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Are Chest, Shoulder And Back Pain Side Effects Of Angioplasty?
Question: O XXXXXXX Aged 64, male, height 163cm, weight 62kg. Working at a private school as accounts cum administration manager.
1. Underwent angioplasty to left anterior descending artery and right coronary artery on 2.7.2013.
2. BP patient for the last 25yrs.
3. Now taking the following medicines as advised by cardiologist:
(a) Clopilet A 75 1-0-0
(b) Prolomet XL 50 1-0-1
(c) Nicardia retard 20 1-0-1
(d) Telma CT 40 1-0-0
(e) Rosuvas 10 0-0-1
4. Last cardiologist’s review was on 11/12/2014 and he did not find any cardiologic problem. The next review will be in October 2015.
5. But I have certain problems like
(a) Occasional chest pain mainly on left side, sometimes on right side, sometimes middle.
(b) Occasional backpain
(c) Occasional shoulder pain
(d) Difficult to walk and do any physical work
(e) Occasional sweating and pain on the right neck below ear
(f) Eye irritation and burning
(g) Slight occasional swelling on both sidesof chest muscles,hand muscles etc
(h) These pains subsidise when pain bams are applied
(i) Feels to go to toilet frequently especially in the afternoon,but only gas exits and poor motion.
(j) Dry skin,black warts/marks on the face,head etc
6. I visited a local physican two/three times,he ruled out cardiologic problems and prescribed certain tablets mainly vitamin tabs like neurokid/multivitamin tabs etc. Once nerve conductivity study was done but no problem.ECG taken on 26/6/2015 shows normal.
7. Now for the last 2 months I take some homeo medicines but I am not much benefited. Two/three set of medicines were tried,now I take (a) lachesis 200 (b)bryonia 200 and(c) crataegus Q
8. Blood reports show that the values of Hb,FBS,HbA1C,LFT,RFT,cholesterol etc are within the desirable range but vitamin B12 shows elevated value of 1290 as against the desirable higher range of 911.
9. My doubts are
(a) Is there any side effects of angioplasty? Before angioplasty many of the problems mentioned above were not their.
(b) Is the problem due to any new block or heart problem?
(c) Is it due to some other problem?
(d) Do I need further investigation?
(e) Is there any treatment required for elevated B12?
10. My cardiologist who did angioplasty is far away for about 4hrs journey,therefore consulting regularly is not possible.Moreover he prefers to see only on prefixed scheduled dates.
11. I don’t prefer to visit a local cardiologist because they may proceed for all sort of investigation and observation in ICU.
12. My XXXXXXX no.-0000.
1. Underwent angioplasty to left anterior descending artery and right coronary artery on 2.7.2013.
2. BP patient for the last 25yrs.
3. Now taking the following medicines as advised by cardiologist:
(a) Clopilet A 75 1-0-0
(b) Prolomet XL 50 1-0-1
(c) Nicardia retard 20 1-0-1
(d) Telma CT 40 1-0-0
(e) Rosuvas 10 0-0-1
4. Last cardiologist’s review was on 11/12/2014 and he did not find any cardiologic problem. The next review will be in October 2015.
5. But I have certain problems like
(a) Occasional chest pain mainly on left side, sometimes on right side, sometimes middle.
(b) Occasional backpain
(c) Occasional shoulder pain
(d) Difficult to walk and do any physical work
(e) Occasional sweating and pain on the right neck below ear
(f) Eye irritation and burning
(g) Slight occasional swelling on both sidesof chest muscles,hand muscles etc
(h) These pains subsidise when pain bams are applied
(i) Feels to go to toilet frequently especially in the afternoon,but only gas exits and poor motion.
(j) Dry skin,black warts/marks on the face,head etc
6. I visited a local physican two/three times,he ruled out cardiologic problems and prescribed certain tablets mainly vitamin tabs like neurokid/multivitamin tabs etc. Once nerve conductivity study was done but no problem.ECG taken on 26/6/2015 shows normal.
7. Now for the last 2 months I take some homeo medicines but I am not much benefited. Two/three set of medicines were tried,now I take (a) lachesis 200 (b)bryonia 200 and(c) crataegus Q
8. Blood reports show that the values of Hb,FBS,HbA1C,LFT,RFT,cholesterol etc are within the desirable range but vitamin B12 shows elevated value of 1290 as against the desirable higher range of 911.
