
What Do My Lab Test Reports Indicate?

I just have a quick question. My overall health has improved tremendously since being put on nadalol and nexium. Basically was told I had Hiatal hernia with gerd that was causing rhythm disturbances. I was cardioverted a few years back with Afib and was told I had Sleep Apnea. Well I am feeling great today, had holter monitor that revealed nothing a few months ago, a few PVC's, had a stress test in 2013 and a radioactive test this year march 2015 when I was having sinus tachycardia for hours.The report showed everything good, efraction rate 67 and no blood flow issues and I was released. As info blood work taken in Hospital and LDL is 79, total cholesterol is 155 and sugar is 94. yes i could lose a few pounds. Had a calcium scoring in 2013 and my score was 23.8, showed a little plaque in LAD area, all others were 0.
Okay, heres the question, when should I get worried that I may get some blockage, Im hoping I wont but you never know. Im trying to be very active in preserving my health. How good is the nuclear stress test good for in relation to blockage. When should I get another calcium scoring? I just want to make sure I take the appropriate steps to get things done. Is there any tests you recommend and how often. Right now my pulse stays between 55-70 all the time. When I do exercise my pulse may go into 100 or so but comes right back down to the 70's within a few minutes.
Thank you
All your reports are perfectly ok . maintain healthy lifestyle
Detailed Answer:
Hello I went through all the details you have provided and I would quickly and precisely answer your concern .
1) All the reports till now shows you in perfect health , your lipids are also very good and no treatment needed for the same
2) the heart rate response to exercise you describe is because of nodalol and it proves that the drug is acting adequately
3) the calcium score mentioned is very insignificant , however as lad is the most important vessel we should take care that it doesn't increase
4) At your age and considering a small plaque calcium scoring and sos CT angiogram once after 3 years and than after 45 years of age once in 2 to years. Though if there is no change in plaque status you may prolong the interval between two scan . By all means not to do 2 scans in a year as the ill effects of radiation is not worth
5) nuclear scan will only go positive after critical blockage develops such that during exercise the arteries don't meet the demand of the heart , so in your case it isn't the best test at present as our aim is preventing you to reach the stage of critical blockage.
However it's a very good teat to know the functional status of the heart.
A simple treadmill stress echocardiography would be non invasive and good enough test in your case which you can do every 15 - 18 months as part of your routine check ups
6) now the plaque can behave in two ways .
One - it will slowly grow and close critical stenosis, the info we will be able to know with the help of these functional stress test
Two- the soft plaque may rupture resulting in an heart attack , one which we can prevent by
Keeping your lipids in check , maintaining healthy lifestyle and good diet habits - which you are already doing .
So keep on with a healthy lifestyle and everything would be ok .Hoping I could help .
Let me know if any clarification needed , I would be happy to help .
Regards Dr Priyank Mody, Cardiologist, XXXXXXX

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