Cardiac mri predicting my future

[fergusthegreat]

Just over 30 months ago I suffered an acs and subsequent single mid LAD stent. I also have a 30% blockage in my RCA.

Because mine and my wife's hobbies are all sports related, mainly surfing and mountain biking, we decided that based on my heart disease diagnosis we would work part time and have less money but more time biking and surfing just in case I had a heart attack . Theory being that we would work part time for as long as we are healthy and if something bad happens to either of us at least we have had a bit more time to enjoy our hobbies.

So for the past 2 years things have been great and I am still healthy but I am thinking about returning to full time work for the next few years. Problem is I don't want to go back if my disease is progressing rapidly. On the other hand if things are pretty stable I'll go back.

So I'm thinking about paying privately to have a cardiac profusion mri as I believe this will tell me everything I want to know about my heart and arteries and the way the disease is progressing without being invasive or having the radiation exposure of a CT scan.

Based on the results we can make some decisions about our future.

I know it probably sounds a bit weird but I just wondered what people's opinions were regarding getting the scan.

Cheers Mark

[shopman]

Like the MOT for the car - it only applies at that actual time. Think you may have to look at further help and advice in conjunction with it.

[MichaelJH Heart Star]

I would not like to say which is the best test. Someone I know applied for a PPL (private pilot's licence). The tests needed were exercise ECG, echocardiogram and angiogram. The first two are non-invasive but the latter is. It will be interesting to see others' thoughts.

[Prada47]

Hi Mark

I had an MRI this Morning (stress) I previously had one about 18 months ago which led to an angiogram and stents to my LAD. I have a 100% blocked RCA and the stress MRI indicated that the Reward wouldn't be worth the Risk to attempt to open it. I was really impressed with the information available from the MRI and the explanation of the degree of Heart Muscle that was not functioning as it should.

As to an opinion on working v leisure that's a difficult one a lot depends on how you feel in your everyday life ? and is your future financially secure I retired at 57 but I knew our future security was taken care of, no point in being retired with out any money.

regards

[Milkfairy Heart Star]

This is a very individual choice.

My husband had angina and a stent inserted into his almost completely blocked LAD 8 years ago. He also has Atrial fibrillation.

His father and grandfather died early following heart attacks.

His younger brother had an out of hospital Cardiac arrest due to a heart attack in his 40's a few years ago.

My husband's attitude is not to worry about something that may not happen . Just because his risks are higher it is not his destiny. He takes his medication including statins, we eat a Mediterranean diet, exercises and manages his stress.

He saw privately through work an experienced Interventional Prof of Cardiology last year and was advised all was well. His cardiovascular health was assessed by an electrophysiologist through the stress of exercise. No other tests suggested.

Perhaps make an appointment with a Cardiologist first and have a discussion with them. They should be able to advise you appropriately.

Any test depends on the quality of the equipment used, the person performing the test, the skilled interpretation of the results by an experienced clinician along with increasingly sophisticated computer algorithms. This you are more likely to find in the NHS at a larger Heart centre usually with a BHF presence in the university and medical school.

Good luck with your decision and keep enjoying life.

[fergusthegreat in reply to Milkfairy]

Thanks for your reply, it sounds as if your husband has a great attitude

[Chappychap]

I agree with the main pillars of your thinking,

-monitor your health and use that evidence to inform the big decisions

-the NHS is a wonderful institution, but it's resource constrained so has to ration and prioritise treatment. If you want gold standard care you may have to augment the NHS with some private work

You're not alone in wanting to track the progress of your heart disease, however most people in that position use either a Carotid Ultrasound (not the doppler test) or a CT Scan. The Ultrasound has zero radiation and is the cheapest option (about £230 but you may need an additional consultation), however it uses the carotid arteries as proxies for the heart. The latest generation of CT Scan machines are now very low radiation doses (equal to the background radiation you'd get from living a few months in a city like Edinburgh built on radioactive granite), the cost however is a bit higher (c £250-280) and there are fewer locations.

But even with these tests you may not get the information you really want. Translating test results into actuarial or predictive metrics is as much an art as a science, and you need a few comparable measurements over a period of time to have any hope of identifying a trend.

You may be better off trying to understand what is the root cause of your heart disease, and in particular the root cause of the inflammation that triggered your heart attack (I assume that's what you meant by an ACS?). A single stent and a 30% blockage are fairly mild compared with many people on this forum, if you could identify life style changes that target your personal causes, and really go after those, then I'd hope and expect that you would have many active years ahead of you.

Good luck!

[fergusthegreat in reply to Chappychap]

I was told by the hospital that I'd had an acute coronary syndrome. I think that a bit of plaque ruptured causing extreme shortness of breath but the blockage didn't completely block the artery so luckily no ecg changes, no raised tropoponin levels and no heart muscle damage.

I have done as you have suggested and tried to address all my risk factors as well as taking my medication.

Was thinking about getting a scan as much as anything to see if it was working.