Angiogram

[Hiphop6]

Hi I have AF no other indicators no chest pain ,angina. No heart attack. Only breathless walking up stairs, never on the flat. Anyone had a diagnostic angiogram as part of their pathway.

[CDreamer]

I haven’t for AF. My husband however did before a planned CV because he had other heart problems and they wanted to be absolutely sure there was no CVD or blockages that could be dislodged.

Why do you ask?

[Hiphop6 in reply to CDreamer]

Have had two cardioversions short lived. No indicators of CVD or high cholesterol.

[fibnum]

I have dealt with Afib for about 3 years and was experiencing episodes every 2 weeks at one point. During that time, I had 2 attacks of either a mild heart attack or severe angina.

After the second, I had an angiogram. I was concerned about getting an Afib episode during it and very uncomfortable with lying flat, but it went fine, and no identifiable heart problem was detected. I was prescribed isosorbide mononitrate to relax my heart and have not had more angina pain in 8 months. No connection to Afib was mentioned. The angiogram was ordered due to the painful attacks.

By changing my diet to reduce constipation and trapped intestinal gas, losing 35 lbs, avoiding alcohol, gluten ( I have found out I have celiac disease), and excess caffeine and carbonated drinks, getting off of most BP meds and exercising well daily, I have successfully limited my Afib episodes to one 5-hour experience during the past 8 months. (knocking on wood!) Deeper breathing and good hydration seem to help also.

The actual answer to your question is: No, I have not had an angiogram ordered as a diagnostic for the source of my Afib. I shared the other info to show what has been helpful for me. If your heart shows no physical problems that might trigger Afib, consider the possibility that trapped gas which irritates the vagus nerve, sleep apnea, and/or BP meds might be culprits.

Best wishes for getting on top of your Afib issues.

I have no medical expertise, only one person's experience.

[Hiphop6 in reply to fibnum]

Thank you for this advice. I've never had any episodes that you describe just breathless going up the stairs.

[fibnum in reply to Hiphop6]

Just to be a bit clearer, the two "attacks" that prompted the angiogram were not associated with Afib. My symptoms with Afib have never involved pain, just a feeling of unease in my chest and a lack of energy. Ignoring it, but taking it easy is my usual response.

[24683579 in reply to fibnum]

Similar experience. Did you discover the intestinal gas, vagus connection your self or through professional help? It would be helpful to know if there's someone professional out there specifically focussed on that type of issue.

[fibnum in reply to 24683579]

Cardiologists and EPs ignored me when I explained that every onset of Afib was set up by a build up of trapped gas over a couple of days. They murmured uh-huh's while more-or-less rolling their eyes. I went to several GI's who had no interest in the Afib-gut connection, but I finally got tested and diagnosed with celiac disease, which set me on a path of sorting out foods I could eat with less gastric distress.

On advice of doctors, I would be deeply into risky meds and ablations by now rather than making dietary and lifestyle changes (e.g. losing weight and exercising regularly, no alcohol...) which have, thus far, been very successful in alleviating Afib.

The identification and elimination of irritants of the vagus nerve as triggers for Afib seems to be only recently recognized by some studies and doctors as a treatment for Afib. No doctor ever referenced it to me. One EP told me 9 months ago that I could "try changing my diet to reduce gas, but it will not reduce your Afib." I went from 12-24 hour episodes every two weeks, to one 5-hour episode in 8 1/2 months. I have been operating on the idea that a preventive beats a cure, and that if we don't understand the cause of an ailment, the meds and treatments are "shooting in the dark" to a large extent.

I know each of us is different, and that I am one case, but from reading comments from others on here, it is clear that the possibility of an Afib-gut connection should be front and center in the diagnosing and, in many cases, treatment of Afib.

[BorzoiGalgo in reply to fibnum]

DR. gupta has a Youtube video about connection of afib with acid reflux.

[fibnum in reply to BorzoiGalgo]

Yes, I have seen that. It was after I had found some answers but supported what I was doing.

[24683579 in reply to fibnum]

Thank you for that comprehensive reply. I completely concur with your experience of doctors' dismissal of gastric related AF when for me, it's ever present in the build up to an AF episode. This is not to criticise GI's and cardiologists, just to clarify their professional scope. It is all they know else they would be making a connection between the 2 congruent symptoms. Studies have come and gone with nothing truly sticking yet. Agree with trying different foods, no alcohol and all, but I'm yet to nail my triggers having attempted extensive diets such as the Fodmap diet that includes gluten free. I feel for me and I'm sure many others that there's an answer there somewhere to the triggers of AF as I am one of many with no structural heart conditions or stomach conditions, fairly young and fit. Lastly, I can only fully agree that gastric/AF connection in diagnosing and treating should be paramount in medical practice.

[fibnum in reply to 24683579]

If you have not done so, consider sleep apnea as a contributing factor. I was awakened with Afib a couple of occasions after not breathing well while sleeping. If I doze in a chair for a few moments, I often feel my heart start to pound a bit because my head has come forward, closing off my airway in the throat. My plan for avoiding Afib includes sleeping on my back, but with my head and shoulders slightly elevated and my head turned sideways with my chin slightly lifted.

