Hi everyone, just give u a bit of a backdrop. I’m 43 and only a year ago I was running 10 miles and going to the gym. However the last year or so I’ve been struggling even walking the dog for ten minutes and struggling to walk up a flight of stairs without getting out of breath it truly is ruining my life. So I went to see about it and had a ct angiogram which they said was fine and they didn’t pick up anything, although they did pick up some emphysema on the lungs by looking at ct angiogram. I’ve been waiting 9 months on respiratory clinic waiting list. My question however is I was considering going private and getting a ct scan of my chest. Just wondering if that would show up anything different to the ct angiogram or is the angiogram looking for the same heart problems as a normal ct scan and would I be wasting my time if I’ve already had angiogram and they haven’t found anything. Just worried sick as I’m still struggling day to day with breathlessness and want answers as to why I’m feeling like this
All help appreciated
Many thanks
chris
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Luv4Luke
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32 Replies
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Hi Chris,
Sorry to hear about your decline in health. It's not nice at all especially when your young, fit and active.
I'm no doctor but I would ask for an angiogram to make check if any of the coronary blood supply is not up to scratch.
I don't want to alarm you at all, and maybe what they've found on your lungs is the cause of your breathing problems but since your getting seen to , get a full MOT done.
Hope you get it all sorted and back on your runs with good health.
Also try not to worry too much, easier said then done , I know. Modern medicine is marvellous at fixing people.
Hi Baly, thanks for taking the time to reply to me. I’ve had a ct angiogram done already but it’s inconclusive. When u say I should get an angiogram I take it that’s a different procedure than the ct angiogram?
I had to use Google for the below, based on the below it looks like they would have found narrowing based on the CT and then carried out a traditional one to follow up if concerned .
Apologies as I misread your post, hopefully someone with a wider knowledge base then me can help you better resolve what's going on.
Cardiac CT Scan (CT angiography) is a less invasive version of the traditional angiogram. The primary difference between the two procedures is that while a standard angiogram involves inserting a catheter into the artery and area to be studied, a CT angiogram does not require catheter insertion.
A significant advantage of a CT angiogram over a traditional angiogram is that a CT angiogram is non-invasive. However, for abnormal CT angiography findings, such as blockage or narrowing of one or more blood vessels, the patient may need a standard angiography as a follow-up.
Yes, I would have thought they might have picked up on something with the ct angiogram. But I was considering going for a normal ct scan of the chest privately. Just wanted to know if with the normal ct scan can show things that ct angiogram can not or if the ct angiogram is more conclusive than normal ct scan and do they look for the same problems
I had a ct scan on my heart last year that showed up some calcifications in an artery and some emphysema on my lungs. I’m now waiting on the ct angiogram. I was told when they scan your heart they also scan your lungs. As you’ve had an angiogram it seems that your heart is ok but they spotted the emphysema which is why you’re going to the respiratory clinic for lung function tests. An angiogram is more detailed and can show up more areas of your heart or lungs so you’ve had the best one already. I’d suggest seeing your gp, telling him about your breathing problems and discuss an inhaler and see what they say. Try not to worry but when you feel breathless, stop and inhale through your nose slowly and exhale out your mouth slowly until you feel better. Good luck.
thxs for the reply yoga, I hope your feeling ok. The emphysema was picked up on the ct angiogram. So I’m assuming that scan does both the heart and the lungs… I was thinking of getting a ct scan of my lungs to see the extent of my emphysema don’t know if that would be a good idea!! Because they said they only picked up a bit of it on the scan so I don’t know if a ct of the lungs would be more conclusive it’s an idea. What’s your thoughts?
