I have AF, gradually worsening, with chest and throat pain during episodes. Cardiologist did an exercise stress test on Tuesday and stopped the test after 3 minutes. He told me I have ischaemic heart disease - which is a bit galling as I have never smoked and do not eat red meat, cheese, eggs etc. - and it came as a bit of a shock! The test threw me into several hours of AF and throat pain.
I was very puzzled that he was able to make this pronouncement/diagnosis as I had not realised that it was possible to make such a diagnosis on the basis of this treadmill test. I would be grateful for comments/advice from others who might have been in a similar situation - or maybe I ought now to be on the coronary artery disease board!
All help gratefully received. I think he is going to advise an angiogram, so any experience of that would be helpful too.
Lots of thanks.
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Singingforever
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I'm sorry to hear that you've received an alarming diagnosis! Your mention of chest and throat pain during AFib is unusual (seems to me anyway) and it's a good thing you're getting thoroughly checked out. I had an angiogram recently and was very glad to have had it. It was an easy and painless procedure that involved having some dye injected into my vein and then lying still while I was scanned.
Could be that you have coronary artery spasm rather than arteries clogged with plaque. I am a slim non smoker and still had a ‘heart attack’ caused by spasm instead of a clot - at least no clot was found so that was the diagnosis. I also get throat pain but only had chest pain once.
I also had an angiogram a couple of years ago and, as TopBiscuit says, it was painless and very straightforward. My only regret was that they angled the monitor screen so that I couldn't see what they were doing!
I think chest and throat sensations are quite common in AF as in some people the oesophagus presses against the atrium. In fact, I am sitting here with just that as I type. I wouldn't call it pain, but still, we are all different.
Bad luck on the diagnosis. The exercise ECG can show many things, including ischaemia, I gather, as this can affect the shape of the ECG trace. Again, this is likely more alarming than it is as I would think most people over 70 have some level of it. Your doctor will either do an angiogram or cardiac MRI, maybe both to determine the extent.
I suspect you will be absolutely fine once all is over - just, like many of us here, getting older...
Cardiologist seemed surprised that I was not getting angina, but I am beginning to wonder if I do but it is not where I expected it to be! I have a lot of pain on the right side - chest and neck, and I have looked it up and angina can be felt there. And this pain is worse when in AF. I had assumed it was coming from a biliary problem that I have and that this problem might be triggering the AF, but now I am not so sure.
I will be seeing him again next week and hope to go armed with a list of questions. And to come out with some answers hopefully.
I am finding it all very hard as I live alone now that my husband has died - he was a doctor and reassurance, or information, was always at hand. I find the night times with the pain very difficult.
It’s must be a dreadful thing to be alone and to be poorly. I feel for you. AF itself is an especially frightening condition to have - although the fear is vastly out of proportion to the danger once blood clots have been prevented. Yet now, on top of that, you have more to worry about. The chances are you’ll be fine, and I’m sure you realise that deep down, but at present you’ll be needing reassurance from further tests and possible treatment. You sound as if you’re in good hands.
Life gives us many trials as my wife and I well know. Do you have family who you can call or visit?
Yes I do have family - two of my adult daughters and their families live nearby; and I am lucky to live in a small village with a caring community and lots of people I can call on for help.
I am just finding it hard to be in limbo and not knowing what I can safely do or what the future prospects are. I must learn to be patient - but night times when heart is awry are quite difficult on one's own - there is nothing family and friends can do about that so I have to put on my big girl pants!
Putting on "your big girl pants" as you put it is good advice & you can promote that by: seeing a physio therapist or going for a massage, taking up walking in a group or by yourself in a park, gardening, birding, sitting reading by a lake or river etc. The idea is to keep your body moving however slowly or quickly depending on your ability which in turn keeps your brain from dwelling on your worries. It sure helps me because when I let my mind wander into my heart related issues I then feel palpitations increase. Keep in mind to start slowly if it's walking for example, and increase as you are able. Good luck! You can do it!
Humour will always take us through but illness and fear are so hard to deal with at times.
I wish you well. I don't know what kind of music you enjoy singing most, but in Suffolk last week we were listening to a nightingale that also seemed to want to sing forever! It was transporting. Utterly marvellous.
"I was very puzzled that he was able to make this pronouncement/diagnosis as I had not realised that it was possible to make such a diagnosis on the basis of this treadmill test."
