British Heart Foundation
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Symptoms

Welcome to our new online community! Here's a space for you to chat about your symptoms and how you manage on a daily basis. Perhaps following your heart attack you're still feeling tired, or maybe after open heart surgery you're still feeling a bit stiff - this is the place for you to compare experiences and perhaps see just how common the issues are that you share.

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Can anyone suggest what my next step should be?

I get breathless on exertion especially when walking up hill. This is associated with mild to moderate chest pain, more often mild than moderate.

I did not have a history of ischaemic heart disease but a recent cardiac scintigram was positive for perfusion decifits in the area of LAD and LCX arteries, affecting 3% of my myocardium. The head of the nuclear medicine department found the findings to be significant whereas the doctor at the cardiology clinic disagreed. She said that I was taking optimum medication for my hypertensive cardiac disease, therefore no further treatment or intervention was necessary. Furthermore, saying that everyone over the age of 50 years would have similar results ... is this true?Bewildered by this response, I asked how to deal with the breathlessness and chest pain and she told me to continue with what I am currently doing ...

Really ... am I supposed to live a life of avoidance? Has anyone else been in a similar situation?

Reply

Hello there - I'm sorry to hear about the symptoms you're having. These do sound like classic symptoms of angina, and considering your test results there are some issues there that have been picked up.

One of the important things we all need to remember is that scans should always go hand in hand with how the patient feels, so if you're having these symptoms and your medications aren't controlling them then you may want to seek a second opinion. You're entitled to do this via your GP - there's some helpful information about this here: nhs.uk/chq/Pages/910.aspx?C...

Take care, Chris

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This was a second opinion Chris. The head of nuclear medicine is also a mature qualified physician in the area of cardiac medicine. She stopped the stress test because my BP195/110 and I could no longer speak due to breathlessness however, no chest pain. She explained that I might need a cardiac catheter which is why she referred me to the cardiology clinic. Whether or not the doctor at the clinic was a cardiologist or not, I don’t know, however she seemed totally unconcerned with the chest pain. I am a non smoker with mixed type moderate asthma and restrictive lung disease of unkown origin plus significant sleep disordered breathing on CPAP. It was very easy for the doctor at the clinic to shift the blame to my known lung disease even though thses were new symptoms.

Despite my issues, I can walk for miles on the flat and only have trouble on inclines, do you really think this could be angina with only 3% of the myocardium being affected?

Reply

Hello there - it's very common for people to only suffer with the symptoms of angina when they're walking up an incline, but are absolutely fine on flat surfaces. Although it's only 3% there is still a chance it may be at the root of your symptoms so it may be worth discussing this again with a cardiologist who may be able to explain if an angiogram is suitable or not and the reasons for this

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Thank you, I will not let this go however, I don’t want them thinking that I am paranoid. Doctors are very quick to jump on the somatic bandwagon.

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