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Had two heart attacks and muscle damage. Had chest pain and suffered from fatigue. Is it a sign of heart failure symptoms?

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General & Family Physician
Practicing since : 2009
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Hi, I have had 2 heart attacks 6 years ago, 5days apart. There was significant muscle damage as the Troponin level after the 2nd heart attack was 24.8. I was caused by spontaineous dissection of right coronary artery. Nothing could be done, I was told. Have continued with life as normal, but have always had on and off chest pain and suffered from fatigue. Lately Im noticing SOB and a dry cough. Am I possibly starting heart failure symptoms?
My question is, if heart failure is diagnosed, do I need to rest more to avoid putting too much stress on my heart? Can I prolong my life if I look after my heart better?
Posted Wed, 13 Nov 2013 in Heart Failure
Answered by Dr. Yogesh D 21 minutes later
Brief Answer:
Yes to all your question.

Detailed Answer:
Hello Mrs XXXX,

Thank you for posting your question.

The answer to all your questions is yes.

Though I would not say that with great conviction for the first one, because of the lack of your entire medial history and investigations.

It is quite hard to treat or salvage in such an unfortunate event.

Your chest pains are most likely due to the compromised blood supply to your heart.

As for the SOB and dry cough, they would definitely fit the picture and it is quite possible that you may be gradually progressing into heart failure due to the damaged muscle.

But to be 100% sure of the cause, I would request you to undergo Echocardiogram, stress test if feasible and please do consult your cardiologist at the earliest.

Now coming to resting and prolonging life expectancy, I would say, yes resting more and avoiding all kinds of stresses on your body as well as psyche would be very beneficial to you.

And to improve the symptoms, and prolong life, the cardiac output can be substantially improved with a judicial use of positive ionotropic drugs such as digoxin, I would suggest you explore this with your treating cardiologist.

You should take care of your heart more, and stop smoking if you are doing it.

Lead a healthy but restricted life, I know I am not sounding nice, but that's the way.

I hope I have addressed your concerns, please do not hesitate to write back to me if you need further assistance.

Wishing you a good and trouble free life.

Warm regards,
Above answer was peer-reviewed by
Follow-up: Had two heart attacks and muscle damage. Had chest pain and suffered from fatigue. Is it a sign of heart failure symptoms? 3 hours later
Thank you for your answers. Last week I was sent for an Xray of front and lateral chest. Would this show up any indications for developing heart failure?
I've made an appointment with my Doctor, should I request an echocardiogram?
Answered by Dr. Yogesh D 43 minutes later
Brief Answer:
Please do request an echocardiogram.

Detailed Answer:
Hello XXXX,

Thanks for writing back.

X-ray might show some changes in the later stages of heart failure, when the heart is noticeably bigger and casts a bigger shadow in the frontal view.

The lateral view wouldn't say anything.

That said, heart failure can exist without the heart getting bigger, a bigger heart is not that good after all.... (You know what I mean).

Yes, please do request your cardiologist for an echocardiogram, that will tell you exactly how well your heart is performing.

Wishing you all the best for your appointment. You may revert back to me after you get your echo report for further discussion.

Warm regards,
Above answer was peer-reviewed by
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