In March I had a slight chest pain which concerned me. GP said all seemed well but referred me to heart clinic.
After CT non invasive angiogram it was found I have severe stenosis in LAD, mild in RCA.
Put on Samvastatin, Bisoprolol, Aspirin and Monomil. I told Consultant didn't wish to take statins until a firm diagnosis was made.
Further tests were 24 ambulatory, which came back quite positive, ultrasound which didn't cause any concerns. I was to have an invasive CT angiogram, but was advised by another Consultant who is a Professor, that I shouldn't have been put forward for it. It was decided between him and me I would have a stress test or MRI. I chose supine bike test. Results came back positive achieving 96%. My Consultant was on annual leave, so another Dr looked at the results and suggested I simply take Asprin and Statins, and handed me back to my original Consultant for onward care.
Really confused as to why I was given all the meds at the outset without any investigation.
To date, despite chasing my original Consultant, I have heard nothing nearly 7 months later.
Surely this can't be right. I just now want a care plan so can move on with my life.
My friend has a similar condition and speaks to her consultant regularly. He is in a different hospital.
Anybody else experienced such delays for what is, at the end of the day a life threatening condition.
Looking forward to hearing views.
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Maninthemirtor
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Quite a mix of things going on, let's deal with the obvious first, stress test, key words sensitivity and specificity, one of the manufacturers state gehealthcare.com/insights/a...
lists the sensitivity - According to previous research examining more than 24,000 patients, ECG stress testing for coronary artery disease has a sensitivity of 68%
and I have seen a figure as low as 50% been mentioned before which means its no better at detecting CAD issues than tossing a coin.
So it becomes a bit of a quandary were using the supine stress test, to assess obstructive CAD? but you already know that you have severe stenosis, but you pass the supine stress test, which is good news that your heart is receiving adequate blood and oxygen under stress i.e. exercise
Do you know the % stenosis in the LAD?
Simvastatin, Bisoprolol, Aspirin and Monomil, probably based on your original findings, statin, aspirin, seem reasonable, bisoprolol for heart rate, and blood pressure seems reasonable, Monomil possibly you had mentioned some other effects before or just covering bases.
It's interesting you don't want to take Statins, what's the thinking behind that?
Now you have the right to be referred to any consultant at any hospital, I would simply go back to your GP and ask to be referred to your friends consultant, assuming it was an NHS hospital your friends consultant worked at, private could be more tricky.
I think you should ask yourself how aggressively you would like to be treated and what kind of outcomes are you looking for? Thus conveying this information to a new cardiologist would get the discussion off to a good start.
Be interesting to carry on the conversation, and you are right to take a more proactive role in your healthcare.
The LAD was diagnosed as severe and RCA mild. Will check my letters as May have that the wrong way round.
I also believe in self help. NHS can't cure everything, many times it has to come from the individual. Since diagnosis I've lost 20 pounds, BMI now at 26 ( working on that). I gave up drinking ( wasn't big drinker really (it all helps), completely overhauled my lifestyle . Hopefully this should go a long way.
I will speak with my GP as need some form of closure. Even booking travel insurance is a bind when you have CAD. At least with a proper care plan I can book a holiday.
Last year I was treated for a heart attack and given a cocktail of medication until further investigation and a concrete diagnosis was made. This is the Acute Coronary Syndrome protocol that is followed when a patient presents with certain symptoms and test findings.
Once my scan results were back and heart attack was formally ruled out, the medication was reduced or stopped accordingly.
Perhaps your local health authority follows a similar protocol for your symptoms and situation.
From personal experience stress tests don't prove anything. If you were found to have severe stenosis on your Angio CT I would insist on an invasive Angiogram. I fought for 10 years to get one as all my perfusion scans/stress tests etc came back clear. My CT Angiogram came back as high calcification. My angio came back as severe amd critical leading to bypass surgery. Just my experience.
I would also take the meds. Statins will stabilise the plaque in your arteries. I wish I'd got them sooner.
Well done on your lifestyle changes which will make a difference. However, having been through what I have I wouldn't wait any longer. Get your Angio done and take the meds.
I was having the invasive on 13th June. All ready to go with gown on and alluring surgery socks. That day it was a Professor of Cardiology carrying out the procedure. When he spoke to me he asked few questions as per consent form, then advised in his opinion, and that of the consultant I had seen the previous day (not my consultant) I shouldn't have been put forward for the invasive at this stage, and askedhad I been having chest pain, which I hadn't since first consultation in March. He wrote to my consultant to advise him and then suggested the bike stress test.
Hopefully I will get to speak to my Consultant this week. Not for the want of trying, so frustrating. If not I will ask to see another one.
I echo what Susie says above, you could smash a stress test and still have serious issues . I was fit and strong prior to my “trapped wind” heart attack and had been to my GP six weeks before complaining of heavy fatigue , I thought my testosterone had dropped . They tested for testosterone, B12, thyroid etc all normal .. 6 weeks later heart attack , angiogram showed triple blockage so bypass surgery for me. I had quadruple bypass on 25th July now recovering very well. Get the angiogram done for certainty. Plenty of fit people smash the stress test but the angiogram finds the potential life threatening issues. Check out Graeme Souness and how he smashed the stress test but had to have triple bypass surgery, he couldn’t believe it, he was so fit !
Take the statins. Even though I was under a specialist for statins due to my intolerance and put on low dose Rosuvastatin which got my cholesterol down to under 5 from 9.6. I still ended up having an emergency CABG x2 with 100% and 70% blockages the following day from my angiogram. Statins not only help reduce the plaque but stop it breaking off thus causing a stroke or heart attack. The consultant told my husband I was about to have a heart attack within a week from which I would not survive. My cholesterol is unmanageable by diet but because of familial hypercholesterolemia. Some people just need to take statins. Good luck 😊
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So confused after recent heart attack
