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Here’s The Situation. Me: 70 Yrs Old 5’4” 137 Pounds
Question: Here’s the situation.
Me:
70 yrs old
5’4”
137 pounds
Never smoked
Take no drugs, except for 1 low dose aspirin a day as recommended by primary care physician
Above average cholesterol
Above average BP
Heart disease on both sides of the family
Active, exercised pretty much every day for last 50 years; also run about 25 miles a week
No personal history of illness; no surgeries; no hospital stays; vegetarian; one beer a day. Committed to clean living and good diet.
Several weeks ago I went to a hospital emergency room because of mild chest pain. No other heart-related symptoms (e.g., shoulder/neck pain; sweating; out of breath). I believe it may be gas; I belch a lot. ER Dr. wouldn’t agree or disagree. Based on EKG and blood test, said pain didn’t appear to be heart-related; said I had a “2” score or 0.99 percent risk of heart attack in next several years. He also very strongly recommended an exercise stress test.
I had the test yesterday. The cardiologist produced this report: “Borderline positive test with apicoseptal akinesis during exercise. EF 60%” The Dr. said the akinesis was at one end of the valve and that the majority of the valve was pumping properly. I asked him if it was serious. He said all heart disease is serious. He said it could be a false positive, but there was 85 percent certainty it was accurate.
Other readings:
Exercise time: 10:16 XXXXXXX HR: 144 (stage 4; 00:44)
% of Predicted: 95% of 151
Peak RPP: 302MTWA Result -0 XXXXXXX BP 210/90 (It was actually 220/90; at this point the Dr. stopped the treadmill because of the high BP; I was perfectly comfortable and could have continued). XXXXXXX Exercise 12.3 METS
Mas ST Depression 1.4 mm in VI (Stage 3 02:58
Dr. recommended a CT coronary angiogram and gave me an Rx for Bystolic. Perhaps the Dr. was being conservative, but I feel short-changed by his opinion. I would just like to know what kind of risk I’m facing. Based on this information, do you have any thoughts?
Thank you.
Bill Schillaci
Me:
70 yrs old
5’4”
137 pounds
Never smoked
Take no drugs, except for 1 low dose aspirin a day as recommended by primary care physician
Above average cholesterol
Above average BP
Heart disease on both sides of the family
Active, exercised pretty much every day for last 50 years; also run about 25 miles a week
No personal history of illness; no surgeries; no hospital stays; vegetarian; one beer a day. Committed to clean living and good diet.
Several weeks ago I went to a hospital emergency room because of mild chest pain. No other heart-related symptoms (e.g., shoulder/neck pain; sweating; out of breath). I believe it may be gas; I belch a lot. ER Dr. wouldn’t agree or disagree. Based on EKG and blood test, said pain didn’t appear to be heart-related; said I had a “2” score or 0.99 percent risk of heart attack in next several years. He also very strongly recommended an exercise stress test.
I had the test yesterday. The cardiologist produced this report: “Borderline positive test with apicoseptal akinesis during exercise. EF 60%” The Dr. said the akinesis was at one end of the valve and that the majority of the valve was pumping properly. I asked him if it was serious. He said all heart disease is serious. He said it could be a false positive, but there was 85 percent certainty it was accurate.
Other readings:
Exercise time: 10:16 XXXXXXX HR: 144 (stage 4; 00:44)
% of Predicted: 95% of 151
Peak RPP: 302MTWA Result -0 XXXXXXX BP 210/90 (It was actually 220/90; at this point the Dr. stopped the treadmill because of the high BP; I was perfectly comfortable and could have continued). XXXXXXX Exercise 12.3 METS
Mas ST Depression 1.4 mm in VI (Stage 3 02:58
Dr. recommended a CT coronary angiogram and gave me an Rx for Bystolic. Perhaps the Dr. was being conservative, but I feel short-changed by his opinion. I would just like to know what kind of risk I’m facing. Based on this information, do you have any thoughts?
Thank you.
Bill Schillaci
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello XXXXXXX
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that these TMT findings are suggestive of myocardial ischemia induced by physical straining and raise suspicion of coronary artery and stenosis.
Anyway, you shouldn't worry because as all the other tests result normal, it indicates that your cardiac muscle is not damaged (intact) and you are at the right time to prevent any possible damage.
It is important to go further with your clinical investigations.
For this reason, I agree with your doctor that a coronary angio CT scan would help clarify the presence and extension of coronary artery disease.
In the meantime, I would recommend continuing taking daily baby aspirin, avoiding straining physical activity and following a healthy lifestyle (regular physical activity, Mediterranean diet recommendable).
Hope you will find this answer helpful!
Wishing all the best,
Dr. Ilir Sharka, Cardiologist
I would recommend as follows:
Detailed Answer:
Hello XXXXXXX
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that these TMT findings are suggestive of myocardial ischemia induced by physical straining and raise suspicion of coronary artery and stenosis.
Anyway, you shouldn't worry because as all the other tests result normal, it indicates that your cardiac muscle is not damaged (intact) and you are at the right time to prevent any possible damage.
It is important to go further with your clinical investigations.
For this reason, I agree with your doctor that a coronary angio CT scan would help clarify the presence and extension of coronary artery disease.
In the meantime, I would recommend continuing taking daily baby aspirin, avoiding straining physical activity and following a healthy lifestyle (regular physical activity, Mediterranean diet recommendable).
Hope you will find this answer helpful!
Wishing all the best,
Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Sharka:
Thank you. I will be seeing my primary care physician next week to go over the data. If he agrees that a coronary angio CT is in order, then I will go ahead with that. I am not going to argue with the same recommendation from three doctors.
Your's is an excellent service. Best of luck with your practice.
Regards,
Bill Schillaci
Thank you. I will be seeing my primary care physician next week to go over the data. If he agrees that a coronary angio CT is in order, then I will go ahead with that. I am not going to argue with the same recommendation from three doctors.
Your's is an excellent service. Best of luck with your practice.
Regards,
Bill Schillaci
Brief Answer:
You are welcome!
Detailed Answer:
Dear XXXXXXX
Glad to have been helpful to you!
If you have any other questions in the future, please feel free to ask me directly at any time!
I would be glad to answer all of your questions or review your future tests for a second opinion!
Wishing all the best,
Dr.Iliri
You are welcome!
Detailed Answer:
Dear XXXXXXX
Glad to have been helpful to you!
If you have any other questions in the future, please feel free to ask me directly at any time!
I would be glad to answer all of your questions or review your future tests for a second opinion!
Wishing all the best,
Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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