I also have an unsubstantiated sense that Metoprolol (100 mg) and or other BP meds may have destabilized my heart's rhythmic security and made me more susceptible to irritated vagus nerve influence. I came off my beta and channel blockers around the time I was figuring out the diet changes, losing weight and exercising more, so it is hard to identify which factor or combination of factors was interacting with my heart to trigger Afib.

I wish that doctors would not be so dismissive about searching for causation for Afib. I cannot help but think that understanding the source would lead to much more effective treatment.

I hope you can identify the triggers and avoid them!

[BobD Volunteer]

Would be right if anti arrhythmic drugs like flecainide were being considered as they must not be prescribe if there is any cardiac artery disease.

[Hiphop6 in reply to BobD]

Wouldn't there be other indicators?

[mjames1 in reply to Hiphop6]

Absolutely need to be other indicators. Angiogram is not a per-requisite for anti-arrhythmic drugs like Flecainide, unless to confirm other indicators, as mentioned in my previous post.

Jim

[BobD Volunteer in reply to Hiphop6]

Think how many people just die from massive heart attacks when they were quite unaware they were living on a tight rope.

[Singwell in reply to BobD]

EEK. But alas true

[Hiphop6]

Thanks for the advice so far please keep it coming.

[mjames1]

Angiogram is generally performed only if you have indications of corornary heart disease (CAD) to look for blockages. It might be symptoms such as chest pain or an abnormal echo or exercise stress test. It would not be performed for shortness of breath alone, or as someone else mentioned here, as a per-requisite for an anti-arrhythmic drug, unless there were other indicators of CAD.

That said, we are not doctors, nor do we have your complete medical history, so there may be something missing to us that your doctor sees. There is also something called a "CT Angiogram" which may be ordered for similar reasons, but does not have as strict guidelines as it's less invasive. Could that be it?

If an angiogram was suggested, you owe it to yourself to ask your doctor why and if uncomfortable with the answer, seek a second opinion. It's an invasive procedure and not without risk, therefore only recommended when medically indicated.

Jim

[Hiphop6 in reply to mjames1]

Thanks it had never been mentioned as part of the course. Not had a stress yet.

[mjames1 in reply to Hiphop6]

So this was a hypothetical question? Your post sounded like your doctor recommended an angiogram. As to a "stress test", again there should be indications or a very good reason, not just taken because you feel you want more information. For example, my ep's protocol for flecainide happened to be an exercise stress test. Other indications might be chest pain, other symptons of cardiac insufficiency or a questionable echo. Whether your shortness of breath walking up stairs merits an exercise stress test is difficult to say in a vaccum, would depend on your whole medical picture as there could be a number of reasons.

Jim

[Hiphop6 in reply to mjames1]

Yes he did.

[mjames1 in reply to Hiphop6]

And what reason did he give you for prescribing an angiogram? I am going to assume an angiogram via catheter and not a CT Angiogram, which is an imaging study.

Jim

[Hiphop6 in reply to mjames1]

Im fishing for real life experiences regarding AF sufferers, This is on behalf of my partner who is dislexic and has no computer skills. A dagnostic! angiogram was recommended and performed we were told it was safe. Unfortunately for him it wasn't. Beginning to think he was wrongly listed for this procedure.

[mjames1]

Sorry about that. Can I ask what the complication was? No one here can tell you whether or not an angiogram was necessary, because we're not doctors nor do we know your partner's complete medical history. But I can say that angiogram is not indicated just because someone has afib, or they are put on afib medications.There have to be other indications as well.

Jim

[Hiphop6 in reply to mjames1]

Dissection coronary artery, congestive heart failure. He survived. Unfortunately we trusted the information given was honest and correct. No serious risks given.

[mjames1 in reply to Hiphop6]

Sorry about that.

Jim

[Hiphop6 in reply to mjames1]

Thank you Jim.

[BrotherThomas]

I also suffered from breathlessness when going up stairs. My cardiologist did not believe that bisoprol was the cause despite the fact that it started within 48 hours of me starting the drug. His view was that it was due to heart failure so ordered a stress test CAT scan. This showed no problems so he ordered an angiogram. This was also OK so the breathlessness was quietly forgotten.

[JOY2THEWORLD49]

Hi

I had no breathlessness until I was prescribed METOPOLOL 23.75 x 3. Also desperately fatigued. I couldn't exert myself. Walking up my driveway breathless!

I tried after getting out of hospital to divide them up breakfast, lunch. PM. No change. I was allowed to reduce it but still it continued. My children were worried.

At 1 year 3mths the 24 hr monitor showed 2 x 2 second pauses at night when avge H/R was 47. The Heart Specialist changed me to BISOPROLOL. Now 157 and no pauses.

The initial H/R Day avge 187! There's the problem. Then 157 still not controlled.

In came the private Heart Specialist. Put on CCB Diltiazem 180mg which took my H/R 105bpm within 2 hours. Scary stuff.

