Re: 'slight' heart failure ?

From: bigjon (bigjon_at_NOSPAMtqfmail.com)
Date: 09/20/04 

Date: Mon, 20 Sep 2004 14:59:01 GMT

Dr. Andrew B. Chung, MD/PhD decided to add:

> bigjon wrote:
>
>> Hi again.
>> Mainly for Dr's here, but any advice or experience/knowledge gratefully
>> received...
>>
>> Brief History...
>> 3 Mi's 2001. Instant (within the hour of third MI) Angioplasty and 4 stents
>> placed.
>> Prescribed daily :
>> Asprin 75mg
>> Clopidogrel 75mg
>> Nicorandil 10mg X2
>> Atorvastatin 40mg
>> Ramipril 10mg
>> Diltiazem 60mg X2
>> No problems for a few months.
>> Suffering recurring slight pain on exertion, but nothing too bad or that
>> couldn't be controlled with GTN spray or suscard.
>> Several admissions through A&E for uncontrollable chest pain (mainly waking
>> from sleep, not on exertion) over next 18 months, diagnosed as Angina and
>> later as Unstable Angina. Angiogram repeated, nothing significant found.
>> Several more admissions for chest pain ( again waking from sleep mainly,
>> not on exertion) up to april this year, then change in medication.
>> Diltiazem increased to 300mg daily.
>> Felt fine for nearly six months - longest period without any chest pain at
>> all.
>>
>> Last week, admitted again through A&E with chest pain and sweating,
>> breathless etc, was told slight heart failure and suspected MI. ECG showed
>> slight change and an enzyme (tropomin ?) test showed slight rise only (I
>> have no figures on these as I was out of it and wife spoke to medics).
>> I was given Isoket and Fragmin intravenously for 36 hours, then rested for
>> another 36 hours.
>>
>> I was then asked to try a Bruce stress test. I duly did, and passed with
>> 100%, no problems or variations. just a little pain in the last few minutes
>> of the test, but nothing showed up on the machine. I was then informed I
>> had not had a heart attack or heart failure, and that if I had Angina it
>> was extremely mild....
>>
>> I get the feeling I have now been dismissed as an "attention seeker" as I
>> was discharged with great speed as soon as this result reached the
>> medics... I have no follow up appointments, and am sort of out alone now..
>>
>> Any ideas why I can do well on a treadmill, yet 72 hours earlier I was in
>> great pain and distress ?(with the ECG and an enzyme test showing changes,
>> I must have actually suffered a MI or similar ? ).
>
> Perhaps you are suffering from sleep apnea.
>
>> I am fully aware that
>> there may be a psychological reason for the symptoms, but if that is so, it
>> doesn't change the fact that I was in pain and I was distressed... Do I
>> simply keep returning to the A&E dept ?
>
> Yes. But meanwhile, you should ask your doctor(s) about the possibility that
> you may be suffering from sleep apnea (your symptoms are occurring while you
> are sleeping).
>
>> My case notes will need their own
>> trolley soon as they are getting too big to carry around...
>>
>
> That is understandable given your history.
>
>>
>> I am thinking I may get labeled as a "crying wolf" syndrome ...
>>
>
> Not while you are hauling your case notes around in a trolley :-)
>
>>
>> Thanks
>> Jon
>
> You are welcome.
>
> All praises belong to my heavenly Father, whom I love with all my heart, soul,
> and mind :-)
>
>
> Servant to the humblest person in the universe,
>
> Andrew

Hmmm..
I will talk to docs about that - hadn't considered it !!
Thanks. 

-- 
Never argue with an idiot. 
They drag you down to their level, 
then beat you with experience......

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