Angioplasty experience anyone?

[Mac Howard]

An ECG has just resulted in a diagnosis of "borderline repolarization abnormality". They intend to carry out an angiogram - which I'm ok with - but when the doctor admitted that this could lead to an angioplasty and a one in twenty chance of a heart attack I baulked and suggested we should investigate a drug, diet and lifestyle treatment first. Didn't go down well with him.

Anyone here have experience of angioplasty?

[DaddyTorgo]

didn't apathetic lurker have one?

[Apathetic Lurker]

nope....I bypassed this sissy procedure and went whole hog for a nice and simple quadruple bypass.....

Had an angiogram which led to the bypass.....Twas too late for the 'plasty


Seriously, better to deal with a possible heart attack on the slab while they putter around with a balloon than risking a possible heart attack while driving, working out etc etc....They have a much much better chance of dealing with it at that point.Have the angiogram done because it will give you the options that are available. Going the drug/diet/lifestyle path might still mean an angiogram sometimes in the future. And your heart might be a bit more damaged at that point leading to a greater chance of a heart attack.....


I'm possibly facing an angiogram in my near future, possibly in August.Which will more than likely lead to another bypass or if i'm lucky just a angioplasty. It all depends on the next stress test and EKG.....

[Tim Tellean]

I had angioplasty in 1995. We didn't know the odds until after. Weirdest part was watching my own heartbeat in 3d.
The procedure is dangerous and painful because they open a hole in your inner-thigh and push the camera to the heart. The compression bandage was on for 8 hours afterwards, and pinched my skin. Add that to you can't move while the blood clots.
It sucked.

[Apathetic Lurker]

[QUOTE=Tim Tellean;2479800]I had angioplasty in 1995. We didn't know the odds until after. Weirdest part was watching my own heartbeat in 3d.
The procedure is dangerous and painful because they open a hole in your inner-thigh and push the camera to the heart. The compression bandage was on for 8 hours afterwards, and pinched my skin. Add that to you can't move while the blood clots.
It sucked.[/QU

Ask for the camera in your wrist...The compression bandage is only on for about an hour or so afterwards...

[Mac Howard]

Thanks for your replies. The doctors put forward the same idea - better to have a heart attack in this controlled environment than in other circumstances. My problem is, however, whether I'm at risk in these other circumstances.

I've had five ECGs and three of them have said "nothing wrong". Two of them and the stress tests say I have a "borderline" problem. My symptoms are mild and do not correspond to normal angina (the only diagnosis mentioned so far). I have no problem with exercise of any kind. When I mentioned "unstable angina" - which has symtoms closer to my own - no one seems interested.

The reaction of the medical practitioners I've spoken to so far seems to be overreacting - I suspect because no medical organisation these days wants to be caught out not diagnosing heart disease - for legal not medical reasons. My suggestion, in the light of a very uncertain diagnosis, they should carry out the angiogram and we should then discuss the results before proceeding didn't go down well as my mentioning Internet information leading to my understanding of the 1-20 (actually 3-5%) danger of a procedure causing heart attack (can't trust the Internet I'm told). The fact they told me in the pre-admission that the chances were 1 in 100 when I later saw their own literature quoting the 5% figure does not fill me with great confidence that they have my best interests at heart (pardon the pun). That 1 in 100 figure was given me as I was asked to sign the document relieving them of any responsibility for problems that might arise during the procedure. I'm reluctant to say they lied but "disingenuous" fits the bill.

As you see, I don't have a lot of confidence in the doctors I've spoken with. On only one occasion - a junior doctor and young trainee doctor combination - did I feel anything I said had any interest for them. It was always "tell me about the chest pain" to which I constantly reply "I've never said I had chest pain".

It may be that angioplasty will be necessary but I want a part in that decision and I want it taken when we have a worthwhile diagnosis not taken without my input. It may be more expensive - but the government pays for it - so so be it.

[Apathetic Lurker]

You are grasping at straws and stalling the inevitable.....

Any surgery has a 3-5 or so percent chance of leading to death..Any surgery...

You dont want to pull a Bart and stall...I did and now i'm paying for it...

[fpres]

Thanks for your replies. The doctors put forward the same idea - better to have a heart attack in this controlled environment than in other circumstances. My problem is, however, whether I'm at risk in these other circumstances.

