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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diabetic. Had CABG. Irregular Left Hand Pain. Did Angiogram. Now Left Hand Pain. Angiogram Needed?

Hello i have a question about my mom who is diabetic (type 1). She had a CABG in 2007. Previously she had irregular left hand pain below the elbow and her doctor neglected any correlation with her heart, but she insisted on him to go for the cardio tests which revealed (angiogram) blockage and therefore she went for surgery. It s noteworthy to mention that this hand pain didn t resolve completely after surgery. This year she has been suffering from a similar left hand pain and she is scheduled for a thallium stress test. If the test comes negative, should she go for an angiogram?
Thu, 2 May 2013
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Internal Medicine Specialist 's  Response
Hi,
Thanks for posting your query.
Diabetes is a multi organ disease with involvement of almost all organs of body due to its complications.
Blood sugar both fasting and postprandial must be in controlled range.
Let me know her blood sugar level both fasting and postprandial.
There appears to be least chance of heart pain as pain is still persisting after CABG.
Thallium stress test is highly specific for heart as decreased blood supply may be detected by this test.
There appears to be less requirement of angiography; still you can go for your personal satisfaction.
She should also go for 1,25 dihydroxy cholecalciferol level, glycosylated hemoglobin, and renal function test.
There could also be possibility of specific dermatomal diabetic neuropathy.
Take care,
Dr. Mayank Bhargava
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Diabetic. Had CABG. Irregular Left Hand Pain. Did Angiogram. Now Left Hand Pain. Angiogram Needed?

Hi, Thanks for posting your query. Diabetes is a multi organ disease with involvement of almost all organs of body due to its complications. Blood sugar both fasting and postprandial must be in controlled range. Let me know her blood sugar level both fasting and postprandial. There appears to be least chance of heart pain as pain is still persisting after CABG. Thallium stress test is highly specific for heart as decreased blood supply may be detected by this test. There appears to be less requirement of angiography; still you can go for your personal satisfaction. She should also go for 1,25 dihydroxy cholecalciferol level, glycosylated hemoglobin, and renal function test. There could also be possibility of specific dermatomal diabetic neuropathy. Take care, Dr. Mayank Bhargava