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Forum Name: Ischemic Heart Disease

Question: 56 year old with history of heart attacks

prplestarlette - Tue Jun 12, 2007 8:50 am

I am writing about my father, who is 56 years old. He has a history of high blood pressure, high Cholesterol, Angina, and two Heart attacks, most recent one being in March 2007. My dad started having Chest pains shortly after his Heart attack and the only thing the hospital did was put him on a heart monitor and send him home with it to "see what the heart is doing" during the pains. I am a pre-med student and I have listened to the device when he calls in to transmit the readings, and can easily tell several PVCs and missed beats. His doctors keep saying "well lets see how you are in a week" and things aren't getting better and no one is d oing anything. What is your opinion on what is going on? It's sad we have this problem since our cardiac hospital here is boasted to be one of the best in the country.

John Kenyon, CNA - Wed Jun 13, 2007 5:46 am

Hello - This is a tough one, for a number of reasons. I am assuming your dad was hospitalized for several days at least following the most recent Heart attack. Was there any intervention done, such as angioplasty or stent placement? If he was diagnosed as havng had a Myocardial infarction it would seem likely there would at least be an angiogram performed to see if there might be any occlusion that could be opened up. On the other hand, if the infarction was apparent but resolved without intervention then it is at least somewhat likely that your father may be having spasm of one coronary artery. This is often difficult to pin down once the spasm has stopped and so subsequent episodes of Chest pain may be suspected of being the result of this form of Angina, which can occur without any actual coronary artery disease being present. In running this by you I am giving your father's doctors the benefit of the doubt. I have to do that because otherwise what is being done would seem unorthodox to say the least. I would add that PVCs are common in the general population and even moreso in post-MI patients, but as long as left ventricular function is preserved, they are not of much consequence. I would think the event monitor is probably being used to determine if, during episodes of Chest pain, your dad's rhythm strip shows any ST elevation which then resolves. All this is speculation, and it would really be helpful to know more about the situation, specifically: was your dad's most recent Heart attack a completed MI or was it a coronary event which resolved on its own? This latter might well explain why the doctor has chosen to use an event monitor or other telemetric device, instead of attempting to open up a clogged artery. If this isn't the case I have to admit to being quite puzzled by the approach. Again, more info would really help. Please do stay in touch.

prplestarlette - Wed Jun 13, 2007 6:36 am

Yes, he did spend several days in the hospital following the latest Heart attack. During his first Heart attack a few years ago they put a stent in. During this last Heart attack, they had to put a stent in the coronary artery as it was 90% blocked and it was a complete MI. Even though doctors say there is something going on, they are not doing anything about it. My father is paying out of his own pockets to continue to use the cardiac gym monthly as they felt the cardiac rehab was not medically necessary (but it was the rehab that detected the problems in the first place). In speaking with my mother, the ST is elevated on the strips.

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