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Having shortness of breath. Family history of heart disease. Blood test done. Any risk?

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I have been short of breath for some time, has sent me to the ER multiple times, not being able to get my breath. They tell me anxiety and send me to my doctor, I do have anxiety at times but no reason for it of late and this has not let up but has gotten worse. Now with ocular migraines, hard to breath even with anxiety meds and muscle relaxers, pain in left side of neck, behind ear and shoulder, bad weakness in left arm/hand and feeling like a belt is tightened around my ribs, sharp twinges of pain occasionally behind left breast and sore to press there.. Got real bad, my doc sent me to the ER again and this time the ECG came back different. Sinus rythm normal P axis, V-rate 50-99......Abnormal R-wave progression, early transition, QRS area>0 in V2, baseline wander in leads V2 V3. Rate 79, RR 759, PR 134, QRSD 80, QT 393, QTc451, AXIS...P 34, QRS 41, T 6, so doctor did blood work and said cardiac enzymes okay, cardiac section CPK 101 &102 (30-135), CKMB 0.84 & .86 (0-2.36), Troponin-i <0.012 to the first (0-0.034), Pro-BNP(B-Peptide) 34 (0-125). Hematology, WBC 8.5, RBC 4.82, hemoglobin 11.7 L, Hematocrit 37.3, MCV 77.3 L, MCH 24.2 L, MCHC 31.3 L, RDW 16.7 H, Platelet 400, MPV 9.0, NE% 67.7, LY% 22.4, MO% 5.7, EO% 3.5 H, BA% 0.7 L, coagulation, Protime 10.5 seconds, INR 1.0 to the first. My doctor, a PA, said the messed up parts of the ECG weren't important (I've never had an abnormal ECG/EKG before). Tech, did ECG 3 times, trying for normal and it was the same all times. He did hook me to a holter monitor for 24 hours, no results back from that yet. History, Dad, 3 heartattacks, stints, now congestive heart failure, 68 yrs old, first heart attack at 42, Grandfather (dad's dad) three major coronary heart attacks with triple bypass surgeries, dead at 69 from 4th and final heart attack, (dad's mom) diabetes, massive coronary from clot, dead at 74. Mom, arrythmia, heart stops while sleeping, very high blood pressure. My blood pressure runs very low to lower end of normal, was 103 over 52 at the hospital ER, I am 44, approximately 200 pounds, 5'4" but stout, middrift fat, mostly muscle. Move and restore furniture for a living, and run a farm, not idle much til here of late and even now still trying to work with breaks often for not being able to breathe, I also smoke little cigars but the shortness of breath made me put them down quick. I am scared and not very trusting of our small town hospital, please help
Posted Fri, 22 Mar 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 30 minutes later
Hi friend,
Welcome to Health Care Magic

Blood tests have ruled out heart attack and heart failure.
The ECG changes are not conclusive of a serious problem.The position of V-3 lead is not a fixed one and may differ at times.

The Holter is to detect rate and rhythm disorders.

The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.

If there is any suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography – it is invasive but it is the gold standard. [CT angio is non-invasive study for the anatomy. If positive, you may need catheterisation, anyway.]

With a bad family history of heart disease, it is wiser to get the investigations done.

X-ray of the chest and Lung function tests (Spirometry) are also in order – to assess the role of lungs / important because of smoking history.

Take care
Wishing speedy recovery
God bless
Good luck
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