Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would like to explain that your mom's uploaded medical data are insufficient to directly proceed to a coronary angiogram.

Though your mom has coronary risk factors such as diabetes and hypertension, her medical check up revealed a normal ECG (without specific ischemic changes, no arrhythmia or conduction disturbances evidence), no evidence of cardiac ischemia on cardiac ultrasound (wall motion abnormalities), no evidence of increased cardiac enzymes levels (in fact there is no confirmation that cardiac enzymes testing was done).

Coming to this point, a comprehensive differential diagnosis should be done between a cardiac ischemia and other alternative options, such as a backbone disorder (degenerative changes of the column and intervetebral disk), a musculo skeletal disorder, a bulous emphysema, GERD, etc..

For concluding about a cardiac ischemia it is necessary to perform additional provocative and cardiac imaging test such as :

-exercise stress testing
-stress (exercise of pharmacological) cardiac ultrasound
-coronary angio CT scan
-a stress nuclear cardiac test (CARDIOLITE).

These non invazive testing would properly rule in/out a potential coronary disorder underlying your mom's actual clinical symptomatology.

Other imaging tests would be helpful to differentiate alternative causes of chest pain:

-chest CT scan or MRI scan would investigate backbone degenerative disorders, pulmonary ailments
-a fibrogastroscopy for possible acid reflux, etc.

As you see further medical investigation is necessary to differentiate the responsible cause of her chest discomfort and coronary angiography would be the test of choice only if sufficient data about cardiac ischemia would be concluded.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Greetings!

Dr. Iliri

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Brief Answer:
My opinion as follows:

Detailed Answer:

Hi again, dear xxxxxxxxx

I am glad your mother is feeling better.

As your mother has coronary risk factors like diabetes and hypertension, there exists the possibility for potential coronary disease.

But, for properly addressing the right responsible cause of her complains, and hence ruling in/out a possible heart problem, I recommend following the above mentioned diagnostic work up, as it is the appropriate strategy for addressing a potential coronary problem.

Meanwhile, I would like to assure you that actually no evidence of even a minor heart attack is present.

So, you have to relax and don't worry too much, as you are right in time for a comprehensive diagnostic strategy.

Wishing a pleasant weekend,

Kind regards,

Dr. Iliri

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Brief Answer:
My opinion:

Detailed Answer:

Dear XXXXXXX

Coming to this point, I recommend you pursuing with the above recommended cardiac tests (exercise stress testing, coronary angio CT or nuclear cardiac stress test).

If they result positive, the next step is coronary angiography.

In case of any further uncertainties, please let me know.

You can reach me directly through the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Best regards,

Dr. Iliri

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