I've had five ECGs and three of them have said "nothing wrong". Two of them and the stress tests say I have a "borderline" problem. My symptoms are mild and do not correspond to normal angina (the only diagnosis mentioned so far). I have no problem with exercise of any kind.




This isn't meant to be taken as any kind of medical advice but just as general information...

stress test result > ECG result

ECGs are great for screening when you suspect something may be wrong. The problem is that it's more useful when it shows something abnormal (i.e., an abnormal ECG in a person with chest pain leads to a trip to the cath lab). If you have a normal ECG, however, all that tells you is that it showed normal cardiac characteristics during that 10-second period of time in which you were resting in a relaxed, reclining position. What happens to heart function in a stressed situation, whether that's an exercise stress test or pharmacologic stress test, gives you much more useful information. I've seen a guys with an acute MI and stone cold normal ECG.

All that aside, you're absolutely well within your rights to personally examine the risks and benefits of any potential procedure. If you have any questions or doubts whatsoever, bring them up with your doctors. Good doctors will take the time to discuss them with you.

[path12]

I had one around 1997. As far as whether or not to postpone it, I'd at least get the angiogram done and see what it says.

[Mac Howard]

You dont want to pull a Bart and stall...I did and now i'm paying for it...

Yes, that is a significant part in my thinking at the moment. But the delay need be no more than a couple of days if the procedure is necessary. And as they allowed a 2 week delay between the stress test and the angiogram then that would suggest they don't believe that a heart attack is imminent.

I'm going ahead with the angiogram - I have no problem with that. I would just like to be more certain that the angioplasty is necessary.

All that aside, you're absolutely well within your rights to personally examine the risks and benefits of any potential procedure. If you have any questions or doubts whatsoever, bring them up with your doctors. Good doctors will take the time to discuss them with you.

I wish I could say that I was dealing with "good doctors" as defined by that. There is, in fact, little willingness to discuss this. This is national health service medicine and doctors here do not see the same responsibility towards patients as they might in a private service.

Here is something I haven't mentioned: about two weeks before my symptoms started I had what I think might have been, not one, but two heart attacks while experiencing a neuralgia attack. I can't help but feel that this must have some significance to the present situation but no one seems to even listen to the story.

Angioplasty is about restricted arteries while the problem could be damage to the heart as a muscle. There are occasional palpitations and irregular heart rhythms which I think have more to do with heart damage than restricted blood flow.

Now I may well be talking absolute nonsense - an engineer not a doctor speaking - but I would like someone who is more knowledgeable to say so and explain why. While I appreciate the replies from you guys I had hoped there might be some medical specialists on the forum to explain.

For me, this is beginning to look more and more like an episode of House. It all began with toothache, moved to gum disease, then to neuralgia and finally to the heart. And I'm not convinced they have the problem solved even here.

And the puzzling context is this: I never felt better in my life :( :rolleyes:

[Mac Howard]

I had one around 1997. As far as whether or not to postpone it, I'd at least get the angiogram done and see what it says.

Absolutely! I have no problem at all with the angiogram. But I would just like more certainty that this unpleasant angioplasty procedure is necessary. Stress tests are said to be only 70% accurate.

[miked]

Yay for the internet, everyone is an expert!

Seriously, I doubt you have read all the studies, and there are likely to be 20 studies that say 1 in 100 and another 20 that say 5% risk. Maybe you should get a second opinion, but to think you've read some internet sites and understand everything is just silly...that's what it sounds like. If you have damaged cardiac muscle, it is most likely due to some ischemic event...especially if you have no history of high blood pressure or myocarditis. It is also quite possible that you've had silent MIs as well, or non ST elevated MI (which won't get picked up on ECGs as easily). Stress tests are the gold standard.

Maybe it's just me, but if I got an angiogram that showed blockages (since that is sort of the point), I'd kind of want them to clear it while I'm in the hospital with doctors around rather than just send me home.

[fpres]

Yes, that is a significant part in my thinking at the moment. But the delay need be no more than a couple of days if the procedure is necessary. And as they allowed a 2 week delay between the stress test and the angiogram then that would suggest they don't believe that a heart attack is imminent.



