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    LAD sen over 1 yr ago, upper lef and right pains sometimes ?
    cvcman posted:
    Ok a little history; 52 yr old male started a biking/running routine over 1 yr ago, sometimes would get mild pressure center chest, reg Dr said " all blood work ad ekg are good probably pulled muscle" asked him for a cardio Dr apt, got it the next day. LDL was 75 HDL was 93 Try's 45 BP 114/65 I had lost 40 pounds, 5'9" 150 pounds.
    Cardi wanted an echo stress, did it, felt fine no pain he saw something he didnt like sent me right to hospital for angio....95% blocked LAD !!!
    Did a medicated stent he said ALL others look fine and he thought with my excersise and eating I would be all set. I still run/bike 7 days a week and eat good.
    Now I have 3 other brothers,my younger brother had the same thing and ended up 6 months after stents having 3 way bypass, other 2 brothers passed echo stress tests fine...
    So fast forward 1 yr post stent, I sometimes get upper right and left side chest pains or cramps when biking/runnin..I went back to my cardio Dr who is VERY thorough and had me do a ech stress test, ran my HR to 165 and said "not even a glitch " fast forward 4 months later same thing kept happening, now he had me do a nucular stress test, same result, he said " perfect " not even a glitch, he said probably muscle related....
    Now my bro that had the 3 way this past month was having upper pains right and left pretty constant and went back to his cardio, they did an echo stress test and saw a "glitch" he didnt like and put him back on Plavix and a nitro patch,,said it could be something plugging up or something else but said another bypass is out of the question but thye can treat medically and if that doesnt work do another angio...
    My ? and concern is this...If im having the same area pains even though I passed 100% the echo and the nuclear stress tests in August shoudl I be worried or concerned ??
    Again my Dr doesnt screw around and he said this " if I saw evne a less than 1% chance there was a poblem you would be right back in the hospital having an angio"
    Also my bro DID have a heart attack BEFORE his first round of stents before the 3 way....
    I hope to get an expert reply here...Thx
    CardiostarUSA1 responded:

    This is not an expert reply. That will come from Dr, Beckerman. In the meantime -

    "Should I be worried or concerned"

    Yes, of course, though the problem may not necessarily be heart-related.

    Unfortunately, no diagnostic test/imaging modality is 100% perfect. Each has its inherent strengths/weaknesses, which can sometimes lead to errors, such as a false-positive or false-negative finding or misinterpretation.

    One example, and at the very extreme, a nuclear stress test can appear normal in some individuals with multi-vessel coronary artery disease (CAD), said to occur due to so-called "balanced ischemia".

    Plus, some individuals may experience coronary artery spasm or there may be microvascular disease (affecting the heart's capillaries).

    Coronary stents (bare-metal or drug-eluting) are just a Band-aid or spot treatment, as it does not address the underlying disease process and what drives the progression.

    Most important, coronary artery disease (CAD) is a lifelong unpredictable (can exhibit periods of stabilization, acceleration, and even some regression) condition, requiring a continuum of care, as well as good doctor-patient/patient-doctor communication and understanding at ALL times.

    Keep ALL known modifiable risk factors for cardiovascular disease (which actually begins very early in life, even as early as in the pre-teen/teenage years) closely in-check.

    Best of luck down the road of life.

    Take care,


    WebMD member (since 8/99)



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    Living with Coronary artery disease (CAD)

    A chronic disease with no cure. When you have CAD, it is important to take...

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    Cardiac tests, diagnostic images.

    Coronary artery anatomy

    Starting with the LAD, the most critical, next to the ultra-critical LM.


    Heart-Healthy Foods

    Avoid foods high in saturated fat and cholesterol. Choose skim or low-fat milk, low-fat yogurt and reduced-fat cheeses. Eat more fish and poultry. Limit servings to five to seven ounces a day. Trim visible fat. Limit egg yolks. Substitute two egg whites for one whole egg or use an egg-substitute. Eat more fruits and vegetables, whole grains, breads and cereals. Use less salt and fat. Season with herbs and spices rather than with sauces, gravies and butter.

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    Good to know, for the primary/secondary prevention of heart attack/brain attack

    Epidemiologic studies have revealed risk factors (encompasses some new, novel, emerging) for atherosclerosis (typically affects carotid, coronary, peripheral arteries), which includes age, gender, genetics, diabetes, smoking (also second/thirdhand), inactivity, obesity, hypertension, high LDL, small, dense LDL, RLP (remnant lipoprotein), high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, HDL2b, LOW HDL (less than 40 mg/dL, an HDL level of 60/65 mg/dL or more is considered protective against coronary artery disease), high homocysteine (now iffy), and high C-reactive protein (CRP/hs-CRP).



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    cvcman replied to CardiostarUSA1's response:
    well I guess im going on the fact that I passed BOTh the nuclear and echo stress tests and when my angio was done the Dr said it was only the LAD that had I figure that and the fact that I do NOT have pains when I push my heart rate to 140 or more running 4 or more miles or when biking my 25 mile route...
    Maybe im wishfull thinking but my Dr did both stress tests himself and was right with me the whole time,,,again he is the one who caught the blockage on my echo stress test when my gp said i was fine...
    I guess i have to trust his opinion right, or do I demand another still on the plavix too

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