With Sunday NZ Healthline with Dr there and Wednesday NZ Heart Foundation Nurse who knew my private Specialist reduced Diltiazem to 120mg.

So Diltiazem 120mg AM for H.Rate control and 2.5mg Bisoprolol PM for BP.

Great, controlled and now 18 months on Diltiazem

120-124 / 69. and 60s H/R Day.

No breathlessness, increasing walk distance, happy that I have H/R and BP controlled and now I can have my operation in October. H/R under 100.

cheri jOY

[dunestar]

I was experiencing breathlessness upon exertion. My pathway to diagnosis was echo, then stress echo which showed global ischaemia. Followed by angiogram which revealed my main coronary arteries were almost clear. So the conclusion was microvascular angina. The small blood vessels fail to respond when placed under the stress of exertion. I have never felt chest pain. My condition is well controlled with medication.

[Jce1960 in reply to dunestar]

Thanks for your reply, stress echo was never given.

[dunestar in reply to Jce1960]

Stress tests are good because they put the heart under stress (believe it or not!) which is when the wheels can start to wobble.

[Maggimunro]

My previously very fit husband starting getting breathless when running, with very mild chest discomfort.

He went for an angiogram after the consultant thought he might have mild angina. He came out of the catheter lab with 5 stents after they discovered two of his major coronary arteries were 95% blocked in several spots.

My point is, his symptoms were incredibly mild but he was a whisker away from a major heart attack.

[2learn]

Hi, same as others I've had angiogram,but not related to AF, was related to leaking heart valves and possible op. So, have you had a heart scan recently that has shown something and agiogram is to check for blockages and furring up.

[Hiphop6 in reply to 2learn]

Thank you for your reply.

[Timetraveler67]

I had te angiogram after being admitted with chest pain Last August, I didn’t know what was going on and when they wheeled me down to have it the Dr put some notes on my trolley which he asked me to sign before he went ahead, he said it was to explain the risks which were a stroke, heart attack Or possible death I was too scared to think it through and signed the form. They went in my artery in my wrist and I watched it on the screan. I suffered badly after with pain in my wrist and arm and a year on it still bothers me. They found no blockage at all and put the chest pain down to something called broken heart syndrome. The day I was disharged I complained of heart palpitations but they dismissed my concerns. Te palpitations continued and a few months later a echocardiogram confirmed Afib which I’d never here’d of and here I am today convinced the angiogram caused it. I’m not a Dr or have any medical training but my advice is get as muc information as you can before this or any procedure, I didn’t have a chance as everything was rushed. Wishing you well

[Hiphop6 in reply to Timetraveler67]

Wow was it an emergency.

[Ducky2003]

I am listed for valve repair surgery (caused by the AF) and had to have an angiogram to check for any CAD as surgeon didn't want any surprises when doing the op. I insisted on having a CT scan version rather than the traditional as, having already had an ablation, I didn't want poking around again.

[Fitbit-Joe]

Like yourself, Im also waiting for a angiogram. Currently taking 5mg bisoprolol as part of my new meds, to deal with palpitations and tachycardia episodes. Cardiologist done a ecg which showed abnormalities, and along with symptoms I was showing, order a angiogram to be done

Have had high cholesterol readings, problems climbing stairs, 3 family members with heart related issues

[lizzieloo2]

When I was diagnosed with PAF about 10 years ago, my then cardiologist sent me for a series of tests to see if there was any physiological reason for it. I had ECGs, an echogram, then a nuclear medicine test. This last test involved injecting a dye etc while lying on a table. Immediately following this injection, my blood pressure plummeted and I had to be tipped upside down. Then after a short break, a CT was done. The report from this test suggested that I had had a minor heart attack at some point and ischaemia so I was then sent for an angiogram. The angiogram showed that nothing at all was wrong and that the nuclear medicine test was wrong but apparently they often show up artefacts. My husband had this test also and it showed ischaemia but the angiogram showed his arteries were as clear as a bell at that time so I wonder why they bother with this test but an angiogram is the gold standard test to show up any real problems

[Jce1960 in reply to lizzieloo2]

It's also very dangerous as we found out if you are the unlucky one, as we were told. Yet this was a diagnostic test , whilst having AF, for CHD with no other indicators prior to a stress test and sold to us as SAFE.

AF

[Moongold7]

Yes. Very simple screening procedure, and I had an angiogram for AF only. It was the first test apart from the usual hospital emergency department ones, where I was admitted with a sudden set of AF symptoms. I had no angina, no heart attack, but just the usual AF symptoms. I actually had to have a second angiogram because there was a shadow on the first screens of some sort, but all went well. You just lie down on your back and they insert a die that runs through the atrial chambers to show just what is happening. There's no pain - not even discomfort and you should be able to get the results quite quickly. Best wishes.

[Jce1960 in reply to Moongold7]

Do you mean a CT Angiogram or did they insert a catheter via your wrist or groin?

[Moongold7 in reply to Jce1960]

Yes, CT angiogram, no catheters or anything else.

[Hiphop6 in reply to Moongold7]

Thanks for your reply.