Not necessarily. In the U.S., this type of delay can and does happen. The delays have more to do with scheduling and availability of interventional cardiologists than it does with the findings on the stress test. (Of course, if someone's having an acute MI in the cath lab, that's a different story).




Angioplasty is about restricted arteries while the problem could be damage to the heart as a muscle. There are occasional palpitations and irregular heart rhythms which I think have more to do with heart damage than restricted blood flow.


That's part of the pathophysiology of heart disease though. Impaired coronary artery blood flow (whether permanent or temporary) leads to cardiac muscle deprived of oxygen leads to heart muscle damage/death. Restricted blood flow is the cause...heart damage is the effect. Two parts of the same process.


Now I may well be talking absolute nonsense - an engineer not a doctor speaking - but I would like someone who is more knowledgeable to say so and explain why. While I appreciate the replies from you guys I had hoped there might be some medical specialists on the forum to explain.


Cardiology isn't my specialty, but I see plenty of patients who have some form of coronary artery disease. My general recommendation for them is: If there's a good reason to be concerned about the heart (i.e., symptoms), it's better to be safe than sorry. And there's no such thing as an invasive procedure that doesn't carry with it some risk.

[path12]

Stress tests are the gold standard.

Maybe it's just me, but if I got an angiogram that showed blockages (since that is sort of the point), I'd kind of want them to clear it while I'm in the hospital with doctors around rather than just send me home.

This. My ECG's were unclear and it took like a month to diagnose (they were originally thinking digestive issue), but the first stress test had a weird blip so they gave me a second one where I had a severe angina response within the first few minutes. That was a Thursday. They had me in the next day for the angiogram and the stents went in two days after that.

Don't fuck with heart stuff. Better safe than sorry.

[Mac Howard]

Seriously, I doubt you have read all the studies, and there are likely to be 20 studies that say 1 in 100 and another 20 that say 5% risk.

The hospitals own literature says 5%. As this conflicted with the 1% given in my pre-admission interview I went to the Internet for confirmation. The figure I found was 3-5%.

Maybe you should get a second opinion, but to think you've read some internet sites and understand everything is just silly...that's what it sounds like.

There is a lot of garbage on the Internet but there is a lot of extremely informed stuff also. The trick is to figure out which is which. One of the sources I've used is a professor from the cardiology section of the Dept of Medicine at the University of Washington and on their web site. I suspect he knows a great deal more about heart problems than your average GP. He certainly doesn't agree with you that a stress test is "the gold standard" but merely a step up from a ECG but in need of better source of information such as a angiogram.

In the last 4 years I've been hung out to dry three times by the medical community - in one case by a very expensive shoulder specialist (anyone who has a "frozen shoulder" diagnosis should contact me). In all three cases they have waved me goodbye with a prescription for pain killers in my hand and the advice that my GP will supply me with repeat prescriptions - for the rest of my life. One of these problems is known as "the suicide disease" because the pain "is the worst known to mankind" (neuralgia). As a result of the Internet and my own persistence I am now free of pain from all three sources that the GP community thought to be permanent.

Your faith in this community is to your credit but misplaced. Because the majority of patients require certainty from their GPs then they tend to give it even where it doesn't exist. I'm not one of those patients. If the news is bad, then let me have it. If you're uncertain, then tell me so. But, worst of all, don't simply remain silent and leave me in limbo.

That's why patients turn to the Internet.

If you have damaged cardiac muscle, it is most likely due to some ischemic event...especially if you have no history of high blood pressure or myocarditis.

I'm grateful for that (and, no I'm not being facetious).

You see three weeks ago I was in the middle of an appalling neuralgia attack. I was on my knees on the floor pounding the carpet with one fist, gritting my teeth and every muscle in my body fighting off the excruciating pain (incidentally brought on by the antibiotics prescribed 4 days earlier). Suddenly there was an explosion inside my chest clearly from the area of the heart. Like being kicked by a mule. For around 3 seconds all sensations disappeared even the neuralgia pain - it was if I didn't exist. I recovered but around 20 seconds later it happened again.

A week later, for the first time in my life, I began to have symptoms indicating heart problems.

You think that might be worth considering in dealing with these heart problems? If you do then you're with me and not the GP.

That's not strictly true. Describing the event above was ignored until I suggested it was "possibly a heart attack". Suddenly my GP's ears pricked up and he admitted there might be something to investigate there.

