Question 1

I'm looking for some advice about my heart health. I had a CT coronary angiogram about three years ago because I was having chest pains and my exercise capacity was low. The results showed no significant stenosis in any artery, but Im wondering if minor blockages might have been overlooked. Also, it mentioned that my circulation is left dominant, and I'm curious if that could be related to my chest pain. Do you think it's necessary to repeat the CT angio even though I'm worried about the radiation exposure?

Accepted Answer

If your CT coronary angiogram from 3 years ago showed no significant stenosis in any artery, it means that there were no major blockages detected at that time. Minor blocks may not have been mentioned in the report because they were not significant enough to cause concern. The fact that your circulation is left dominant is just a variation in the blood supply to your heart and is not necessarily a cause for chest pain. Based on the information provided, if you are still experiencing chest pains or other concerning symptoms, it may be advisable to consult with a cardiologist to determine if a repeat CT angio or other cardiac tests are necessary. However, the decision to repeat the CT angio should be based on your current symptoms and risk factors, rather than just for routine surveillance. It is important to weigh the potential benefits of the test against the risks of radiation exposure.

Question 2

I'm really worried because for the past week I've been experiencing heaviness in my chest, my left arm feels strange, and I've even had some episodes where I've felt unconscious and really anxious. It's getting to the point where I can't sleep at night. Do you think there's something serious going on, and what should I do about it?

Accepted Answer

consult to cardiologist

Question 3

I've recently had a stress echo and it came back negative. Ten years ago, in 2011, I had an angiogram and it looked fine then too. In 2015, I went through a nuclear test, treadmill test, and some other checks, and they all turned out normal. Lately, Ive been having this dull pain in my neck that sometimes reaches up to my ear and jaw, and it also bothers my shoulder. My neck and upper back always feel stiff. My physiotherapist says my posture is pretty poor, mentions scoliosis, and thinks that might be causing this pain. I don't have issues when I'm walking and I can climb up to 12 floors without a problem but the neck and back pain, especially on the left side, really gets to me. Occasionally, I feel a sharp pain on the left side of my chest, but it fades away quickly. My chest is tender, and some spots are really sore to touch. Do you think it's safe to rule out any cardiac causes? Is there any other test I should consider doing?

Accepted Answer

Based on your history of negative stress echo, normal angio in 2011, and normal nuclear test and TMT in 2015, it is less likely that your current symptoms are related to cardiac issues. However, it is important to consider other potential causes for your neck, ear, jaw, shoulder, and chest pain. Given your description of neck stiffness and pain, along with the presence of scoliosis affecting your posture, it is possible that your symptoms are musculoskeletal in nature. To address your current symptoms, you may benefit from a muscle relaxant such as **Cyclobenzaprine** 10mg to help with the neck and back stiffness. Additionally, you can consider taking **Ibuprofen** 400mg for pain relief. Since you mentioned tenderness in your chest and certain points, it may be helpful to rule out any musculoskeletal chest wall pain. However, considering your history and current symptoms, further cardiac testing may not be necessary at this point. To improve your posture and alleviate the neck and back pain, regular physiotherapy sessions focusing on postural correction and strengthening exercises may be beneficial. It is important to continue working with your physiotherapist to address the underlying cause of your symptoms. If your symptoms persist or worsen, it is advisable to follow up with your healthcare provider for further evaluation and management.

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