Re: What is unstable angina?
- From: tonyzsims@xxxxxxxxx
- Date: Sat, 04 Aug 2007 07:22:32 -0700
On 2 Aug, 18:24, tonyzs...@xxxxxxxxx wrote:
On 30 Jul, 19:56, MarilynMann <ma...@xxxxxxxxxxx> wrote:
On Jul 30, 1:44 pm, tonyzs...@xxxxxxxxx wrote:
On 28 Jul, 17:38, MarilynMann <ma...@xxxxxxxxxxx> wrote:
On Jul 28, 12:35 pm, tonyzs...@xxxxxxxxx wrote:
I have looked at the Medline definitions for stable andunstable
angine, together with references in this group. I don't have any
problem in understanding that stableanginais characterised by chest
pain associated with physical activity, and that it is caused by an
insufficient blood supply to the heart. Neither do I have difficulty
in appreciating that it is due to a narrowing of the coronary
arteries, and possibly the presence of plaques.
Where I do have difficulty is in understanding the distinction between
stable andunstableangine. So far as I can make out it seems to be
the nature of the chest pain that makes the crucial difference ie
withunstableangine the pain can occur during periods of rest and is
not associated with physical activity.
I have raised this question before in connection with bypass surgery.
I had a double bypass just over a year ago following the discovery of
calcified plaques in the coronaries. My level of discomfort has
always been low both before and after the operation. I Know several
people who have been diagnosed as having stableanginabut whose pain
level is quite severe, certainly in comparison with my own. I also
feel that my level of fitness is greater than theirs. Can it really be
that I am more prone to a sudden heart attack than they are? I may be
grasping at straws but I should like to think that I am in the stable
category rather than facing the prospect of being 'unstable'. How can
I settle this matter? Any advice or comments would be most welcome.
Tony, england.
Point of clarification: has your doctor told you that you haveunstableangina?
Marilyn- Hide quoted text -
- Show quoted text -
Yes. That description was on one of the documents is had sight of
after my bypass operation just over a year ago. It took some time to
come to terms with the definitions I unearthed on the net, and
unnerved me. Hence my question. I have not had a heart attack and
have not felt close to one..I refuse to believe, with such mild
symptoms that I should consider myself at death's door, or, at least
close to a heart attack. Maybe I am a sublime optimist in putting the
diagnosis into question. I should like to explore ways in which this
diagnosis could be wrong. If the marker foranginais an insufficient
supply to the heart muscle, then I don't think I have it (despite two
coronary plaques, both of which are bypassed.) But how can I nail it?- Hide quoted text -
- Show quoted text -
Are you sure theunstableanginadidn't occur *before* your bypass?
In other words, is your doctor saying you haveunstableangina*now*
or that you had it before the bypass?
I think you need to get with your doctor and get him/her to explain to
you better what's going on and what your prognosis is.
Marilyn- Hide quoted text -
- Show quoted text -
Thank you Marilyn. The problem here is that there were virtually no
symptoms to discuss with the doctor. All I had was a low level of
discomfort/ache in the lower left chest. My doctor said this could
not beanginabecause the discomfort would have been more pronounced
and in any case located in the centre of the chest. I don't think much
would be gained from discussing it with him. I would much rather have
input from the members of this group. The results of a stress test I
had before the operation were excellent. It was only the discovery of
two calcified plaques in the coronaries that led to the bypass
operation. My own intuition on this, and again I may be absurdly
optimistic, is that there was not an insufficiency of blood to the
heart, hence the low level of discomfort. Playing eighteen holes of
golf three times a week may have engendered a degree of angiogenesis.
It was only very recently that I came across the concept of
revascularisation and the therapy based on EECP. I feel sure that had
I known about this therapy I would have gone for it rather the
barbaric procedures of bypass surgery.
Thank you,too, Marilyn for your advice re chest discomfort. I cannot
lightly disrgard it, but I have played golf again today and feel
OK. One last question: is it at all possible that a diagnosis ofunstableanginacould be based on the presence of plaques and that
alone? And again is there a possibility that it could be wrong?
Tony, England.- Hide quoted text -
- Show quoted text -
Thank you Marilyn. I was interested in your notion that ches
discomfort does not necessarily indicate the lack of a blood supply to
the heart, but womewhat alramed that I may be fooling myself into a
false sense of relative immunity. I was also interested in your
statement that the presence of a plaque does not necessarily imply
unstable angina. On the question of the diagnosis my doctor did not
diagnose unstable angina before the operation - he did not have the
relevant inofrmation to do so. The cardiologist who was in charge of
the CT scan and angiogram only commented on the presence of plaques.I
only found out about the diagnosis by getting sight of hospital
documents following the operation. My guess is that this was more the
result of a need to fill in a form by doctors working in a highly
pressurised bypass factory. What exercises me is whether I still have
unstable angine even after the operation. The consensus seems to be
that I do and that I could be struck down any time. If so I cannot
see what purpose was served by having the operation.
.
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