A combination of heart disease as "the silent killer" and the possibility of litigation if it's not diagnosed has the medical profession in a blue funk about it. Nothing like mentioning a heart attack to get a reaction :)

Here's the problem when humans become fixated on a certain explanation for events:

Yesterday afternoon I suddenly had that pressure high up on the chest just between the ribs. Disappointed (because I've not had the problem for a few days) but observed it and added it to the list of symptoms (I don't normally have this in daytime but soon after waking up in the morning).

But then there was gurgling in the chest, I emitted a big burp, and the pain disappeared. It was wind!

That's the problem. When you are convinced of certain explanations then you start to see confirmations everywhere - even where they don't exist. My concern here is that the people I'm dealing with seem to have become fixated on an angina, even where I can find no angina described (either by them or on the Internet) that matches the symptoms I have, and are ignoring other possibilities.

And just to compound that, in a discussion I had last night with a retired nurse who was the matron of a private hospital for many years (an experienced nurse but not a doctor). On seeing my stress test graphs she suggested the problem could be a heart valve that is slow to close and allowing a small drop in blood flow (the graph shows a small negative transition immediately after the T pulse - the pulse of flow that comes from the heart muscle "repolarising" or resetting after the pump pulse.) Heart valve damage might have occurred during those chest impacts.

She went on to say that the effect was "very tiny" and "borderline" doesn't really cut it.

Maybe it's just me, but if I got an angiogram that showed blockages (since that is sort of the point), I'd kind of want them to clear it while I'm in the hospital with doctors around rather than just send me home.

As I keep saying - the angiogram is fine. That will give us a much greater certainty than the stress test. But I wish to discuss the results of the test before moving on to the angioplasty. The doctors, who I think are as concerned about the cost as anything else, want permission to go ahead without any further input from me.

As a professional engineer who once spent a few years trouble-shooting large computer systems for a living, I know that some of the worst decisions are made when only part of the information is available or taken into account. I replaced many a "faulty" component or board only to find the problem was elsewhere which could well have revealed by deeper investigation. You tend to take the easy option. I don't want a dangerous procedure like an angioplasty to go ahead only to find nothing is fixed and with the possibility of muscle damage and/or valve damage then that is a significant possibility.

Both my sister (step sister - no familial connection) and my nephew (her son) have had angioplastys. Neither fixed the problems they had. Both had dangerous angioplasty procedures, presumably believed to be necessary by their medical advisers, and both procedures proved to be ineffective. Both went on to have bypass surgery.

That's another problem revealed "on the Internet" but confirmed above - angiplastys are only temporary fixes. There is no longevity associated with a angioplasty fix.

If all this seems very arrogant then let me point out that I'm not saying what the problem is but merely pointing out that there seem to be several possibilities which appear to be being ignored. The nurse I spoke to last night was surprised for example that no scan had been made of the heart which might well have revealed valuable information. As far as I can see nothing outside of angina related problems are being investigated.

I could be completely wrong on that - but the lack of any worthwhile communication on the subject is the cause if that's so.

[Mac Howard]

Not necessarily. In the U.S., this type of delay can and does happen. The delays have more to do with scheduling and availability of interventional cardiologists than it does with the findings on the stress test. (Of course, if someone's having an acute MI in the cath lab, that's a different story).

I imagine the same here. But I was already in a hospital bed, the stress results revealed only a "borderline" problem (which has recently been described as "tiny" by an experienced nurse). If a heart attack had been imminent I think, at the very least, they would have kept me in and not sent me home for a fortnight. They're as afraid of litigation here as much as the US and if they'd sent me home and I'd died from a heart attack my family would have been living in a mansion for the rest of their lives :)


That's part of the pathophysiology of heart disease though. Impaired coronary artery blood flow (whether permanent or temporary) leads to cardiac muscle deprived of oxygen leads to heart muscle damage/death. Restricted blood flow is the cause...heart damage is the effect. Two parts of the same process.

The problem seems to be a small negative transition after the T pulse. I have no adverse physical reaction (ie chest pain or breathlessness) during even extreme physical stress whatsoever. There was no physical stress at all during or after the stress test.

Doesn't this push it away from "stable (effort) angina" and towards 'unstable (crescendo) angina" if it is angina at all?

