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    What do these lab reports indicate?

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Posted on Tue, 8 Aug 2017 in Hypertension and Heart Disease
Question: Hi my question is regarding my cardiac health. Though I have been diagonsed with GERD but I get disturbed whenever there is a chest pain or palpatation of heart or my heart rate increases.
Reason for my worry is because my Stress Test was inconclusive in Feb 17 as i could not walk on treadmill
I have undergone following tests since Feb
1. ECG in feb..may . XXXXXXX and july
2. 2D echo in feb
3. Stress test in feb
4. CT scan angiography in feb
I keeo feeling chest pain...pain in left arm...back many times

I just want someone to go through all the attached reports and prescriptions and also compare all ecgs as I have RBB too. And suggest what should I do
doctor
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I passed carefully your question and reviewed all your uploaded test report and would explain that your chest pain does not seem to be related to any cardiac issues.

Your cardiac performed tests (exercise cardiac stress test and coronary angio CT scan) have excluded coronary artery disease.

Regarding the Right Bundle Branch Block, it could be related to different possible disorders like pulmonary embolism, a congenital heart disease, cardiomyopathy, etc..

But as the cardiac ultrasound has resulted normal, it means that you have a normal cardiac structure and all structural disorders like a congenital heart disease and cardiomyopathy have been excluded.

Coming to this point, I would recommend performing a ventilation-perfusion pulmonary CT scan to exclude possible pulmonary embolism as a possible cause of RBBB.

Anyway, the RBBB does is not related to the chest pain.

I agree with your doctor that the chest pain is not related to the heart.

Coming to this point, I would recommend checking your cervical vertebral column, to exclude possible degenerations of the column or disc herniation, which could cause irradiating nerve pain in this region.

I would also recommend avoiding large meals and spicy food. Eating in small portions can help improve your GERD situation, besides the medical treatment (which you should follow regularly based on the medical prescription).

You should know that GERD can trigger chest pain and palpitations while exertion.

Hope to have been helpful!

If you have any other questions, please don't hesitate to ask me again!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 6 hours later
Yes few questions
1. I could not complete the stress test and stopped in between . Because of this the technician called the cardiologist doubting blockage of artiteries.
Can u pls check the stress test report and if u want i can upload some graphs too. could it be bcos of rbb that i was not able to complete stress test?
doctor
Answered by Dr. Ilir Sharka 14 hours later
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

The test was inconclusive, because you have not reached 85 % of the theoretical maximal heart.

In other words your heart rate during this test wasn't high enough in order to come into significant conclusions.

This may be related to a low physical performance.

From the other side, I would like to assure you that there was no significant evidence of coronary artery disease (cardiac ischemia) evidence on your cardiac stress test.

That is:

- no significant changes of ST segment
-no chest pain
- no arrhythmia or conductance disorders.

A rational alternative to definitely exclude a possible cardiac issue and make up your mind is to perform a nuclear perfusional cardiac stress test.

I would also recommend performing the above mentioned tests in order to investigate for other possible causes like backbone degeneration and pulmonary embolism.

Hope to have clarified some of your uncertainties!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 44 minutes later
thanks a lot. one last question. how do we differentiate the chest pain or uneasyness, breathless etc happining because of heart and happening cos of gas
doctor
Answered by Dr. Ilir Sharka 42 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

The chest pain related to gas is usually associated to burping and relieved by antiacids or PPI (omeprazole, lasoprazole, etc.). It is usually related to the meals. Bending over can trigger the pain related to gastro-esophageal reflux.

While the chest pain related to the heart is usually triggered by straining physical activity and it is relieved by resting, but not by antiacids of PPI.

Hope to have clarified some of your uncertainties!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

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