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An_255089 posted:
Help need advice! I been having chest pain for at lease 3 years now I am 48 years old female with Father died at 50 from heart failure , brother died at 36 from heart failure and a brother who had a major heart attack at the age of 48 .i have had atrial flutter a year ago and had a ablation done also test positive on tilt table test. I work out 5 days a week 2 of the days with a trainer still weigh 200 lbs and 5'7 . Blood work TSH 9.77, TPO 497 , CRP 947 on thyroid meds. Just had a stress test and echo my cardiologist right after said everything is normal she said if I want she can do a angiogram , I request copy of results it said blood pressure 178/99 at peak , said abnormal test due to moderate anterior wall defect , left atrial enlargement at 4.3 , moderate mitral regurgitation ,finding poor R wave progression , some PACs and ST. Patient had chest pain and neck pain with shortness of breath. I tried to ask and she said its normal. The defect must be a shadow . What should I do? I feel I can't take much anymore.
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hypogirl65 responded:
Sorry CRP Quant at 12.1
 
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cardiostarusa1 replied to hypogirl65's response:
Hi:

"Patient had chest pain and neck pain with shortness of breath"

"Just had a stress test and echo my cardiologist right after said everything is normal she said if I want she can do a angiogram"

An invasive angiogram (heart catheterization) is still considered as being the "gold standard" for imagng blockages in the coronary arteries and determining the degree (percentage of narrowing/stenosis) of the blockage(s).

If you do decide to have an angiogram, be sure to discuss any worries or concerns in advance with your cardiologist. Make sure that the risks/possibilities of complications are fully explained.

HeartSite

Cardiac Cath

http://www.heartsite.com/html/cardiac_cath.html


Noteworthy, as applicable, there is also the non-invasive 64-slice Cardiac CT, which allows doctors to view/examine the heart and the coronary arteries in never-before-seen detail.

Far better yet, the newer blazingly fast (benefit of less radiation exposure to the patient, and less contrast media) 320-slice Cardiac CT scanner can measure subtle changes in blood flow, or minute blockages forming in blood vessels, no bigger than the average width of a toothpick (1.5 mm) in the heart, and the brain.

Take care,

CardioStar*

WebMD member (since 8/99)





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An_255089 replied to cardiostarusa1's response:
Thank you ! question ? if there is no sign of a block could something else be wrong and if a angiogram can find out other problems than a blockage?
 
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cardiostarusa1 replied to An_255089's response:
You're welcome.


"If there is no sign of a block could something else be wrong"

Well, chest/thoracic area pain, stationary or radiating elsewhere, with or without accompanying symptoms, has various causes, cardiac and non-cardiac, which includes, but not limited to, pulmonary, gastrointestinal, musculoskeletal, and psychological/psychogenic.

......"and if a angiogram can find out other problems than a blockage?"

Like any diagnostic imaging modality, an angiogram does have its limitations beyond the visualization of blockges, though it can show specific problems, such as a coronary artery anomaly/abnormality (congenital, born with it).

Plus, if/when the patient has an angiogram, and one or more blockages are seen, there's a seldom talked about/discussed term known as fractional flow reserve (FFR), which uses a tiny wire that accurately measures blood pressure and blood flow through a blockage in a coronary artery, and can be performed at the same time as an angiogram.

According to various medical literature and media reports, FFR measurement has proven to be very useful in determining if the interventional cardiologist should perform angioplasty, with or without stenting, on blockages such as 50%, give or take a little.

Also, since you said that you had an echocardiogram, worth mentioning here, a stress-echocardiogram may/can reveal problems (such as in the heart chambers or valves) only when the heart is put under a load, and of course, compare the difference in heart function (includes wall motion) at rest and stress.

Take good care,

CardioStar*



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Be well-informed

MedlinePlus - Trusted Health Information for You

Chest pain

http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm

Mayo Clinic

Chest pain

http://www.mayoclinic.com/health/chest-pain/DS00016

eMedicne Health

Chest pain

http://www.emedicinehealth.com/chest_pain/article_em.htm


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