Chest Pain Input Please

[li10up]

I'll see the cardiologist on Thursday. The person I spoke to on the phone said something about breast shadowing so there is still a chance that my heart is fine. She said they will likely want to do an echo cardiogram or some other tests. Fixable or no problem is what I'm looking for. No problem would of course be the best. She also told me I could keep riding - just don't overdo it. Apparently the cardiologist I'm going to see is a long distance cyclist so he will understand about me wanting to stay on the bike, etc.

his nuclear stress tests NEVER show any blockages and it took him practically grabbing the cardiologist by the neck to insist on an angiogram.

Was he having chest pain? Any reason why the nuclear stress test didn't show anything but the angiogram did? Makes me a little nervous if they tell me it's "breast shadowing" and I'm still having some chest pain. Should I push the issue if they tell me that?

[Ninabike]

The strees test only identifies areas of the heart muscle which may be affected because it shows changes in the electrical pattern of the heartbeat. An angiogram is the definitive test which shows each coronary artery and the Dr. is able to pinpoint the exact area of the artery which may be partially blocked. Blockages are often a combination of plaque buildup and blood clots, i.e., the plaque causes irregularities on the inner surface of the artery and platelets tends to stick to those areas, thus causing small clots to form. That is the reason for anticoagulants, and is why they tell persons who are having chest pain to take an aspirin. Aspirin interfers with clotting.

[Crankin]

Yes, my husband was having pain, first in the jaw and neck, then eventually as the blockages presumably got worse, it was at lower and lower heart rates, in the chest area. When he had to ride slower than me to climb a hill to avoid the pain, was when he insisted on the angiogram. They never said why the blockages didn't show up; both are in the major descending artery. Sometimes when you are very fit, your body works a little differently, though.
Good luck.

[Craig]

I too had a scary experience cycling.

It was April 14th and I was following a couple of younger riders up the canyon when my chest developed a sudden extreme pressure. It was like having someone sit on my chest. It really took the wind out of my sails. I fell behind and couldn't maintain my speed or heart rate. My heart dropped from 170 bpm to 138 and I couldn't force myself to keep up.

The pressure stayed with me for several hours. I rode home & rested but it wouldn't go away. I don't mind telling you that it scared the crap out of me.

The next day I asked a Dr friend of mine what to do & he suggested getting a nuclear stress test. I went in on Tuesday and all went well until I reached about 172 bpm. I didn't feel a thing but the technician asked me to repeat some of tests to double check his results. 15 minutes later during the interview with the DR I experienced slight angina. He recommended getting a multi-scan CT.

A week later I got the CT and they discovered 2 small calcium deposits on one of my coronary arteries. He said it was old stuff and their greater concern was soft plaque which showed up as shadows in my artery.

I couldn't get an appointment for over a month and everything looked like I would need an Angioplasty Stint which would be followed by medication for the rest of my life.

Being an impatient man & not liking my options so far, I turned to the internet. I read an article about acupuncture & Chinese herbs that helped some people with their angina.

I turned to Dr Ming here in SLC. She is a Chinese Cardiologist who understands both Eastern and Western medicine.

She put me on herbs with a warning to follow my doctors advice & not take any chances. I continued cycling regularly but cautiously.

What I discovered was that if I kept my heartbeat under 165, I could enjoy a ride without angina. Whenever I went over 165 bpm I would get angina.

My miracle is that after being on the herbs for a month, my angina went away. By May 28th I could push my heart up to 170 bpm with no problems, and now I can go up to 180 bpm.

When I finally got to my doctor's visit there was no need for Angioplasty. He was baffled.

I have experimented with my herbs and even dropped them for a few weeks at which time the Angina returned and when I got back on them for a week or so I was just fine.

This is my experience and I hope it helps someone. I suspect that Western Medicine is fairly narrow minded and it might be worth checking out Eastern alternatives. It worked for me.

PS. I am following my western doctor's advice by taking a baby asperin daily and limiting my red meat intake. I watch my cholesterol and get regular doctor visits. Good Luck & Best Wishes

CB

[ChickWithBrains]

Sounds more like pleurisy or a form of costochondritis. The former can be viral. The latter is also inflammatory but musculoskeletal. Both can come and go and take weeks to resolve.

What can elevate the d-dimer? HRT, pregnancy, any resolution of any clotting (including external bruises, small amounts of internal bleeding, hemorrhoids, etc)... the d-dimer test is great if it is NEGATIVE. It is incredibly nonspecific and not helpful if positive because so many things can elevate it. The ONLY role of the d-dimer test (and there are several varieties; only two are reliable, and many hospitals still use the older kinds) is to test a low-risk patient and move them into a very low risk post-test probability pool. (Say that three times fast!)

[KnottedYet]

Would those explain the anterior cardiac ischemia?

[li10up]

I'm starting to feel like a hamster on a wheel. The ER CT scan of the lungs was clear. The stress test showed anterior ischemia so I had a CT scan of the heart (different hospital). Those results came back as nothing wrong with the heart or arteries but they found a "nodule in the left lung". I was so happy to hear my heart was ok that I didn't ask about the nodule...what is that...he said something about possible fungus and then said more tests would be needed. Now I'm thinking how did the CT scan at the ER show clear lungs but the other one shows a nodule. I have to admit that I'm starting to get a bit scared after looking up stuff online. So, I've quit doing that for now. I called my GP and asked if they could get the results from the ER and explain why one is ok and the other shows a problem and to ask where we go from here. What the heck is going on here?!?

[aggiecorgi]

Wow, this thread is totally scaring me. I've had exactly the same path since May of this year and just recently started biking again. At the end of May I took a trip to California and over the week biked around 350 miles. I had the exact same symptoms on my day of return (felt like something was sitting on my chest, couldn't breathe, chest pains).

I went to the ER when I got back, and they did CT scans, X-rays, bloodwork, echocardiogram, EKGs, and kept me overnight. They said I had pericarditis (inflamation of sack around heart). The EKG was the only thing that was kinda off, and that's how they made the diagnosis. They also checked for a pulmonary embolism. I continued to have pain so they thought I had acid reflux and am currently on prilosec 2x a day. They also did an upper endoscopy to see if everything in my upper digestive tract was working properly.

I have recently tried to get back into biking/running, but I have the pain after exercising, but not during. I still have the feeling that I can breathe normally but am not getting enough oxygen in. Did the doctors say why nothing showed up on the ER cat scan? I'm beginning to feel like a hypochondriach since starting having these pains. Chest pains for me are much less now, but still naggingly there. Do you think I should push to see a pulmonologist?

[li10up]

aggiecorgi - I'm still having the chest pains but less frequently than before. I see the lung specialist this afternoon. I sent a letter to the radiologist at the ER asking him to take another look at my scan. He called me to tell me that there was a nodule visible and to offer up an excuse for missing it. Good thing I had another scan later and that Dr. saw it...otherwise it might have been missed altogether. If you aren't comfortable with the diagnosis you've received you should talk to your doctor again. My experience is proof that they can miss things.