persantine

[janne]

I have agreed to be a part of a research study at the heart institute(they like my age and lack of risk factors haha).  I had to have a stress test with persantine. I have in the past few months had 2 treadmill stress tests(reached the maximum heart rate) and experienced no chest discomfort. One test showed myocardial ischemia(false positive?), the thallium was negative.
My history is MI in June/03, LAD stented, 39 year old female, no risk factors (quit smoking) and have had on-going symptoms since heart attack.
While having the test with persantine, I experienced the exact same symptoms I experience off and on on a day to day basis,(shortness of breath, pressure in the chest area, a feeling of food stuck in my throat and chest and a choking sensation). None of which are necessarily associated with exercise(sometimes it is, sometimes it isn't).
Some of these symptoms during the test all disappeared within minutes of them injecting me with something to counteract the persantine. They also gave me a spray of nitro which helped.
I continued to have chest pressure(not as severe) and shortness of breath off and on over the next 6 hours or so(more than I usually do), but it was gone after that.
I do not have the results yet and I'm scheduled for an angiogram this Friday regardless of the results. But, I was just wondering whether this reaction is an indication of a blockage or is it a normal reaction to persantine? Apparently I did the full length of the test (time wise), they just inject with the counteracting drug automatically anyway.
Thanks for your help.
Janne

[janne]

Thanks for the response.  The persantine showed a "slight abnormality" in the imaging part (but I'm not sure about the ekg part).  I'm not sure if it is related to this area or not. I only got a few minutes to speak with the doc who did the test. I guess I'll just take a "wait and see" approach. I really don't want to take anymore meds then I already take. If the chest discomfort continues, I will probably look into other causes, but for now, I can live with the symptoms, the fatigue is the only real difficult part.
Thanks again for your help.
Janne

[Cleveland Clinic]

While its impossible to tell, a 60% lesion should really not be causing your symptoms unless you have some element of spasm involved.

If your persantine was ok, ie no ischemia in that territory, I would probably try to maximize your medications while also looking for other causes of your symptoms.

good luck

[janne]

Hi Doc BKJ
I'm not sure if you will see this or not, but I didn't want to take up space posting where someone may want to post a question.

I had my cath today and all it showed was a 60% blockage just above the stent (which is mid-LAD) and encroaching slightly into the stent.  He said it would be tricky to fix and that they don't like to fix anything less than a 70% blockage as they consider it insignificant.

I'm not quite sure where I go from here, but the nurse told me that my regular cardiologist will probably want to tamper with my medications to see if they can get rid of the symptoms. They are not sure about the artery spasming but may want to try some medications for that.

I'm glad that it is over, but still feel like I am left hanging as I have an insignificant problem, but still have symptoms.  I guess my next trip should be to a shrink haha.

Thank you very much for all of your help.  You've been able to answer a lot of my questions that I always think of after I leave a doc's office.
Happy Holidays!
Janne

[janne]

Thanks for your help.  I'll let you know what happens with the cath, but will just re-post under this post so I don't waste a place where someone could have asked a question.
Thanks again. I'm really looking forward to finally ending this whole thing and getting on with my life. You've been a great help over the past months.
Janne

[Cleveland Clinic]

Janne,

Alot of people experience symptoms with persantine that are related to the medication and not necessarily to ischemia suggested by blockages.

In itself, your symptoms do not constitute an abnormal test.

Let us know the results of your catheterization.

good luck