I had ct angiogram no treatment needed. But on ct colonoscopy it picked up some Bronchiectasis in lung so I had CT chest which showed I do have bronchiecstasis and was referred to respiratory specialist. It can cause breathlessness . Obviously not saying you have though
Luke, maybe have a private consultation with a chest physician to get the ball rolling. You can always get him/her to refer you back to the NHS with their thoughts/findings. They would be understanding about that. They will tell you what might be most appropriate from the respiratory point of view. I would have thought they would want to see some Lung Function Tests (LFTs) e.g. peak expiratory flow, vital capacity etc. These are easy non-invasive cheap tests which just take a minute or two blowing into a tube. They would show whether your lung function was normal (irrespective of early signs of emphysema). If it is, then that's not the cause of the breathlessness, which would then most likely be to do with the heart, though could be something wrong with your red blood cells - did they do a Full Blood Count, Haemaglobin blood test? Naturally they would still want to document the emphysema, but I think that's probably mainly via the Lung Function Tests (LFTs) and a standard XRay (I could be wrong they will tell you). If the LFTs are normal, other cardiac tests which might make sense would be a Stress Echo ultrasound test. It's non-invasive and shows up whether the heart muscle is working normally or not. I'm not sure another CT would be helpful - an MRI might be more appropriate (as you've already had one CT). Depending on the result of the stress echo, they might want to do an angiogram, but as has been said that's a down the line as it is invasive and has some risks. It sounds as if the cardiologists think the breathlessness is respiratory, so the chest physician is probably the next step.
hi saladay, u make some interesting points!! Firstly my lft’s were ok, irrespective of emphysema diagnosis. That leads me to conclude that maybe it is a heart condition although they say it’s unlikely to be a heart issue having done the ct angiogram, however im still looking for answers, as there has got to be something that’s causing this constant breathlessness. Thxs for your reply 👍
Maybe ask for the stress echo next which would give an insight into cardiac function. Also I'm assuming your Full Blood Count was normal? It's either the lungs (sounds like that's not the case), the heart pumping the blood to the tissues, or the ability of the blood to carry the oxygen e.g. red cell or haemoglobin defect.
hey saladay, thanks for your input, it has been really helpful!!! I will ask for the stress echo next time I speak to the doctor. Or can I get it done privately? Cheers
oh I think I may have had the stress echo test. I was hooked up to a treadmill with some stickers on me. But I only lasted a couple of mins on it due to my breathlessness does this sound like the stress echo test??
It sounds like a stress ECG. With the stress echo, they put you on a treadmill but then lie you down and apply an ultrsound probe to your chest with cold ointment on it. Usually ask you to lie on your left side etc. It shows up any defect in the activity of the heart muscle but doesn't show perfusion of the vessels. For that you would need an angiogram, but that is more invasive and has some risks associated e.g. 1% stroke or heart attack. If the stress echo shows a defect then the need for an angiogram might be validated.
Hi, The terms can be confusing. A CT angiogram is done with contrast dye injected where whereas a cardiac CT usually doesn't. I've had both for an aortic aneurysm. Injecting the dye will show more detail compared to without. It probably won't be worth it to get the regular CT. The article below compares a CT angiogram and a traditional angiogram (cardiac catheterization). It also explains the cardiac CT - no contrast as opposed to CT angiogram with contrast. Frustratingly, it doesn't explain the results. Good luck!
I'd defo push for more tests, not a angiogram as others have said it seems youve had the gold standard already (i had this done last year to rule out heart issues) but i did also have an echocardiagram this looks at the structure of the heart etc (they usually do this before an CT angio tbh )im assuming youve had a 12 lead ekg etc aswell? in my experience (and they way my brain works) i find it more reassuring if they test and eliminate things rather than "assume" at least i have the piece of mind to know everything has been looked at so to speak.
A CT angiogram will be able to show permanent blockages of the coronary arteries however it cannot show whether the blood vessels are working properly.
You can have angina/ ischaemia without blocked coronary arteries caused by microvascular dysfunction or coronary vasospasms.
Microvascular dysfunction causes microvascular angina. Some people experience breathlessness rather than chest pain when they have angina.
Microvascular dysfunction and coronary vasospasms can be diagnosed by an invasive functional angiogram when how the blood vessels themselves work is assessed.
Microvascular dysfunction can also be diagnosed by a perfusion MRI in some cases.
The BHF has this information about microvascular and vasospastic angina which you may find helpful.
