my ecg is normal. my tmt exactly 2 mths ago was normal. got an echo done now and all is normal except Mitral valve abnormal e/a reversal. i have been in lot of stress and my bp has been high for last one week.
Optional Information: Person's Gender: Male Person's Age: 37
why did you have these tests done?
And what is your question today?
sir i got these tests done coz i was under going lot of stress, hadnt slept in last 5-6 days due to a heart attack to a close family member. so got my bp testes which is normally 16/86, but now it was 156/100. i have been in stress for last 3 months and so just as full health check up had got my ecg and tmt done on 4th may which was absolutely normal. thus got my echo done now for my comfort and it shows everything normal except mitral valve doppler abnormal e/a reversal
It does not appear to me that any of these tests should have been done. That's the problem with doing tests without specific reason, or without a good reason for looking for a specific finding. So many things are evaluated in an echo that almost everyone will have something that is outside the range of "normal." E/a reversal in the absence of any other "abnormality" is of no medical significance. It's sometimes seen in people with longstanding high BP (rather an unlikely explanation at your age) and in patients with a certain kind of congenital cardiomyopathy (which if you had it, it would unquestionably have been shown by the echo). If your concern is the e/a reversal, rest assured that it is of no importance in your case.
the tests had been done sir coz i had been experiencing chest tightness in the last 2 months. Docs diagnosed it as SEVERE GERD but for my comfort as i suffer from anxiety and panic, the said u get these tests to calm u down which the ecg and tmt done 2 months back did. but now with this family issue, i again went into lot of tension and bp went too high, so i got echo done as i had left it last time 2 mths back.sir ur advise is i should not be worried. all my blood work is fine except my ldl is 76 but my hdl is 26. There is no history of heart problems in my father or mother side's family.
Getting tests because of patient anxiety is fine unless the tests are not completely "normal," in which case the anxiety just gets worse. The exercise test may have been reasonable, and the fact that it was normal should be reassuring that your symptoms were not a sign of a heart problem. You do have a low HDL, but keeping physically active, eating a good diet, and maintaining a normal weight (and, obviously, if applicable, not smoking) is the only "intervention" that is appropriate for you.
yes i have become overweight in the last one year. before that i sued to jog for 8 kms every day, 7 days a week. but due to work pressures stopped it and was on wrong diet. yes i have been smoking only for the lat 1-11 yrs and now am on quitting program.
sir can i start running and cycling with these tests reports. nothing to worry sir?
Yes. And such behavior is strongly encouraged!
i have been noticing palpitations..a forced orheavy beat now and then when i am sitting or lying and butterfly like feeling in chest. Docs here say all due to stress..is that true?
and lastly should i take a bp medicine for a week. my doc wants me to
Stress certainly can cause such palpitations. They are usually due to extra heart beats. Extra heart beats, either premature ventricular or premature atrial contractions (PVCs or PACs), are extremely common, and almost everyone has them at one time or another (although not everyone is aware of them). They are almost always benign, but if they are really bothersome to you, you may want to get a heart monitor (there I go, suggesting another test, after what I've said!) There are two main kinds of monitors. A Holter monitor records every heartbeat, but is usually worn only for 24hrs. Unless you are sure that you will have your symptoms during a random 24hr period, you may want to have your doctor order an event monitor. This monitor can be worn for as long as it takes for you to have your symptoms (usually up to 30 days), and will record automatically whenever you have an abnormal rhythm, plus any time that you press the "Event Button" on the monitor (as you would when you have your symptoms). But unless your palpitations persist, and are really bothersome, further testing is not needed.
What BP med was prescribed?
nubeta 2.5 once a day for 7-10 days
I see no reason not to try it. It's a safe med, and if you end up needing a med to control your BP, this will have been a test run.
but is it possible that after a week of this med i may not need to use bp med. bp may settle down on its own
That's possible, particularly if your stressful situation improves and you resume your exercises and proper diet.
u there sir
Yes. Do you have any more questions?
yes sir, my final thing..if tests r normal then what is the reason for this chest tightness, vague left shoulder pain. n how long before these tests results change. when should they be repeated.
N started excercies yday n aduring brisk walk developed left arm pain which inx during the day and then subsided after nearly 24 hrs later
Such symptoms often never get a specific diagnosis, and are probably due to musculoskeletal strain or even vague conditions such as fibromyalgia. With a normal stress test and echo, the chances that your symptoms are due to a heart problem are very low, but if you continue to have L arm pain with exertion, perhaps a more specific stress test (such as one done with nuclear imaging) should be done. But my guess is that test would be normal, too, and you still would be without a diagnosis.
Not a very satisfactory result, but unfortunately, that's not an uncommon situation. But so far I am reassured that your heart is okay.
so should these 3 tests be done regularly every month or 6 months or yrly.
I would not recommend repeating any tests already done unless your symptoms change. Would you mind going to http://hp2010.nhlbihin.net/atpiii/calculator.asp and using the risk calculator there, then posting your result back here.
Ok
Lastly sir when read on net, ppl post that all tests were normal but still when they went further down, it was hrt or suffered heart attacks shortly after tests. y is this so. thanks for all the help.
That can happen, which is why I mentioned the nuclear stress test, and asked for your risk score.
That's quite high for someone you age, although it still means that if we observed 100 people like you for 10yrs, only about 3 of them would have a heart attack or begin to have symptoms from coronary artery disease (CAD). In my practice I would do further testing, probably a nuclear stress test, or an exercise test done with echocardiographic monitoring (a "stress echo"). Alternatively, an angiogram could be done as the next step. In the meantime you MUST stop smoking.
And take the nubeta.
i am taking nubeta 2.5 now
Please realize that I cannot provide specific advice or recommendations for you, I am just telling you what I would advise and recommend to one of my patients who was in a situation that appeared to be similar to yours. But since I have never examined you, and do not know all of your medical history, this advice may turn out not to be appropriate for you.
And daily aspirin would be a good idea as well.
but your feeling is that my heart should be okay. And if i start excercises again and quit smoking immed my risk would reduce
Correct.
But if your exercising brings on your arm pain, I would cut back until you can get further evaluation.
thank u sir. it is very reassuring for me. i would quit as i am already on with the quitting prog. Will excercise and yoga (already started) to get bp under control. I should be fine i feel.
Good plans
this arm pain jus hppened once. nvr before. i used to run 8 kms till smtime back
If the arm pain (or chest pain) is brought on by exertion, it suggests you are overstressing your heart. That may not be the case, but such symptoms should be avoided until more evaluation has been done.
If it hurts, stop doing it.
ok sirthanks a ton.help appreciated
You're quite welcome. Good luck.
will work to get the risk below 1%. its possible with lifestyle changes ??
Yes. For example, just run the risk calculator without saying that you smoke.
but it says that tick yes if u have smoked in the past which will always be true in my case
I believe it says "Smoker - Select “yes” if you have smoked any cigarettes in the past month"
And your cholesterol should improve with diet and weight loss.
ok sir..got it..thnx
Experience: Cardiologist
good luck, particularly with the smoking!