Chest Pain Input Please

[li10up]

Ok, I had the nuclear stress test yesterday. Stayed on the treadmill for 12 minutes and got my HR up to 181. Everything went well and I should hear from my doctor "within a few days." Now I'm expecting the ol' ticker to be just fine so when I get a call saying my stress test results are "normal" should I just say "Okay, thanks." and leave it at that or should I press for more info? Seems like after all of that I should get some info that tells me a little more about the health of my heart. What do ya think? As you can probably tell I haven't always been real pleased with my doc's relaying of information. He isn't usually a wealth of information. Maybe I'm just more inquisitive than some. What questions should I be asking?

[blueskies]

Asthma could also be a possibility.

[maillotpois]

Are you still having chest pain? Did they do an echocardiogram at any point?

They probably ruled out asthma, because she's not having any shortness of breath - just chest pain (right?).

[li10up]

I'm still having chest pain several times throughout the day - not intense pain but I notice it being there. Doesn't seem to be related to when I eat, lay down, etc. Yes, I've had 3 EKGs so far and nothing alarming on any of them. Hoping to get the nuclear stress test results today...but don't know what questions to ask other than if any blockages were seen. No shortness of breath. I could barely ride 12 miles on Tuesday...but that might have been due to not eating all day because of the test. Then I got a quick bite at McDonalds about 2 hrs before the ride....so maybe that had something to do with it. I just can't believe that 12 miles felt like 60. Maybe I was just having an off day. Sure hope I get my results today. I'm wanting to try the 100 mile route of the Waco Wild West on the 29th but as it stands now I'm not sure that's a good idea.

[maillotpois]

By EKG, you mean the thing where they put the round stickers with wires coming out of them on your chest, right? I meant echocardiogram, which is like an ultrasound of the heart. Did you have one of those?

[li10up]

maillotpois, I misread...no, I have not had an echocardiogram...just EKGs and the nuclear imaging - which I'm waiting for results. All the docs seem to think it is not heart related - which is a good thing!

[li10up]

Well, I rec'd my results from the nuclear stress test - anterior ischemia. So it looks like I've got some sort of heart issue going on. I'm going to be referred to a cardiologist. Hope it's soon as I'm still having these chest pains.

[maillotpois]

Wow. Sounds pretty serious. I hope the cardiologist is helpful. Glad you're being looked after by the right people and what a relief to finally have the issue nailed down. That's got to be the best part - you finally have a diagnosis (from real doctors ) and now you can just get to work on fixing it.

[emily_in_nc]

Wow, keep us posted. VERY glad you took this seriously and got tested. I don't know a thing about AI, but hope it's treatable and that you can still ride. Let us know what you find out and we'll all be pulling for you here!

Emily

[Ninabike]

From an old CCU nurse, "anterior" refers to the front part of the heart and
"ischemia" refers to lack of oxygen. That means that the front portion of your heart is not receiving sufficient oxygen. You could still have normal restng EKG's because there is no heart damage. Normally, ischemia occurs when a major coronary artery is partially blocked and the portion of the heart which receives blood supply from that artery is not receiving sufficient blood supply. There are 4 major coronary arteries. The stress test allows them to view any EKG changes which may occur when the heart is placed under stress/excercise and, since the heart needs more oxygen when under stress, the area of the heart affected will be demonstrated. Sometimes, smaller arteries can be the source of the problem, but usually it is one of the 4 major arteries. The condition is easily treated, sometimes with an angioplasty and the insertion of a stent which opens the artery and allows it to remain open.

Mind you, I am relaying this information mearly based upon the diagnosis of anterior ischemia. We normally think of coronary artery disease (blockage of the coronary arteries) as an older person's disease. However, some people can be gentetically predisposed to this condition at a younger age. The main thing is to get a diagnosis because heart disease is easily treated. Ultimately, this will not keep you off your bike, as excercise will build collateral circulation in the surrounding blood vessels. Please do ask the cardiologist any questions you may have. Ask to see diagrams of the heart and the vessels.

All the best and I know you will be fine!!

[Torrilin]

Sounds like the answer is "we can fix that". I don't know much about heart problems, but fixable sounds *real* good.

[KnottedYet]

If they put you on clot-busting drugs to clear the artery in your heart, just be sure to ask them if you need to limit your biking activities while on the drugs. They'll know what they want you to do based on the dosage and such they give you.

Those drugs can make you bruise and bleed easily.

(but it's worth it to save your heart!)

[maillotpois]

yeah, I guess that's the next question: what's causing the blockage? is it a blood clot or is it arterial plaque/narrowing arteries. I wonder how they figure it out. maybe an echocardiogram after all.

when do you see the cardioloist?

[Crankin]

Well, if it is a blockage, you definitely do not need to restrict your cycling after it's "fixed." My husband had 2 stents put in in June 2005. He was (and is) super fit, but is the victim of horrible genetics and starting way too late on the exercising/eating right. In fact, his nuclear stress tests NEVER show any blockages and it took him practically grabbing the cardiologist by the neck to insist on an angiogram. He was walking 2 miles 3 days after surgery, riding flat 13 miles after 5 days and after a week he met me on a ride I was leading in Harvard MA (can you say hills?). Now, he did keep his HR down for about 6 weeks and the doctor was not really thrilled, but he didn't say stop. After about 6 weeks, he was told to do whatever he had been doing before. Being on Plavix (blood thinners) does cause bruising from even the tiniest little bump, but it hasn't gotten in the way of anything. We had one crash last winter where his elbow swelled up; we knew it was from the drug, so we rode to the ER to get it checked out!
No one who looked at my husband would think he had cardiac issues; just because you are fit doesn't mean this can't happen.

[KnottedYet]

When I was on Lovenox (sp?) injections they really did a number on me with the bruising. Thank goodness I only had to be on the injections for a few days!

No biking or jogging or such during that week. (no nose-blowing or eyebrow plucking, either!)

Now that I'm just on low-dose aspirin to keep clots at bay, I can do whatever I want.

Do make sure the docs know what your regular activities are if they put you on clot-busters (the heavy-duty short term stuff). For clot-free maintainence type blood thinner drugs you should be fine.