Cardiology isn't my specialty,

But I do value your contribution.

And there's no such thing as an invasive procedure that doesn't carry with it some risk.

But a 1 in 20 chance of a heart attack is a little more than "some". Am I wrong to think that before such a procedure takes place, assuming there is no evidence of an imminent attack, a scan of the heart should be made? I was asked several times "have you had a xxxxx (can't remember the term) heart scan?". The answer was "no" but no scan was forthcoming.

Can you understand why I'm thinking that not everything that can/should be done first has been?

[fpres]

You see three weeks ago I was in the middle of an appalling neuralgia attack. I was on my knees on the floor pounding the carpet with one fist, gritting my teeth and every muscle in my body fighting off the excruciating pain (incidentally brought on by the antibiotics prescribed 4 days earlier). Suddenly there was an explosion inside my chest clearly from the area of the heart. Like being kicked by a mule. For around 3 seconds all sensations disappeared even the neuralgia pain - it was if I didn't exist. I recovered but around 20 seconds later it happened again.

A week later, for the first time in my life, I began to have symptoms indicating heart problems.


What you described above should really be investigated in a comprehensive manner if that hasn't already been done.


They're as afraid of litigation here as much as the US and if they'd sent me home and I'd died from a heart attack my family would have been living in a mansion for the rest of their lives :)


Perhaps this is where your answer lies. For better or worse (mostly worse), defensive medicine is the law of the land (in many parts of the world, I imagine). Even as a huge proponent and practitioner of evidence-based medicine, I'm cognizant of the medicolegal aspect of everything I do and how it *does* affect some decision-making. Any healthcare provider who says that it doesn't to at least some small degree is delusional, lying, or reckless.


Doesn't this push it away from "stable (effort) angina" and towards 'unstable (crescendo) angina" if it is angina at all?


I can't say one way or another. Medicolegal reason aside, I prefer to read printouts myself and come to my own conclusions. No offense intended...I don't go by the interpretations of physicians I don't know well enough to trust either.


But a 1 in 20 chance of a heart attack is a little more than "some". Am I wrong to think that before such a procedure takes place, assuming there is no evidence of an imminent attack, a scan of the heart should be made? I was asked several times "have you had a xxxxx (can't remember the term) heart scan?". The answer was "no" but no scan was forthcoming.


Sorry, I wasn't aware that no echocardiogram was done. It's standard-of-care in the U.S. to check an Echo with doppler study at around the same time that a stress test is done.

Yes, an echo should generally be done as a first-line test before more invasive procedures (assuming it's a non-emergent situation). It really is the best way to assess for the presence of valve problems or heart failure.

[Mac Howard]

What you described above should really be investigated in a comprehensive manner if that hasn't already been done.

Precisely my reaction. It was the reason I went to see the GP in the first place.

The reason I speak of an "obsession" or "fixation" is because it was on mentioning a mild discomfort in my chest that this event - which, for me, is clearly the most outstanding event of the current problems and impact on the heart - is simply ignored. I can't believe that, if there is a heart problem, this can be ignored and surely it has to be dealt with as part of the investigation.

All I've had from doctor after doctor is "Tell me about the chest pain" which has been answered by "I've never said I had chest pain". But no one has ever asked about this event. I've tried to tell every one about it but it generates no interest at all. At least not until I described it as "possibly a heart attack". Not that that interest went very far.

I can't say one way or another. Medicolegal reason aside, I prefer to read printouts myself and come to my own conclusions. No offense intended...I don't go by the interpretations of physicians I don't know well enough to trust either.

But from the symptoms alone. There is no physical stress of any sort from exercise. None whatsoever. I occasionally go into the gym - treadmills, rowing machine, weight lifting - no ill effect. No ill effect in the stress test. 2/3 kilometre runs down Surfers Paradise Esplanade each day - no ill effect.

What distress I have - very, very mild - occurs 10 minutes or so after I wake up while I'm lying in bed and once while watching TV.

I do not buy that this is stable or effort angina. My step-father (no familial connection) had effort angina for 30 years. This is nothing like it as far as the physical symptoms go. From the descriptions, it is similar to unstable or crescendo angina (except that attacks have not increased in severity so far). The diagnosis on the stress test print out is "borderline repolarization abnormality", "abnormal inferior Q waves" and "minimal ST depression".

