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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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History Of Multiple Sclerosis. Tried A Dose Of Tysbri, Had Allergic Reactions. Tests Show Minor Plaque, Tricuspid Valve Leak. Suggestions?

I am 48 years old with only a Hx of MS. I tried my 1st dose of Tysabri in November and had an allergic reaction and they stopped the med and gave me Benaddryl and steroids. Since I am very lightheaded, SOB and have chest pain. I can not tolerate any activity. My Neuro says it is Cardiac. I had a Chest CT that just shows some minor plaque, my echo only show a Tricuspid Valve leak mild- mod. I had a nuclear stress test that made me lightheaded, SOB and gave me some chest pain. The results show my heart rate accelerates to fast, there is poor Cardiac perfusion in one section of the heart and Aortic enlargement. A Cardiac Cath is recommended, what do you think it may show, and what kind of tx is needed. I know I need this test, but I am frightened to do it. I really don t have a choice as I can not tolerate any activities. Need some advice, or what to ask the Drs.
Tue, 23 Apr 2013
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Cardiologist,  's  Response
The objective of the Cath will be to see directly into the arteries of your heart; if blockages are seen and your doctors think that they may correlate with your symptoms, then the options for management would be intensive medical therapy, balloon angioplasty with stenting (if focal, few blockages are noted) or bypass surgery (if high risk features or several blockages noted). you already have a cardiac imaging test showing abnormal perfusion, in the setting of ongoing, unclear symptoms I believe the angiogram makes sense.

Hope this helps,

Dr Brenes-Salazar
Mayo Clinic Rochester
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History Of Multiple Sclerosis. Tried A Dose Of Tysbri, Had Allergic Reactions. Tests Show Minor Plaque, Tricuspid Valve Leak. Suggestions?

The objective of the Cath will be to see directly into the arteries of your heart; if blockages are seen and your doctors think that they may correlate with your symptoms, then the options for management would be intensive medical therapy, balloon angioplasty with stenting (if focal, few blockages are noted) or bypass surgery (if high risk features or several blockages noted). you already have a cardiac imaging test showing abnormal perfusion, in the setting of ongoing, unclear symptoms I believe the angiogram makes sense. Hope this helps, Dr Brenes-Salazar Mayo Clinic Rochester