Should I follow threw with test?

[Me967]

Hi.  I know this is going to sound crazy; but, I have to ask.  
Since Feb. I had one really bad attack and was having alot of issues with chest pains, (severe and mild ones every few seconds/ minutes), shortness of breath to the point of breathlessness where I could not finish a sentence with my voice gone until I took a breath, very tired after the slightest of activities. I requested my medical reports due to this and a old issue in Feb. with my Dr. that I feel pretty stupid about now.
On my reports I had asked alot of questions about a Mobitz ll block on here.  

I finally went to the doctor and she done alot of blood work. (results pending)  I'm expecting them to all be well except for the hsCRP in which is usually high.  I felt alot better several days "before" going to her.  She done an EKG and it was one of my best ones.  It only showed the poss. old infarction and a incomplete RBBB.  YA.  She looked at the old EKG and said I should have a total cardio workup.  I'm afraid that since I feel better and better each day that the Echocardiogram and SPECT stress test is going to be a big waste of time on everyone's part and money on mine.  With the symptoms all going away......I just don't know if it's worth it?  
Should I hold off on these test to see if the symptoms come back and then go?  
I just don't know if they would be able to tell now that I'm not symptomatic?

Amy

[Me967]

Hi.  Thank you for explaining the FS and thanks for the comment on "outstanding".  That made me feel really really good and all of the time on the treadmill worth while.  
Thank you very much for all of your help and kindness.

Take care,  Amy

[kenkeith]

You have a very good report...reached 10.10 METS with 92% of predicted heart rate, outstanding...Its normal to have EF flucuate within the normal range 55-75%.  The 53% is an estimate and well within the statistical margin of error.

FS (fractional shortening) is similar to EF.  EF relates to volume capacity for measurement and FS is dimension capacity.  FS calculation is LV diastolic dimension minus LV systolic dimension divided by LV dimension.  For you it is 3.78 - 2.76 divided 3.78 =  26.98 or 27%.  Report states 27% and normal is over 25%.  There will be normal flucuations with FS as well as EF...necessary to maintain a balance of blood flow between the heart's right and left side.

Take care

[Me967]

Hi.  Well the results are back from the Echo and Stress test and are good.  The EF in 2006 on ecko was 72% and now it is 53% but I think that is due to working out more in the last two years.  Also I was feeling pretty good when I done the test.  The results are:

BLOODWORK end of it from what I understand:

No Allergies - food or respitory
Chol.------under control now with Lipitor

Low sugar--------(hyperglycemia)--add protien and fat to each meal + health carb.
Low Iron-----------2 oranges a day, multivit. plus iron tab.daily        
Low Calcium----drink more reg. milk(2% ok) vs. soy
Low thyroid------(hypothyroidism)-take Levothyroxine .25 on empty stomack, recheck and possibly move to .50

STRESS TEST report sumerized:

Bruce protocal for 8:01 achieving Max METS 10.10.  Resting rate 100bpm rose to a max of 166bpm which represents 92% of age predicted hr.  Resting bp 132/78mmHg rose to a max. bp or 168/70mmHg.  Was stopped due to attained HR.
1.) NSR   2.) 10.10 METS achieved/ 9.37 METS expected  3.) Norm. BP & HR response  
4.) No ischemic changes, ? face,race,? PVC recovery  5.) mid SOB at peak. No CP  6.) Nuclear to follow.
Impression:  Normal stress myocarial perfusion study using SPECT technique
                   LV EF is 65%, w/o evidence of wall motion abnormality.

ECHOCARDIOGRAM w color doppler:

Status:  Routine OP   Contrast medium: No contrast used.
Impresssion: Aneurysmal atrial septum, EF 50-55%.  Everything Normal
2D measurements:
Left Ventricle:
Dias dimension: 3.78 cm  (3.5-5.5cm)                Systolic dimension: 2.76 cm  (2.5-4.0cm)
Septum Diastolic: 0.851 cm  (0.7-1.2cm)             LVPW diastolic: 0.977 cm  (0.7-1.1cm)
Volume diastolic:  61 ml
EF simpsons:  53%  (55-75)                              Volume systolic:  28.4 ml
FS:  27%                                                          EF teich:  53%  (55-75%)

Left atrium
LA diameter 2D:  3.03 cm (1.9-3.8 cm)              LA Index: 20  (16 is less than 28 ml)
LA Volume:  36
Right ventricle
Diastolic dimension: 3.37 cm
Right atrium
Diastolic dimension:  2.9 cm
Doppler measurements:
Mitral valve
Peak E-wave: 64 m/s
Peak A-wave: 74.2 m/s                Deceleration time:  260 msec
E/A ratio: 0.86
Tissue doppler
E' velocity: 0.11 m/s                    E/E`ratio:  581.82
Pulmonic valve
Acceleration time:  100 msec
EOF

I think this means everything turned out well.  I am still using my treadmill at home; but, I seem to be tired easy (getting use to thyroid meds).   I think they cause leg cramps too.  I am still gaining weight which is upsetting but they say the thyroid will do that also, along with everything else.  I don't think I need the apt. with the cardiologist now, but, I do have a Ultrasound of thyroid to do yet.  Maybe that was the problem all along causing the symtoms and bad EKG readings.   I don't know.  

I did ask her if it got real bad like it did before; if I should just ignore it or call her or ? and she said if it gets like that again to go to the ER.?   GRRRR.  Anyhow, just thought I'd let you know the results.  Just a tad bit curious if EF flucuate like that and if its good?  

Thank you;  Amy  :-)

[kenkeith]

Thank you for your reply...keep us posted.

[Me967]

Hi.  Well as far as the range for the hs CRP/ cardio CRP levels it states on the lab work that: "1 is low, 1-3 is ave. and >3-10 MG/L is high.  And anything over 10 should be evaluated for non-cardiovascular etiologies".  Mine range from 6 - 20 on all my test.  She only told me it puts me at risk for cardiac issues.  I am on Lipitor to try to lower the level of CRP and Chol.

I did get a call yesterday about my blood work and was told my iron (transferrin) is still up, my sugar was up and they want to talk to me about my thyroid test and starting meds for that and go over the results with me.  She had me come in for a 2 hr. glucose tolerance test today.  YUK  Boy does that stuff ever make you lightheaded, it's not that good to say the least.  ha ha.  
She wanted me to come in this week about the blood test results but, I told them I would rather wait until the following week when I could talk to them about everything at once (concerning ecko and stress test).  Rather than having to come in twice.
  
After receiving your answer I did not question the test although just about all of the symptoms are gone.  

Tomorrow I go for my echocardiogram and spect stress test.  This time they don't want me to take my Lopresser pill before the test.  Wish me luck on good results.  Thank you so very much for your comments.  They are GREATLY appreciated.

Amy

[kenkeith]

Hi Amy,

Most recently, CRP has made headlines as it relates to heart disease. New studies indicate CRP may be elevated in heart attacks. There is also a high sensitivity CRP test (hs-CRP) in addition to the regular CRP test. The hs-CRP measures very low amounts of CRP in the blood and is typically used to assess risk for heart problems.  Does the doctor have an answer to why your CPR level is high?

You shouldn't accept intermittent shortness of breath, and at other times asymptomatic to govern your judgement to whether or not to seek medical attention.  It is a good sign to feel well, but it can't rule out a treatable medical problem, and sometimes early treatment prevents or delays a serious condition.  

You want to rule out an enlarged heart's left ventricle due to ischemia that may have damaged heart cells.  That could explain shortness of breath and fatigue.  Take care.