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Is angiogram advisable when suffering from shortness of breath?

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Practicing since : 2004
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I am a 76 byear old male with a Hiatal Hernia. As a child had diptheria, scarlet fever,mumps, chicken pox, measels etc.Currently get short of breath easily when working involving bending, or extensive use of arms for sawing etc. Can walk 2 miles before getting breathless.I have been taking atenolol for high BP.In the last 2 years I have undergone treadmill tests (top10percentile for my age), Thallium treadmill tests, A test where was injected with a XXXXXXX that made me feel I couldn't breathe instead of using the tread mill and pictures taken, 2 64Bit digital CT (tumography?) scans, echocardiagram, carotid ultrasound and nothing was found except a small amount of plaque(45%) in the left ventricular artery. Nitro doesn't make much difference when I get breathless, and I don't get chest of left arm pain. My Cardio now wants me to undergo an angiogram. I don't feel this is probably necessary, also I suffer from panic disorder so the thought of being in the hospital for several hours terrifies me. At 76 should I just keep taking my meds and forget more tests?I hope that this website does not mean you have to give a CYA answer.I do plan to have some pulmonary testing done at a medical friend's fathers suggestion, but the angiogram is scheduled before I can do that.
Posted Sat, 22 Feb 2014 in Hypertension and Heart Disease
Answered by Dr. Benard Shehu 1 hour later
Brief Answer: I suggest to postpone angiography... Detailed Answer: Hi XXXX, I read your query very carefully! Your stress test data and your physical performance (2 miles of walking before dyspnea) show that you have a good physical performance. Furthermore you mentioned that you suffer from panic disorder that may be a big problem during and after angiography procedure. Based on this my opinion is that you should postpone angiography, at least wait for pulmonary test results. I suggest that you should potentiate your medication therapy with Baby aspirin statins, ACE-i in order to keep your BP and heart rate under control ( BP <130/85 mmHg and HR <85/ min). Also i suggest to live a healthy lifestyle. I recommend that you repeat stress test every sixth month and if the results are worsening than you should go for angiography. Hope it answered to your query! Dr. Benard
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