If an Angiogram and CT scan shows nothing..then it is almost certainly no blockages..an Echocardiogram would pick up any other heart disturbances you may have and would save you all that radioactive results of another CT..as they are quite high...emphysema would cause shortness of breath...so that should be your next step as thankfully the heart seems fine...hope you can get that seen to quickly..lung function can be checked quite easily yourself..there is a little plastic object sold in the drugstores called a peak meter that you can blow into and it comes with a chart which tells you how mich it should be...a spirometer may help too...also sold in drugstores and inexpensive..may help you a bit to know how your air flow stands..breathing exercises are also something worth investigating..best of luck with whichvever way you choose to go
Hi Elsabounre, yes heart side seems ok… however as someone touched on my peak flow tests seem fine. That would suggest the emphysema is not the cause of the breathlessness and points more to a heart problem I’m super confused by it all to be fair thxs for getting back to me 😀
Hi just to add my experience i had 2 ct angiograms with contrast the first one was inconclusive as there was artefact which basically means the image is not clear enough so I had another one which was inconclusive again ! The cardiologist rang me and said there was nothing to worry about put me on a cocktail of tablets and said if anything got worse go back to gp. I like you had no angina pains but I could hardly get up the stairs even holding on to 2 bannisters ! My son paid for a private cardiologist who referred me for a private ct scan it was 850 but the best money I have ever spent It showed a severely blocked lad and triple vessel disease. The private cardiologist rang the day after the scan ! I sent a copy to the nhs cardiologist who booked me in for angiogram through wrist and I had 2 stents fitted. I am not saying for one minute your situation is the same but I don't think having an inconclusive scan is acceptable. The nhs cardiologist would if totally discharged me and I would still have an over 90 percent blocked lad ! I realise a private ct scan is expensive and we are just normal people it was a lot of money but was so worth it. You must be very worried about all of this and you need answers ! Imust add that my new nhs cardiologist is brilliant ! Most people on here have had brilliant treatment from the nhs so maybe I was just unlucky. I would also say that since having my 2 stents it feels like I am breathing fresh air again the difference is amazing. Your situation could be totally different but if you don't want to wait 9 months and you can find the money for a private scan I would say its worth it for piece of mind . Good luck with everything
I don't think you were unlucky. A lot of people have treatment like that from the NHS. It can be very substandard and very dangerous with a lot of very casual clinical decisions being taken.
Hi poppy, I’ve not had the virus, god forbid. Although I have thought that I may have had it at some point and maybe didn’t realise. And that maybe has something to do with the breathlessness.
Hi Chris, I suffered similar symptoms to you and had a CT scan and told everything was fine. Like you I was always fit and did a lot of running and weight training however I too was exhausted and out of breath struggling to walk my dog. I pursued things through a consultant privately and had an angiogram which resulted in a stent for a blocked artery. I had a new lease of life after the procedure and returned to my physical exercise without any issues.
Hi Luke My mother had emphysema and your symptoms are the same as hers but as I know from myself it can also be heart related but my best guess is its the lungs Hopefully you will see them soon I had a angiography with dye before my heart valve replacement and I was told my lungs liver and kidneys wre all fine and the heart was my only problems
I've been back and forth to my doctor for 2 years now complaining of breathlessness. Spirometry test was better than expected for someone half my age, echo scan showed heart to be working fine. I also had an ordinary CT scan of my chest. I had a heart attack 5 years ago and 2 stents. At the time they found 2 more partial blockages that didn't need stents so now I'm waiting for a CT angiogram which I asked for a couple of days ago. I've found it very difficult to get answers. The only other possibility my GP could think of was that I have very bad upper spinal damage which could be causing muscular tightness affecting the vagus nerve.
My cardiac treadmill stress test with dye injected and an ECG showed narrowed coronary arteries and I'm now waiting on my angiogram test for next week. A year & half ago I had an MRI test done (constant cough) which showed a leaky mitral valve, some coronary arterial narrowing & small spots on my lungs so I went back 3 months later for another MRI to check if the spots had changed - thankfully they hadn't. Since then my cough has mostly gone but I had it for 2 years! Everyone is different & it sounds like you are being looked after.
hi there, If I was in your position I would perhaps ask for an MRI scan which has much better resolution. My neurologist and cardiologist have ended up scheduling MRI which I have had done following previous CT scans.
hi Luke, having been diagnosed with AF, had a CT scan highlight a narrowing in my RCA, two years ago. So they advised a follow up catheter angiogram, which showed my RCA was not blocked, they did a pressure test with a Boston wire, which read 0.9. 1 is completely unblocked, so they recommended medical management…..
are you taking any prescribed medicine or over the counter meds? I’ve had a lot of both of these over the last couple of years and all have affected my breathing quite badly.
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