possible and also mix in strength exercise a couple times a week but at my age lifting lighter weights with multiple repetitions, which is in a way, aerobic exercise.  

I was having stents inserted because of angina every three to six months for quite a while, and with the heart damage, enlarged heart, etc., I find 'improvement' simply an end to the aggressive CAD.

Cheers.

[ed34]

great news on your improvement. If you have a fair amount of unreversable damage, do they know why things are improving? I always see it with the analogy that a pump has lost a blade on its impeller. This pump will never be more efficient again because the impeller blade cannot be replaced. When they say unreversible tissue damage, how does the heart improve? Does the remaining tissue strengthen to compensate or something?

Have a snort or two for me :) mines a double whiskey

[erijon]

Congrats my friend! Glad to hear things went well Flycaster..............

[Flycaster305]

I have a similar problem, I can walk briskly on a straight plane very well, but hills make me struggle, and stairs are a bigger struggle.  I haven't had cabgx but had a couple of heart attacks, multiple stents, a pacemaker and a spontaneous dissection of the RCA, as it was called, but I think it really was a little leak caused from a harmonic effect of being between two stents.  I've also had two pluresy attacks.

Pluresy hurts!  You are breathless when taking even a small breath, sort of feels like broken ribs.  It is not even close to angina pain, or at least what I feel - angina for me is a gripping pain, lots of imagined pressure, pluresy pain is exceedingly sharp, sort of like an internal sunburn feel.  The lung hits the infected plural lining and the reaction feels like someone slaps a sunburn.  You would feel pluresy pain at sleep as well as when moving about, but you would need pain medication.  

I'm much older than you, I think, and I have a fair amount of unreversable heart damage, and that is why elevations and stairs make me struggle.  However, the drug Ranexa really helped me.  As I understand it, Ranexa maximizes the amount of oxygen the heart tissue can absorb.

Tonight I'm celebrating.  I had my regular three month meeting with my Cardiologist, and he reviewed my echo, my yearly stress test, my blood tests, and my cholesterol is perfect for a patient with CAD, my EF has risen to 44%, and he told me to continue what I'm doing regarding exercise and diet.  We are popping  a cork or two.    

[ed34]

In the last two years I've had 2 nuclear perfusion scans which reveal a good amount of blood reaching all tissue areas. However, as I've indicated in many posts, this did not reflect my angiogram which showed my LAD as severely diseased. I wonder though, if I had MVD would this have been evident on the nuclear scan? I'm not sure how easy it is to spot.
With regards to pluresy, I had a chest x-ray less than a month ago, and it was very clear. Several Doctors over the last month have used a stethascope on me to hear my breathing and have stated how clear it sounds. I believe pluresy gives a kind of grinding sound.
This issue is really bugging me and I'm not sure if anyone will ever find the cause. I have been thinking very hard about my symptoms and I remember my low sats seemed to start after my cabgx3. I was asked to cough lots of times to try and raise the oxygen level. I think it's since that time that my breathing has suffered. I can't think of anything involved in a cabg that can affect my breathing. A good way to explain it is I feel as though my lungs are smaller than they were before surgery. When I take a deep breath, it doesn't feel as though as much air goes into them before they are full. I remember wondering if my lungs hadn't inflated properly after surgery but x-rays have shown they are. Maybe I'm barking up the wrong tree, maybe it is heart related but I can't help but keep thinking about my lungs.
I will read up on MVD and see if I have any more of the associated symptoms.

Please keep your comments coming, any train of thought is always welcome.

[joanincarolina]

I sent you a separate note.I have cardiac microvascular dysfunction. Your stented LAD may not be of help to your cardiac microvessels that feed from and to the LAD-a major coronary artery. My O2 sats, even with microvascular spasms, is fine. But the SOB can be with or without some exertional demand presented to the heart. Also,if you have MVD,in some degree,you are probably decreasing your chances of developing any collaterals to help your heart muscle. I would avoid lifting anything heavy, go slow on stairs, (inclines get me) until you get an answer in this difficult to diagnose condition.I correspond to a lady in the UK who has this and she was seen in London where they have a clinic devoted just to MVD patients. I am followed closely at Emory, in Atlanta, Georgia. I am on nitro patches just to go slow on a flat surface! I have a good understanding of this MVD and its progression.Read my journal here at 'joanincarolina'or my group under cardiac microvascular dysfunction cardiac syndrome x.

[cblmn7]

I dont know about the angina but the 02 will be affected and it will show on a x-ray. i got the plursey while i was in the hospital.

[ed34]

Interesting and it would explain the shortness of breath. Does Pluresy give Angina symptoms in the throat and chest pains? I suppose it could if the heart is lacking Oxygen. I'm intrigued now with your comment because my sats level was 90-92 when being discharged and it normally runs at 99%.
Doesnt pluresy show on an xray? ive had recent ones taken.

[cblmn7]

i dont know if it will hep you but i had similar symptoms after i got my first 4 stents and it ended up being pluresy.