9. My doubts are
(a) Is there any side effects of angioplasty? Before angioplasty many of the problems mentioned above were not their.
(b) Is the problem due to any new block or heart problem?
(c) Is it due to some other problem?
(d) Do I need further investigation?
(e) Is there any treatment required for elevated B12?
10. My cardiologist who did angioplasty is far away for about 4hrs journey,therefore consulting regularly is not possible.Moreover he prefers to see only on prefixed scheduled dates.
11. I don’t prefer to visit a local cardiologist because they may proceed for all sort of investigation and observation in ICU.
12. My XXXXXXX no.-0000.
Brief Answer:
Continue meds, may add some for symptoms.Get treadmill stress test done
Detailed Answer:
Hi XXXXXXX I am Dr. Priyank Mody and I would be addressing your concern to the best of my abilities.
First I will thank you for such detailed history.
Now coming to questions.
Angioplasty would have been done on the vessel because they would have been critically blocked putting large part of heart muscle at risk of damage. So the benefit surely outweigh the risk on properly selected patient.
Now the medication you are on is the perfect combination of all the drugs which have proven benefit in strengthening your heart and reducing any future risk of heart attack. So in the medication list would like to add none if there are no symptoms , however omega 3 fatty acid 2 gm a day can be added instead of the homeo meds you have described. . Also anti anginal like sustained release nitroglycerin or Nikorandil may be added for symptoms.
A antacid like pantoprazole should be added for coexisting gastritis due to all the meds you are on.
Now the important question, what were the symptoms that you got angioplasty done on the first place, was is during routine evaluation or you had breathlessness on exertion or chest heaviness. So are similar symptoms occurring again.
The symptoms you describe are very non specific for any cardiac problem, the best to rule out stents re blockage or a new block is to undergo a routine treadmill stress test, see if symptoms increases during exertion and what are the ecg changes, if none forget about it. Also stents do not cause the symptoms you mentioned. The bowel movement disturbance and warts are not due to cardiac problem.
Your b12 is just on borderline high and it doesn't need any treatment. Try avoiding vitamin b12 containing multi vitamin.
Hoping I could help.
Regards
Continue meds, may add some for symptoms.Get treadmill stress test done
Detailed Answer:
Hi XXXXXXX I am Dr. Priyank Mody and I would be addressing your concern to the best of my abilities.
First I will thank you for such detailed history.
Now coming to questions.
Angioplasty would have been done on the vessel because they would have been critically blocked putting large part of heart muscle at risk of damage. So the benefit surely outweigh the risk on properly selected patient.
Now the medication you are on is the perfect combination of all the drugs which have proven benefit in strengthening your heart and reducing any future risk of heart attack. So in the medication list would like to add none if there are no symptoms , however omega 3 fatty acid 2 gm a day can be added instead of the homeo meds you have described. . Also anti anginal like sustained release nitroglycerin or Nikorandil may be added for symptoms.
A antacid like pantoprazole should be added for coexisting gastritis due to all the meds you are on.
Now the important question, what were the symptoms that you got angioplasty done on the first place, was is during routine evaluation or you had breathlessness on exertion or chest heaviness. So are similar symptoms occurring again.
The symptoms you describe are very non specific for any cardiac problem, the best to rule out stents re blockage or a new block is to undergo a routine treadmill stress test, see if symptoms increases during exertion and what are the ecg changes, if none forget about it. Also stents do not cause the symptoms you mentioned. The bowel movement disturbance and warts are not due to cardiac problem.
Your b12 is just on borderline high and it doesn't need any treatment. Try avoiding vitamin b12 containing multi vitamin.
Hoping I could help.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Dear Doctor,
Thank you for the prompt reply. On XXXXXXX 16th 2013 I experienced chest pain, radiating pain on neck, hands and on back and also sweating, subsequently angiogram was taken and two blocks were noted.