Mentioning unstable angina has not invoked a response, either positive or negative, from the GP I spoke with.

Sorry, I wasn't aware that no echocardiogram was done. It's standard-of-care in the U.S. to check an Echo with doppler study at around the same time that a stress test is done.

Yes, an echo should generally be done as a first-line test before more invasive procedures (assuming it's a non-emergent situation). It really is the best way to assess for the presence of valve problems or heart failure.

They keep asking if a scan has been done but when answered "no" they move on and nothing happens on this front. I feel, at times. like I'm being railroaded towrds the angioplasty while little effort is being used to look at this problem comprehensively. I feel they're running headlong down one path while ignoring all other possibilities.

To be perfectly frank, if it hadn't been for the neuralgia-induced impacts to my chest, the other symptoms are so mild I would never had seen a doctor at all.

Maybe I'm lucky and they've picked up a problem in the very early stages accidentally. But I would have appreciated a great deal more explanation if this was so. If an angioplasty is necessary then, of course, I'll have it though what I've read suggests it's only a temporary solution. But I have not only not been convinced but little attempt has been made to communicate the severity or otherwise of the situation at all.

This is, of course, "socialised medicine" where the idea that patients are client or customers is down to the personality of the doctors not demanded as part of the service. Few doctors seem to have the appropriate personalty for this and an obsequious attitude from the patient tends to be required. As you will have gathered from these posts that really isn't me and on my previous experiences of the Australian national service a critical approach is certainly justified.

[fpres]

This is, of course, "socialised medicine" where the idea that patients are client or customers is down to the personality of the doctors not demanded as part of the service. Few doctors seem to have the appropriate personalty for this and an obsequious attitude from the patient tends to be required. As you will have gathered from these posts that really isn't me and on my previous experiences of the Australian national service a critical approach is certainly justified.

I don't know if you have the ability to see a second GP given your health system's protocol. If it's possible, it may be something to consider. You're obviously not comfortable with the handling of this situation, so maybe a fresh pair of eyes and ears may be more receptive to your concerns.

If you like, I can e-mail you some relevant evidence-based reference material (unbiased) that you may not have access to. Just PM me your e-mail address if you're interested.

[Mac Howard]

I don't know if you have the ability to see a second GP given your health system's protocol. If it's possible, it may be something to consider. You're obviously not comfortable with the handling of this situation, so maybe a fresh pair of eyes and ears may be more receptive to your concerns.

If you like, I can e-mail you some relevant evidence-based reference material (unbiased) that you may not have access to. Just PM me your e-mail address if you're interested.

In fairness to the "system" - I've recently moved into Surfers Paradise which is the holiday/tourist capital of Australia. At any one time two thirds of the town's population are holiday makers or tourists and the GP clinics are set up to handle the short-term problems that these bring. You can't make an appointment to see a particular doctor for example - you just walk in and whichever GP is first available will deal with your problem. It's ok in that you need only walk in with your problem and you'll see a GP within a half hour but there is no way of establishing a relationship between patient and doctor in this environment. As soon as this is over (I go back into hospital tomorrow morning) I'll look to register with a GP clinic outside of Surfers.

I think the problem is because of the limited communication between the GP I saw and the hospital. The GP was told the full story - including the neuralgia induced attacks - but when I mentioned a mild chest discomfort when I woke an hour earlier he immediately had the ECG done. Seeing the result he said "You haven't had a heart attack but there's something unusual in the printout and I want you to go up to the hospital.

As far as I can see the only information the hospital received was this printout. They looked at that, lay me on a bed in the emergence room and from there on their first question was always "Tell me about the chest pain" which I usually replied with "Well I wouldn't call it a chest pain it was just a bit of discomfort".

They did their own ECG and it showed nothing. I heard one doctor say to a nurse "I don't see what the GP has seen".

I was on a trolley in the emergency department for seven hours (they wanted to do a second blood test which they said had to be done several hours after the first) during which they did another ECG which did repeat the GP's result I was spoken to by at least 5 doctors, mostly junior but one consultant, and I tried to explain to them the neuralgia chest impact but lying on your back talking to doctors who are merely interested and not involved didn't achieve anything.

All this time I felt that they were obsessing on the very mild "chest pain" and ignoring what I felt was a very significant impact on the heart. But I couldn't get away from "Tell me about the chest pain".