Explanation from Cleveland Clinic website
"A healthcare provider takes pictures of your heart before (at rest) and after you exercise. A cardiologist compares the amount of blood flow to the muscle of your heart at rest and after stress. A decrease in blood flow signal usually indicates a blockage in one or multiple arteries in your heart."
"I think he is going to advise an angiogram, so any experience of that would be helpful too"
Presumably a CT angiogram. I had one 5 years ago. It's just a CT scan where they inject you with a dye so they can see the blood flow through the blood vessels supplying blood to your heart.
I've had lots of MRI's, CT's and X-rays over the years so I don't remember the specifics but again, the following is from the Cleveland Clinic website and it sounds about right from my perspective (in Australia) but I didn't think it took anywhere near an hour. However, maybe I'm just thinking about the actual scan time.
"What to expect during a CT angiogram?
During a CT angiogram:
A technician gives you a numbing medicine and inserts an IV through your arm or hand. Contrast dye flows through the IV.
For a coronary CT angiogram, the technician attaches sticky patches (electrodes) to your chest. The electrodes connect to a machine that records your heart rate and rhythm.
You lie on a table that glides into a machine shaped like a doughnut (CT scanner).
A technician operates the CT scanner from another room, taking images from several angles. They may instruct you to hold your breath for a few seconds to prevent chest movement during the scan.
The actual CT scan may only take a few seconds to minutes. With setup time, the procedure typically takes around an hour."
From my perspective, the scan process is certainly nothing to be concerned about.
I had the chemical stress test they will not do the other on me. that was a couple of years ago originally, I had another one last year. It only takes about two seconds for me to feel all the distress from the chemical. I don’t know if they had you hooked up or not. I was all hooked up. They could see everything going on, I actually had more problems than I did their first time. Then again a lot has either happened or uncovered. They caught the a fib at the very beginning thankfully. I don’t just have a fib in fact that is gone with the palpitations. I have a flutter, but all four ventricles have issues , it’s like someone put me together backwards I think of myself as a Lego set lol
have they also looked at the possibility of anxiety or gastric problems? I have severe anxiety. I didn’t realize it was that bad but my EP does and has from day one. This is why he reminds me. It’s not always the heart. When I have an anxiety attack, it says if someone has me by the front of the throat, choking me and yes, I feel like I’m having a heart attack. It’s almost that feeling as if you are going to cry very hard to breathe. I have had this quite a while, but of course, once diagnosed with a fib, I blamed it all on that , my recent annual my doctor showed me all my numbers on a chart. I have an unusual pacemaker. FYI, anyway he said people without pacemakers would want what I have. It’s so good. I can do anything normal people can. They should explain to you more if you have any blockages , if you had anything like that, though, I would think they would stent you. I did not need anything like that. sometimes I annoy my EP at this point in our relationship. It’s also a good friendship but he reminds me who the doctor is lol. He tells me not everything is because of your heart. He reminds me how many parts we have in there that can have a problem. I did discover very early after being diagnosed eating too much no matter how good it is will put me into painful a fib that will double me over. It took me twice to figure it out when we went to our favorite tex mex restaurant where I love their sangria. we didn’t even make it to the car in between filling up on their homemade chips and everything else good oh my goodness my cousin wanted to go straight to the ER but I ran through my brain and I realized it was probably over eating and alcohol. The second time was at my favorite Japanese restaurant no alcohol just tea but again the meal I had was amazing and I ate it all. Same thing barely able to walk from the restaurant. I was in so much pain and unable to breathe.
talk to your doctor and get more answers. Don’t be afraid to ask if you don’t ask them then you will be afraid because you don’t know what’s going on. Do not use things to measure your heart rate blood pressure yes but not crazy. I’m saying this because my doctor made me do that. You make yourself crazy and you will find yourself taking it 24 seven just like people are doing with the diabetic one and smart watches etc. I am monitored 24 seven by the clinic anything goes wrong they will know before I do that’s good enough for me . What I keep telling people now is get out of your head about it. I don’t mean ignore serious or real things but don’t keep thinking about it. It’s like having an upset stomach the more you think about it the more you feel sick.
you are going to learn something new almost every day you are gonna learn that you learned some things wrong most of the time it is my doctor. I listen to. We also have some amazing people on here. Best of luck. you are just in the beginning just keep in mind. Whatever you have done is a Band-Aid for the most part. There is no cure so if you get an ablation or anything else and eventually, you start feeling lousy again that’s not abnormal. I had one last six months. The other lasted over a year, the third one almost killed me. It made me worse. Did nothing for me. That’s a whole other book. Same with cardioversions they can last an hour a day. I had one that lasted 3 1/2 weeks of heaven. My second one did nothing and there were complications on the table . After that, it was the pacemaker best thing I ever did.
