"I have had EKGs, a stress test, blood work and over night monitoring. My doctor has ordered up a CT......"
Nuclear stress test or treadmill-only? How about an echocardiogram,which is a very versatile imaging modality that can quickly confirm or rule out various cardiac conditions.
Keep pursuing this particular individualized health/medical matter until you are 100% satisfied/confident with the diagnosis, treatment and prognosis.
In general-only here, chest 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.
Non-cardiac chest pain, as applicable to the patient
The chest contains many muscles, bones, tendons, and cartilage and strains or sprains to any of these may/can can cause chest pain. Chest pain associated with musculoskeletal injury is typically sharp and confined to a specific area of the chest.
The pain may/can be brought on by movement of the chest and/or arms into certain positions, and often is relieved by changing position.
The pain may/can be triggered off by pushing on part of the chest and often become worse when taking a deep breath. Though the pain typically last only seconds, it may/can also persist for days or longer.
If/when chest pain increases when you press your finger on the painful site, or if you can pinpoint the spot that hurts, it is most likely chest wall-related pain, which may/can be caused by strained muscles or ligaments or even by a fractured rib.
This pain may/can be brief or fleeting and often described as being sharp.
Also, of the different types/kinds of heart conditions, various symptoms may/can be acute (occurring suddenly), be chronic (occurring over a long period of time), come and go (be transient, fleeting or episodic) or even be silent.
Additionally, here, coronary artery disease actually begins (the process/progression of) very early in life, even as early as in the pre-teen/teenage years. Studies performed in the past have shown that fatty streaks (represents the earliest precursor to plaque development and plaque is the pathological hallmark of atherosclerosis) are the beginning of atherosclerosis in the coronary arteries. Soft plaque (more dangerous and unpredictable than hard or calcified plaque) is the early stage of atherosclerosis. Best of luck down the road of life.
WebMD member (since 8/99)
Heart Disease: Heart Attacks
More than 1 million Americans have heart attacks each year.
Hi: ....."because the artery was connected to the heart on the inside rather than the outside."
"The doctor said I was born with this."
"How common is this?"
Sounds like myocardial bridge or bridging, an uncommon congenital (born with it) condition, which means literally a "bridging" of heart muscle (myocardium) over one of the major arteries in the heart (the coronary artery has actually tunneled through a part of the heart muscle), usually the left anterior descending (LAD) artery, involving the first 10 to 20 mm of it.
Symptoms mainly depend on physical activity and how much compression or squeezing of the bridge there is over the particular artery during the heart's pumping/contraction or systolic phase of the cardiac cycle
This condition more often has a benign course, though unfortunately, myocardial infarction (MI, heart attack), and absolute worst case scenario, sudden cardiac death (SCD), have been reported.
Why not a nuclear (Cardiolite or Myoview) stress test?
It's often good in determining whether a blood flow-limiting blockage (ischemia) is present or not and if a heart attack has occurred or not.
Isotope/Nuclear Stress Test
SEE: Actual rest/stress nuclear images
The physiciancan separate a normal left ventricle, from ischemia (live muscle with flow that is compromised only during exercise) and the scar tissue of a heart attack. The distinction is made in the following way......
Hmmmmm, haven't heard that term (an all but discontinued specialized treatment modality) mentioned here since the advent of drug-eluting stents and the overall success rate of it.
I know several individuals who had in-stent restenosis (ISR) in a bare-metal stent, and had the narrowing (stenosis) cleared with angioplasty, atherectomy or laser, and then a drug-eluting (sirolimus or paclitaxel) stent was placed making a so-called "stent sandwich".
L@@king back, the main Intravascular brachytherapy (IVBT) treatment systems were: Cordis CHECKMATE, Guidant GALILEO, Novoste Beta-Cath, Beta-Emitting Liquid-filled Balloons, Radioactive Stents.
Best thing to do is check/inquire directly to hospitals/medical centers to see if IVBT is still in use there. Contacting the manufacturers is another option.
The hospital/medical center you choose can make a difference...a critical difference.
Credentials, Experience, ResearchU.S. News & World Report
Has the blockage occurred where a bare metal-stent was placed?