There was something of a "patients should be seen and not heard" aspect to this period of the proceedings :rolleyes:

They put me into a cardiac ward overnight to take a stress test the following day. The other five patients in the ward really looked like they needed to be there and I - feeling absolutely fine - felt like a fraud. I mentioned that to the ward sister and she just laughed.

It was the ward sister, who had come in to tell me that the second blood test was ok, who showed me the three ECGs and explained what they were looking at and how the second (the first in the hospital) did not have the same problem as the other two and that the stress test would probably confirm the suspicion there was a problem.

The stress test however came up with a "borderline" result and confirmed again that I had no physical distress from exercise - which I find counter-intuitive if the problem is a restricted artery.

About an hour after the stress test I was visited by a doctor who said I could go home but made an appointment for an angiogram - which he said would remove the doubts one way or another - in a fortnight's time.

It was during the pre-admission talk with a junior doctor and a trainee (an absolutely gorgeous young Asian girl - my blood pressure soared :) ) that mention was made of a possible angioplasty and even by-pass surgery.

Both are very serious, indeed dangerous, procedures and I certainly haven't seen anything either from my own symptoms (I feel as good as I ever) or evidence/diagnosis/description from medical staff to justify it. Being sent home with a prescription for aspirin and a "See you in a fortnight" does not suggest that they believed a heart attack was imminent in these times of knee-jerk litigation.

What particularly troubles me is that, as far as I can see, no investigation has been made as to any other form of heart problem. No scans, just the ECGs, blood tests and the stress test. I can't help but feel that those impacts during the neuralgia attack - by far the most frightening experience I ever had - might have caused problems other than restriction of an artery and that possibility should be investigated.

I'm ok with the angiogram and that will go ahead tomorrow morning but I would be much happier about the angioplasty if the other possibilities had been/are investigated before proceeding with that.

I've seen the GP recently and said much of what I've said above. He agrees that the neuralgia heart impact should be investigated but became a little huffy when I suggested that the angiogram should be done and then the results should be discussed with me before proceeding with whatever treatment was thought necessary. That did not go down well with him.

Despite his agreement that further investigation of other heart problems should be made he made no suggestion of a subsequent visit and this clinic system means that if I just go in there to see someone there is only a one in eight possibility that he will be the GP that I see.

Thanks for your offer of extra information - my email address is [email protected] - but I guess I will have had the angiogram (at least) before I read it.

[DaddyTorgo]

You'll be fine Mac. Hoping it's no big deal for ya tomorrow.

[Mac Howard]

You'll be fine Mac. Hoping it's no big deal for ya tomorrow.

Thanks, Daddy. As I'm lying there for an hour and a half just waiting for the heart attack to happen I'll remember your good wishes :banghead: :)

[Mac Howard]

Thanks for your information, fpres.I haven't read it yet - this is the first time I've been able to log on to the internet since last Thursday (I went to my sisters after leaving the hospital and they don't have any worthwhile connection). Will read your email fully later.

It's the usual good news/bad news situation.

The good news is that the angiogram showed there was no problem with restriction of arteries. There was no need of any further procedures - I was on the table no more than 30 minutes. I'm advised that there is some build up of the usual gunk in the arteries but "consistent with your age" and the advice to the GP was "medical therapy".

The bad news is that we don't know what the problem is. There is no question that there is some heart problem - hopefully minor - but I'm not being given any information at all yet in the way of a diagnosis. A nurse did comment in looking at my file that one blood test did reveal a small "leakage" which might be consistent with a heart valve problem.

They've arranged an echocardiogram for this coming Thursday at another hospital. Wish they wouldn't do that as there's always the possibility of a failure of communication when bureaucracies are miles apart.

So, we start all over again with the added info that this isn't caused by arterial restriction.

[Swaggs]

Bump... anyone know what happened to Mac Howard? Was browsing some older stuff and came across his name and realized I hadn't seen anything from him in a long time.

Looks like he was last on the board almost a year ago and I did a search and saw this was the last thread that he started. Hoping everything is alright with him (looks like SaaP is still up and running?).

[stevew]

Looks like he posts about Australian politics on some of their news sites, as of a few months ago. Probably just doesn't visit here any more.