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Question
Posted by: LN | 2011/10/05

Heart conditions

Dear Doctor

Just inquiring if angina or any other heart condition (eg blocked arteries) can be diagnosed before the event actually occurs.

I am 48 yrs old and both my parents was diagnosed with angina in their late 40''s. My father eventually died of a heart attack at 68 yrs.

My BP (124/83), sugar (6.4) and cholesterol levels (4.67) are all normal.
I am asthmatic and get frequent acid reflux.
I do not experience any chest pain, but am easily fatigued and become short of breath esp when climbing stairs.
However, it relieved when I take my asthma inhaler- not to sure if i may be masking the symptoms of angina by taking the pump.

Your advice will be greatly appreciated.

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Our expert says:
Expert ImageCardiologist

Dear LN.

The simple answer to your question - whether angina or any other heart condition can be diagnosed before the event actually occurs - is yes. You are obviously referring to coronary disease, which usually is present in mild form, without symptoms, for many years before it actually causes trouble such as heart attacks. The difficulty is to identify and then treat the condition long before it causes trouble. The traditional way to do this is with an exercise ECG. However exercise ECG’s by their nature cannot identify mild narrowing.

A much better test is to look for evidence of hardening of the arteries with a special x-ray (a CT scan) called a coronary calcium score. If at the age of 48 you already have some coronary calcification then you need to take cholesterol lowering medication even though your cholesterol is “normal”.

My advice would be to see your doctor and ask him to request a coronary calcium score on your behalf. A cardiologist or I can then help you to interpret the result.

Best wishes, JT.

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2
Our users say:
Posted by: Sue Hall | 2011/10/13

My husband had a heart attack Aug 4. We are on so much meds
it blows my mind. We Have had Our cardiologist give us meds, then he was out of town and his stand by cardiologist added a couple things then our family dr. who is not a cardiologist got involved and added some things. Now my husband has had dizzy spells when laying flat in bed and when first rising up to a sitting position. Once up and about he is fine. Along with dizzyness he
had vomiting and could not sleep or take any liquid or food. scarey.
One of these people put him by accident on two types of pills so he was getting double dosed by two different meds that did the same thing. Now we are being put on another drug and I am so sick of all the meds. Its like 14 pills.What to do? Too many fingers in the pie I say. Blessings to you Dr. Thanks sue

Reply to Sue Hall
Posted by: Cardiologist | 2011/10/11

Dear LN.

The simple answer to your question - whether angina or any other heart condition can be diagnosed before the event actually occurs - is yes. You are obviously referring to coronary disease, which usually is present in mild form, without symptoms, for many years before it actually causes trouble such as heart attacks. The difficulty is to identify and then treat the condition long before it causes trouble. The traditional way to do this is with an exercise ECG. However exercise ECG’s by their nature cannot identify mild narrowing.

A much better test is to look for evidence of hardening of the arteries with a special x-ray (a CT scan) called a coronary calcium score. If at the age of 48 you already have some coronary calcification then you need to take cholesterol lowering medication even though your cholesterol is “normal”.

My advice would be to see your doctor and ask him to request a coronary calcium score on your behalf. A cardiologist or I can then help you to interpret the result.

Best wishes, JT.

Reply to Cardiologist

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