To treat a blockage that has occurred at the site of an uncoated, bare-metal stent, placement of a drug-eluting stent (for eligible patients) often provides a very satisfactory long-term outcome.
If the blockage is short, sometimes balloon angioplasty or cutting balloon angioplasty are enough to effectively treat the blockage. Balloon angioplasty is a procedure in which a small balloon at the tip of the catheter is inserted near the blocked or narrowed area of the coronary artery. When the balloon is inflated, the scar tissue of the blockage is compressed against the artery walls and the diameter of the blood vessel is widened (dilated) to increase blood flow to the heart.
The cutting balloon catheter has a balloon tip with small blades. When the balloon is inflated, the blades are activated. The small blades score the plaque, and the balloon expands the previously placed stent .
Has the blockage occurred where a drug-eluting stent was placed?
Determine proper placement. First, it is important to know if the stent was actually placed and expanded properly. An intravascular ultrasound (IVUS) examination can help determine if the stent was properly deployed. If the stent wasn't properly placed, sometimes simply re-expanding it is all that is needed.
If the stent was well-expanded and tissue regrowth has occurred within the stent, using a different type of drug-eluting stent is generally the best option.
Review the type of drug eluting stent used. If a Sirolimus - type (Cypher, Xience, Endeavor) drug eluting stent was used, the physician will consider a Taxus stent (delivers paclitaxel). If a Taxus stent was used, the physician will consider a Sirolimus analog delivering stent.
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The only way to truly determine "why is this" is via proper diagnostics.
The bottom line
Coronary artery bypass graft (CABG) surgery is just a clever way of temporarily circumventing the problem (atherosclerosis), as it doesn't address the disease process and what drives the progression.
Coronary artery disease (CAD) is a lifelong unpredictable (may/can exhibit periods of stabilization, acceleration and even some regression) condition requiring a continuum of care, which includes having the appropriate follow-up diagnostics (such as nuclear stress test, stress echo, angiography) performed as deemed necessary.
Best of luck down the road of life.
WebMD member (since 8/99)
Living with Heart Disease
Coronary Artery Disease (CAD)
CAD is a chronic disease with no cure. When you have coronary artery disease, it is important to take good care of your heart for the rest of your life.....
This is especially true if you have had an interventional procedure or surgery to improve blood flow to the heart....../It is up to you to take steps to stop the disease from....
Good to know for the primary and secondary prevention of heart attack and brain attack
Epidemiologic studies (EDS) have revealed risk factors (encompasses new, novel or emerging) for atherosclerosis, typically affecting the carotid, coronary, and peripheral arteries, which includes age, gender, genetics (gene deletion, malfunction or mutaton), diabetes (considered as being the highest risk factor), smoking (includes second and thirdhand), inactivity, obesity (a global epidemic, "globesity"), high blood pressure (hypertension), low HDL (now questionable, according to recent studies) high LDL, small, dense LDL, RLP (remnant lipoprotein), high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, HDL2b, high homocysteine (now questionable), and high C-reactive protein (CRP/hs-CRP).
Be a questioning patient. TALK to your DOCTOR and ASKQUESTIONS. Studies show that patients who ask the most questions, and are most assertive, get the best results. Be vigilant and speak up!"
- Charles Inlander, People's Medical Society
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Hi: "I keep thinking she is gonna, she will just up and have a heart attack any min"
A heart attack is typically caused by a totally blocked/occluded coronary artery, not a fast heart rate (tachycardia).
..."they can not figure out why she is having IST."
General info -
Tachycardia (appropriate and inappropriate) is caused by something that disrupts the normal electrical impulses that control the rate of your heart's pumping action. Many things can cause or contribute to problems with the heart's electrical system. These factors include:
Damage to heart tissues from heart disease
Abnormal electrical pathways in the heart present at birth (congenital)
Disease or congenital abnormality of the heart
Sudden stress, such as fright
High blood pressure
Drinking too much alcohol
Drinking too many caffeinated beverages
Medication side effects
Abuse of recreational drugs, such as cocaine
Imbalance of electrolytes, mineral-related substances necessary for conducting electrical impulses
Overactive thyroid (hyperthyroidism)
**In some cases, the exact cause of tachycardia can't be determined.
Best of luck to your wife and you down the road of life.
WebMD member (since 8/99)
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