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Question
Posted by: Hoosain | 2011/05/11

Heart risk?

Dear Doctor

I am 48 years old- never smoked (&  no alchol) in my life. My BMI is about 24.5. Blood pressure is normal (124/76), cholesterol (4.8-random) and blood sugar on the low side generally (never above 5.3, even after a meal).

But the problem is that I tend to tire very easily with shortness of breath and panting (even after sexual activity)- and generally just want to sleep (esp after a meal). I also have a touch of asthma (only on reliever pump)

Both my parents were diagnosed with angina in their 40''s. My father eventually died after a massive heart attack at age 68 years (although he was deemed fine 6 weeks prior to the event).
My mother is still alive at 67 years (have also diabetes, stomach ulcers, arthritis, hyperthyroid and asthma (2 years now).

My question: Can an ECG or stress ECG pick up a heart condition BEFORE the event and can an angiogram be done at this stage i.e to determine if any blood vessels are narrowing already?

Thanking you

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Our expert says:
Expert ImageCardiologist

Hi Hoosain, those are very good questions.

You do not have any of the traditional "risk factors" for coronary heart disease except unfortunately for your family history. Your tiredness may be completely unrelated to your heart, but clearly it is important to make sure whether or not your heart is the cause.

A stress ECG is a notoriously unreliable test for detecting coronary disease - it often fails to detect disease which is present ("false negative") and sometimes says there is disease when there is in fact none ("false positive"). It would neverteless be worth doing, with certain reservations.

If positive, you should then have an angiogram. However if negative, bear in mind the possibility of a false negative and have at least one additional test in the form of a coronary calcium score. This is a simple CT scan of the heart, without dye, to establish whether or not you have premature "hardening of the arteries". At the age of 48 you should have none. (Score zero.) If you have any hardening of the coronary arteries at all, with the symptoms you describe, then I would have an angiogram.

One way or another it is very important to establish without doubt whether or not you have coronary disease. Please arrange to see a cardiologist to help you resolve these questions.

I hope that is helpful. Best of luck

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1
Our users say:
Posted by: Cardiologist | 2011/05/17

Hi Hoosain, those are very good questions.

You do not have any of the traditional "risk factors" for coronary heart disease except unfortunately for your family history. Your tiredness may be completely unrelated to your heart, but clearly it is important to make sure whether or not your heart is the cause.

A stress ECG is a notoriously unreliable test for detecting coronary disease - it often fails to detect disease which is present ("false negative") and sometimes says there is disease when there is in fact none ("false positive"). It would neverteless be worth doing, with certain reservations.

If positive, you should then have an angiogram. However if negative, bear in mind the possibility of a false negative and have at least one additional test in the form of a coronary calcium score. This is a simple CT scan of the heart, without dye, to establish whether or not you have premature "hardening of the arteries". At the age of 48 you should have none. (Score zero.) If you have any hardening of the coronary arteries at all, with the symptoms you describe, then I would have an angiogram.

One way or another it is very important to establish without doubt whether or not you have coronary disease. Please arrange to see a cardiologist to help you resolve these questions.

I hope that is helpful. Best of luck

Reply to Cardiologist

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