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21 Jul 2005

thank you but can i just ask
thank you for your advice. I did tell G.P. about the pain between my shoulder blades he then thought given my family history that i should see a caridoligist. I did that today i had some test done but he wants to put some dye in my blood as i only managed 3 mins. on the tread mill as i was gonig lighthead and dizzy. I did try to ask him if this light headnees was heart related put he brushed me of and did not want to anwere any of my questions. I think he was a bit miffed that i had not compleated the tread mill test. could you please tell me if it is realated because apart fom the the shoulder pain and palpations i have no other angina like symtoms. thank you agin. (339) I LAST WROTE ON THE 6/7/05
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Expert
HeartDoc

01 Jan 0001


Dear Sooty and Carol-Ann,

IF you could not complete the treadmill test, then you really do need to be investigated. You may have serious coronary artery disease, or you could have a valve problem causing the dizziness. Either way, the cardiologist does need to investigate this. The way this is done is by two important investigations. One is a type of ultrasound, called an echocardiogram. That can give useful information about the contractility of the heart and function of the valves. However, this investigation is very dependant on the experience and technical expertise of the person (a technician) performing the test. The investigation yielding the most accurate and uncontroversial results is an angiogram ( catheterisation). This involves a catheter being threaded into the aorta and heart via the groin or arm, and a special dye is then injected. Special x-ray movies are then taken, and the heart function, valve function and coronary artery anatomy is clearly shown. After an angiogram, the diagnosis is usually undisputed, and a treatment plan can be drawn up.

I can understand your reluctance to undergo this, but angiograms have become quite commonplace these days. At our unit there can be anything up to 20 per day.
Please think about this carefully, in view of your high risk profile. The investigation will yield valuable information one way or the other, but you are still the patient, and reserve the right to choose not to undergo it.

Your cardiologist cannot be miffed if a patient cannot complete a test – that by itself tells him something !! Sooty, this is too important for you to be stuck with a doctor who makes you feel uncomfortable. If you are not comfortable with this cardiologist, please ask around for another one, until you find someone whose approach is acceptable to you.

Carol-Ann, the words you gave mean: Aetiology just means “cause of”, sinus arrhythmia means an irregular rhythm of the heart, but this irregularity comes form the sinus node, which is the main pacemaker of the normal heart. “Tachycardia” just means a fast pulse rate. Costochondritis is a condition of inflammation of the cartilage of the ribs. Where the ribs come around to the front and attach to the breastbone, the bony ribs gradually become cartilage, and this cartilage is what actually attaches to the breastbone. As cartilage is flexible, it allows for the movement of the chest with breathing. When these cartilages become inflamed, they can cause chest pains often mimicking angina. It usually responds to a course of anti-inflammatories and painkillers, and it is not a serious condition at all, just an uncomfortable nuisance. You probably had inflammation of the rib cartilages, causing a mild fever and some pain. As a normal response, your heart rate went up, and here and there you got a “speed wobble” in the form of an irregularity. If the diagnosis is correct, then once the condition subsides, you irregular and fast pulse should return to normal again.

Good luck both of you. Please keep me informed via the forum.

HeartDoc
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
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