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Pastimes : Heart Attacks, Cancer and strokes. Preventative approaches
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To: LindyBill who wrote (1830)11/1/2008 1:34:24 PM
From: LindyBill1 Recommendation  Read Replies (1) of 39304
 
A comment from Dr Davis on the linked post:

keep in mind that the Track Your Plaque program recommendations are based on people without symptoms. The presence of symptoms change the rules somewhat.

Because your wife has symptoms consistently provoked with physical exertion, her doctor might consider:

1) Hypertensive phenomena--i.e., some people provoke high blood pressures with exercise that causes chest discomfort. This can be confidently assessed with a stress test.

2) "Microvascular angina"--sometimes also called "syndrome X," a different syndrome X than the metabolic syndrome. This is a syndrome peculiar to women in the peri-menopausal years that is provoked by an inappropriate constrictive effect in the smaller arteries of the coronary artery tree. It is curiously responsive to l-arginine. While it requires a heart catheterization for confident diagnosis, it can be easily presumptively diagnosed by the clinical situation, but your wife's cardiologist would need to do this for her.

3) Pure uncalcified plaque--Though it is uncommon, it does happen. The best place to start is a stress test (e.g., stress echo) to assess coronary flow. Alternatively, a CT angiogram would help, though I still remain leery of the radiation exposure.

4) Other unusual causes--e..g, pulmonary hypertension, coronary anomalies. These can only be diagnosed by your wife's cardiologist.
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