I have just seen the cardiologist. He has added in ranolazine which he says should reduce chest pain when I am in AF. I am to have an angiogram during the summer and a stent will be put in if needed. I am finding it hard to take in as I have a healthy diet and have never smoked.
I am not familiar with that, but I definitely have seen. It doesn’t matter how good you have been all four of my ventricles are messed up. That’s why I have problems. I never smoked not a Barbie doll, but always physically healthy one night out of the blue a fib showed its ugly head My cousin has a friend in Vegas, who just got a fib last year. He was a hockey player professional, but I know for a fact, he partied hard still does at times They found with him he had a valve issue they fixed it. He was fine and still partying so to speak. If life was fair, those of us who had been well-behaved would not be suffering now there’s no sense trying to figure out why we have it. We just do. I also know of heart problems in the family, but no one thought to write all this down for future family now they ask about your brother and father on certain things but it’s usually just simply something like heart or cancer, etc. I have it on both sides, but I also know everyone was a heavy smoker and more none of which I’ve done ever. So many things places they worked with asbestos my dad was a firefighter smoked besides and died of cancer. My mother died of heart and cancer both within 11 months by the time they know what we’ve done we can’t correct it anyway, because we already have what we have is my thought. I find in Texas smoke more. I keep away from it, but I grew up in a house full of it. Could’ve should’ve would have doesn’t matter it’s what we’re doing now.
I don’t think I ever questioned why because there’s just so many variables in life. I am more of a person that takes the problem and tries to solve it and get rid of it. I would like to punch a fib right in the nose. lol I have turned a fib into a visual little monster that is not gonna get away with things
they are doing so much you don’t even know about you won’t read about it yet but they aren’t just sitting around over 400,000 people in the US supposedly suffer from a fib right now and it’s going to increase. I’m not so sure about the increase. It depends how smart the younger generation will be.
You have not heard of my doctor, although he is on things like you tube but he is not famous YET he is young. There’s no way to tell you how brilliant he is. I have a feeling he was working on stuff before he came out of the womb. He even won on the college show of Jeopardy. He is soft-spoken, but he gets his point across and if you annoy him enough like I can do, I can see it in his eyes. If I have asked about One too much and he has already answered he will ask me why I keep worrying about that. I had a scare last year and even he was unsure. It was a mechanical thing. He got me right in with the tech assigned to me. Yes, I have my own tech. They got the engineer on the phone. Yes, the engineer from the company who makes the pacemaker. what it turned out to be something I should not have seen on my phone in my application. Yes, I have an app on my phone. They can take a reading whenever they feel like it without me even knowing especially if they see something not right. When I go in the office, it’s like a magic wand and they have everything they need to know. First time I went my tech discovered they had left to switch on that should’ve been off. I was feeling like I had an echo and my chest. It was not harmful, but it felt weird to me. She turned it off right there no surgery.
all of this is very safe, no single person can mess you up in there so when you hear about hackers forget about it I said that the Italian way lol
as you can tell when I throw in lol etc. I have a joy of life. I never thought I would have again. My doctor said there is nothing I can’t do that. A normal person can do. I’m sure that means within reason like don’t walk across Niagara Falls on a rope lol I don’t like height anyway.
Roll with things there’s nothing you can do to fight it except have a good attitude and do what you’re told. Don’t overdo anything. I am still not allowed to do some things. The number one thing he’s after me now is getting my stress, anxiety and depression better we spoke with my primary who started working with me yesterday. Stress and anxiety, etc. can be your worst enemy besides yourself. I have always had it. My medication was as needed, but it was my EP who said you don’t seem to realize how much you need it so he’s not just a doctor. He is a person and he watches your mind and your body I hope you find someone like I have, I can’t believe how blessed I was having him in my life I am gonna be 72 back to being 35 in my head lol I may have to settle for 40 🤣 most of my life. I said I was 35 in my head and I felt that’s what kept me going so well.
until lately I felt like I was 135 so whatever you’re feeling one of us on here has also felt you’re not alone
That must have been a shock to the system but I believe such a diagnosis, in itself, doesn’t necessarily tell a great deal and calls for further investigation and discussion with the specialist.
An ECG trace can be very definitive of certain heart conditions.
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