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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest tests to diagnose the cause of chest pain and shortness of breath after 5 stents in the LAD

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 6328 Questions

Posted on Thu, 2 Aug 2018 in Hypertension and Heart Disease
Question: I am a heart patient 61yo. Had a small MI 2014, no stent. had ongoing chest discomfort. UPMC XXXXXXX Went to XXXXXXX clinic for a second opinion-3 months later, stented the artery. Still had discomfort.
Cut to March 2017, went on vacation, came home, felt sick, short of breath, pain, Went to the ER. did an EKG, everything OK, wanted to send me home but I felt dizzy and they kept me overnight. Next day cardiology group came in and said they "would take a look", 15-20min, and see if there was anything urgent. i was relieved and said OK. The next day they put 5 stents in my LAD artery. I still have chest pain occasionally, sometimes after exercise, so I am seeing a cause- effect there. Sometimes I dont have pain for days or a week at a time. Lately I have been getting short of breath which is very uncomfortable. It comes and goes. I think it may have a gastric origin, like most of my symptoms I think may, but Im not sure. I know that the worry is driving me insane and the docs will not talk much about it. I need a doctor detective.. any ideas will be helpful- the current cardiology group refuses to do a stress test. Are there any other tests which may put an answer on what is causing my symptoms? If I can get another angiogram with a guarantee NOT to stent the hell out of me, but to see if the 5 stents are still holding up then I would go for it. thx
Answered by Dr. Ilir Sharka 30 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:

Welcome and thank you for asking on HCM!

I passed carefully through your question and would explain that shortness of breath could be related to heart failure or a lung disorder.

Coming to this point, I would recommend performing some other tests:

- a cardiac ultrasound to examine your heart function and structure
- NT pro BNP levels for heart failure
- a chest X-ray study and pulmonary function tests to investigate for possible lung disorder
- complete blood count for anemia.

I would also recommend you to closely monitor your blood pressure values.

Regarding coronary angiogram, you should know that this test would be advisable only if you had typical chest angina, coupled with specific ECG changes and raise in cardiac enzymes.

But, as it is a short time since your stents and you don't have any of the above features, there is no need to perform a new coronary angiogram.

Hope to have been helpful!

I remain at your disposal for any other questions whenever you need!

Kind regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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