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In XXXXXXX I Had An Echo Of My Heart. It
Question: In XXXXXXX I had an echo of my heart. It showed mild aortic calcification but a strong heart 65 ejection factor. I have PAD - mild to moderate. I also have very mild echo-dense calcification at the forks of my carotid. This week, I went to the internationally-recognized Montreal Heart Institute and saw the head of research there. He has ordered a new echo of heart, a blood pressure monitor that I can wear for a week, and a Doppler of my legs to be done on Nov. 28th.
The pain upon walking has improved since 2012. My LDL is 1.45, ratio of HDl/Tot.Chol = 3.0.
He said that new drug therapies should be available within two to five years for atherosclerosis. He knows since he has already developed some which are in trials as we speak. I take Crestor = 10 mg., baby aspirin, Amlodipine, and Olmetec, COQ10 and eat well, do not smoke and meditate for 2 hours every day. I am anxious. Am I a walking time bomb for heart disease? He said that my LDL was so low that it could reverse the atherosclerosis. Comments please. I need reassurance that I am not going to drop dead. I am asymptomatic.
The pain upon walking has improved since 2012. My LDL is 1.45, ratio of HDl/Tot.Chol = 3.0.
He said that new drug therapies should be available within two to five years for atherosclerosis. He knows since he has already developed some which are in trials as we speak. I take Crestor = 10 mg., baby aspirin, Amlodipine, and Olmetec, COQ10 and eat well, do not smoke and meditate for 2 hours every day. I am anxious. Am I a walking time bomb for heart disease? He said that my LDL was so low that it could reverse the atherosclerosis. Comments please. I need reassurance that I am not going to drop dead. I am asymptomatic.
The doctor I saw said he did not feel it necessary to have a stress test. This man is internationally-known = Dr. J.C. Tardif.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on Ask a Doctor service!
I passed carefully through your question and would agree with your doctor, that as long as you don't have typical chest pain symptomatology and a normal blood lipid profile, there is no reason to panic about coronary artery disease or any heart attack.
I agree also on the fact that your low LDL and high HDL is a protecting factor against atherosclerotic.
So I don't think that an exercise cardiac stress test is necessary too.
Anyway, considering the fact that you suffer from PAD and there were some calcifications on your aortic valve on your recent cardiac ultrasound, I would recommend considering performing a coronary angio CT scan in order to examine your coronary arteries and also help calm your anxiety.
You should discuss with your doctor on this test.
Wishing good health,
Dr.Ilir Sharka, Cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on Ask a Doctor service!
I passed carefully through your question and would agree with your doctor, that as long as you don't have typical chest pain symptomatology and a normal blood lipid profile, there is no reason to panic about coronary artery disease or any heart attack.
I agree also on the fact that your low LDL and high HDL is a protecting factor against atherosclerotic.
So I don't think that an exercise cardiac stress test is necessary too.
Anyway, considering the fact that you suffer from PAD and there were some calcifications on your aortic valve on your recent cardiac ultrasound, I would recommend considering performing a coronary angio CT scan in order to examine your coronary arteries and also help calm your anxiety.
You should discuss with your doctor on this test.
Wishing good health,
Dr.Ilir Sharka, Cardiologist
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Listen I want another doctor's opinion. I keep getting you for some reason! ...sorry, but
My lipid profile is below normal...it is optimal! And can lead to reversal of atherosclerosis, according to him.
If he does not think a stress test is in order re my coronary arteries, why then would he recommend an angio CT scan if I am asymptomatic? That does not make sense.
Thank you doctor.
If he does not think a stress test is in order re my coronary arteries, why then would he recommend an angio CT scan if I am asymptomatic? That does not make sense.
Thank you doctor.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
I am really sorry to have confounded you in some way!
As we have discussed before, I don't think that your shortness of breath is related to the heart.
That is why Dr. Tardif has not recommended performing a cardiac stress echo.
From the other hand, as you blood lipid profile is excellent, there is no risk of progression of atherosclerosis related to the blood lipid profile. From the other hand there are some studies, which indicate that low LDL and high HDL levels can be a protective factor and also lead to reversal of atherosclerosis.
Anyway, the reason why I recommended performing a coronary angio CT scan or a dobutamine stress echo (before) was to be 100% sure that the blood flow in your coronary arteries is optimal and thus helping you calm your anxiety too.
In medicine we can not be 100% sure until we do tests. In fact this happens in other professional fields too.
From the other hand, there is no reason to panic about sudden death, because I don't think that this is going to happen to you (based on your recent performed tests and the fact that you have no symptoms of angina).
Another option, would be to follow up with a cardiac ultrasound and a Doppler ultrasound of your leg vessels after 6 months.
I would also encourage you to follow your healthy lifestyle, which can help you live a long life for sure.
I remain at your disposal for any further questions whenever you need!
Wishing all the best,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello again!
I am really sorry to have confounded you in some way!
As we have discussed before, I don't think that your shortness of breath is related to the heart.
That is why Dr. Tardif has not recommended performing a cardiac stress echo.
From the other hand, as you blood lipid profile is excellent, there is no risk of progression of atherosclerosis related to the blood lipid profile. From the other hand there are some studies, which indicate that low LDL and high HDL levels can be a protective factor and also lead to reversal of atherosclerosis.
Anyway, the reason why I recommended performing a coronary angio CT scan or a dobutamine stress echo (before) was to be 100% sure that the blood flow in your coronary arteries is optimal and thus helping you calm your anxiety too.
In medicine we can not be 100% sure until we do tests. In fact this happens in other professional fields too.
From the other hand, there is no reason to panic about sudden death, because I don't think that this is going to happen to you (based on your recent performed tests and the fact that you have no symptoms of angina).
Another option, would be to follow up with a cardiac ultrasound and a Doppler ultrasound of your leg vessels after 6 months.
I would also encourage you to follow your healthy lifestyle, which can help you live a long life for sure.
I remain at your disposal for any further questions whenever you need!
Wishing all the best,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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