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Forum Name: Valvular Heart Diseases

Question: 3 1/2 years after triple bypass


 arience - Thu Nov 19, 2009 1:47 pm

i am going to be 50 in feb, female, heart attack with triple bypass in 8/2006. major damage done to bottom chamber of heart, ICD in, every 3 months, heart failure specialist and regular doctor.
i have been doing pretty good so far. sleep at least 8 hrs now a night, cholesteral is 139, tri's are 69, sugar is 6.1, walk a mile every day at lunch, lost 16 lbs in the 3 years (that is a battle), sodium under 2000 a day, very little fried anything, starting menapause, anxiety issues (xanax for that), still smoke my 3 cigarettes a day (i have real issues with this) i want to quit, but i just cant seem to give up the 3. happily married for 30 years, 3 kids, 3 grandchildren, everyone happy. will someone explain to me what the heck is wrong with me
i still get pains near the edge of my breast, next to the breastbone(is actually sore to touch), pains in my back between my shoulder blades, feelings of shortness of breat (happens when i am sitting, not walking, or climbing stairs, exertion.), i am positive in my mind that something else is really wrong with me. have my arteries clogged up again, is there something else i should be doing?, what if they missed something - thats not normal and i know it. does menapause actually make women this crazy? i started taking soy supplements because the doctor says i will have to work my way through this with no medication. i spend hours waiting for me to just drop over. i know, its in my head and i cant help it. some other perspective would be great.
 John Kenyon, CNA - Wed Dec 02, 2009 10:53 pm

User avatar Hello -- First, you would seem to be doing really well overall, and are to be congratulated on the progress you've made as well as having chosen good doctors (or at least tripped over them). While the 3 cigarette habit isn't something I could endorse, it beats the heck out of a pack a day or more! If smokers only smoked 3 cigarettes a day there's be a whole lot less ill health worldwide. Still, needless to say, when you smoke a single cigarette, you add a significant burden to the cardiorespiratory system during the time the cigarette is being smoked as well as for some hours afterward. This is more important with significant left ventricular damage, of course, but at least you're at a known and minimal level. I hope you're able to eventually break it off completely, but for now that's real progress.

As to the pains: you mention the anterior chest pain is even tender to the touch. This isn't heart-related and since you've had bypass surgery you are especially prone to both costochondritis (inflammation of the cartilege between the ribs where they attach to the sternum) and just plain chest wall tenderness. Whenever pain can be elicited by manual pressure it is not heart-related. The other pain, that between the shoulder blades, is of course likely something else, and could conceivably be heart-related, but is more likely related to the chest wall tenderness in front or another orthopedic issue. The shortness of breath definitely sounds anxiety-related, mainly because it doesn't occur during exertion but at rest. And you must realize anxiety is extremely common in people with known heart disease, especially when there is a concern there may be something "they missed." You've had a pretty comprehensive workup and are being followed. Yes, you did sustain your MI at a rather young age, but you've done very well since, especially considering the degree injury you sustained.

Continue to be followed regularly, check this pain (especially the upper back , infrascapular pain) by doing upper body movements and stretches to determine if you can duplicate the pain on movement, as this will rule out cardiac pain as well. And you might want to have asthma ruled out as a cause of both the chest discomfort and shortness of breath. There's nothing that says you couldn't have asthma. And of course consider a possible role for anxiety in this also. If all the physical things are ruled out you might want to consider seeing someone who practices cognitive behavioral therapy (CBT), since you already know this is an issue, and CBT is often very effective in managing this problem. Finally, while I'd never say menopause makes women "crazy" it certainly can affect the mood a great deal -- this is not just a joke -- and with anxiety already present, menopause can aggravate this problem a great deal.

I hope this is helpful to you. Please follow up with us here as needed, and keep us updated as well. Good luck to you, and keep up the good work!

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