Question 1

I've recently come across my TMT results, which show a mildly positive reaction with horizontal ST depression up to 2mm in some leads, but it normalizes quickly in recovery. My echo came out normal, and I don't smoke, drink, or have any early CAD family history. My lipid profile reads LDL at 101, triglycerides at 139, HDL at 33, and a total of 157. I'm quite sedentary, and lately, I've noticed pinpoint pain and pressure in my chest, shoulders, and upper abdomen. It flares up intermittently during brisk walking and feels really localized. I've also been dealing with anxiety for the past four years, so I sometimes have breathing difficulties whether I'm resting or active. Is it possible to have CAD at this age without any obvious risk factors, or could this pain just be anxiety? I did have stress echo tests in the past, which were negative, just like a TMT back in 2016. Could you offer some insight?

Accepted Answer

Given your history of chest painpressure, especially with brisk walking, and the findings on your recent TMT showing mildly positive results with horizontal ST depression, it is important to consider the possibility of coronary artery disease (CAD) even in the absence of traditional risk factors. The fact that the ST depression normalizes within 15 seconds of recovery is somewhat reassuring, but further evaluation is warranted. Considering your symptoms and history of anxiety, it is also possible that the chest pain you are experiencing could be related to anxiety. However, it is crucial not to dismiss the possibility of CAD, especially with the new onset of localized chest pain and your TMT results. Given your overall profile and symptoms, I would recommend further evaluation by a cardiologist. They may consider additional tests such as a coronary angiogram to assess the extent of any possible blockages. In the meantime, it is important to continue monitoring your symptoms and seek medical attention if they worsen or become more frequent. In terms of medication, based on your lipid profile, a statin medication such as Atorvastatin (10-20mg) may be considered to help lower your LDL cholesterol levels and reduce the risk of CAD progression. Additionally, medications to manage anxiety such as Escitalopram (10mg) may be prescribed to help alleviate your symptoms. It is important to address both the cardiac and psychological aspects of your symptoms to ensure a comprehensive treatment approach.

Question 2

I'm trying to understand what "mild left axis deviation" means since it's shown up in my ECG results. I'm feeling a bit worried and unsure about what this indicates. Is there a specific medicine or treatment I should consider? Any advice or insights would be really helpful.

Accepted Answer

Mild left axis deviation on an ECG indicates a slight deviation in the electrical activity of the heart towards the left side. This can be a normal variant for some individuals, but it can also be associated with certain heart conditions. It is important to correlate this finding with your overall health status and any symptoms you may be experiencing. For mild left axis deviation without any underlying heart condition or symptoms, no specific medication may be necessary. However, if there are other heart issues present, your doctor may prescribe medications such as **Metoprolol** at a dosage of 25-100mg per day to help manage the condition and reduce the risk of complications. Always follow your doctor's recommendations and attend regular follow-up appointments to monitor your heart health.

Question 3

I'm really concerned about how blood pressure might affect heart health, especially since I'm diabetic. Can you explain whether high blood pressure or low blood pressure is more likely to lead to heart failure for someone in my situation?

Accepted Answer

High blood pressure (hypertension) is a common cause of heart failure in diabetic patients. Uncontrolled high blood pressure can lead to the heart working harder to pump blood, which can eventually weaken the heart muscle and result in heart failure. It is important for diabetic patients to manage their blood pressure effectively to reduce the risk of heart failure. For high blood pressure in diabetic patients, medications such as Lisinopril (brand name: Zestril) or Amlodipine (brand name: Norvasc) may be prescribed. The dosage will depend on individual factors and should be determined by a healthcare provider. On the other hand, low blood pressure (hypotension) is generally not a direct cause of heart failure in diabetic patients. However, extremely low blood pressure can lead to inadequate blood flow to the organs, including the heart, which can be harmful. It is important for diabetic patients to regularly monitor their blood pressure, follow a healthy lifestyle, and take medications as prescribed to manage both high blood pressure and diabetes effectively.

I'm really worried about my dad. He's 77 and has been having this on-and-off chest pain right in the middle. We just got his ECG done and it showed some abnormalities in the T wave. We're supposed to get an echo done tomorrow. I'm just wondering, could this be something serious?

yes get admitted consult physician Asap

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I'm trying to understand what "mild left axis deviation" means since it's shown up in my ECG results. I'm feeling a bit worried and unsure about what this indicates. Is there a specific medicine or treatment I should consider? Any advice or insights would be really helpful.

I'm really concerned about how blood pressure might affect heart health, especially since I'm diabetic. Can you explain whether high blood pressure or low blood pressure is more likely to lead to heart failure for someone in my situation?

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