That was the reason for angioplasty on 2nd July 2013 at a leading hospital at Kochi and it was done by an expert and well experienced cardiologist. After angioplasty I was better than now for about a year. The present difficulties –mainly difficulty in walking, physical work developed after 1 year of angioplasty. On contacting the doctor at Kochi on 29thOct 2014,10thNov2014 & 11thDec2014, after physical examination and blood reports he ruled out cardiology problems but high BP were notised and that is why he added Telma CT 40.And told me that once BP comes to normal the difficulties of walking etc will come to normal. But the difficulties remain.
I would like to add that there was no known reasons for block-no family history, no smoking, no drinking, no overweight, cholesterol was near normal and ECG was also normal even 1 week before the pain was experienced.
You have suggested for TMT but I have difficulty in walking therefore is it advisable to go for TMT. Is there any other test? About 25yrs back I was diagnosed for early cervical spontilosis and essential hypertension. By nature I get nervous quickly.
About B12, about 4 yrs back on routine health care blood analysis it was noted that B12 was high as that of now. At that time I consulted a physician here and he told that elevated B12 was not problematic and advised me to just ignore. But as this remains high even now. Either B12 is not used properly or excess is not removed through urine. Am I wrong in doubting some functional disorder?
I am practically a vegetarian and not in the habit of taking vitamin tabs regularly.
Could you pls clear my doubts?
Thank you
O XXXXXXX
Thank you for the prompt reply. On XXXXXXX 16th 2013 I experienced chest pain, radiating pain on neck, hands and on back and also sweating, subsequently angiogram was taken and two blocks were noted.
That was the reason for angioplasty on 2nd July 2013 at a leading hospital at Kochi and it was done by an expert and well experienced cardiologist. After angioplasty I was better than now for about a year. The present difficulties –mainly difficulty in walking, physical work developed after 1 year of angioplasty. On contacting the doctor at Kochi on 29thOct 2014,10thNov2014 & 11thDec2014, after physical examination and blood reports he ruled out cardiology problems but high BP were notised and that is why he added Telma CT 40.And told me that once BP comes to normal the difficulties of walking etc will come to normal. But the difficulties remain.
I would like to add that there was no known reasons for block-no family history, no smoking, no drinking, no overweight, cholesterol was near normal and ECG was also normal even 1 week before the pain was experienced.
You have suggested for TMT but I have difficulty in walking therefore is it advisable to go for TMT. Is there any other test? About 25yrs back I was diagnosed for early cervical spontilosis and essential hypertension. By nature I get nervous quickly.
About B12, about 4 yrs back on routine health care blood analysis it was noted that B12 was high as that of now. At that time I consulted a physician here and he told that elevated B12 was not problematic and advised me to just ignore. But as this remains high even now. Either B12 is not used properly or excess is not removed through urine. Am I wrong in doubting some functional disorder?
I am practically a vegetarian and not in the habit of taking vitamin tabs regularly.
Could you pls clear my doubts?
Thank you
O XXXXXXX
Brief Answer:
To rule out cardiac cause, thallium scan (preferred)/dobutamine stress ech
Detailed Answer:
Hi did go through all the history. I will still suggest a stress test as you can't walk the best alternative is to get a stress perfusion scan (thallium scan) , best in this senerio or dobutamine stress echo in a good centre. In both tests the subject your heart to strain by using medication and see the blood pressure to all parts of heart, so if positive we will know mostly which heart territory is supplied with less blood and hence treat it.
B12 is stored in the body in liver and muscle, so the store in enough to last for 5-6 years, it is not secreted in urine but in stool, which also effectively recycled, so it will take years before the values normalise and you need not worry for the same.
To rule out cardiac cause, thallium scan (preferred)/dobutamine stress ech
Detailed Answer:
Hi did go through all the history. I will still suggest a stress test as you can't walk the best alternative is to get a stress perfusion scan (thallium scan) , best in this senerio or dobutamine stress echo in a good centre. In both tests the subject your heart to strain by using medication and see the blood pressure to all parts of heart, so if positive we will know mostly which heart territory is supplied with less blood and hence treat it.
B12 is stored in the body in liver and muscle, so the store in enough to last for 5-6 years, it is not secreted in urine but in stool, which also effectively recycled, so it will take years before the values normalise and you need not worry for the same.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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