Confusion About Next Steps in Cardiovascular Treatment: Seeking Clarity

Feeling confused about the next steps in treatment?

Hello Doctor: I have previously undergone an exercise electrocardiogram (with poor tolerance, my heart rate reached 206 and blood pressure was 189/142 after running for 3 minutes).
I am not sure if the short duration of the run contributed to the lack of ischemic symptoms mentioned by the physician.
I also had an echocardiogram (showing mitral valve prolapse with regurgitation, tricuspid regurgitation, and moderate pulmonary regurgitation), an electrocardiogram (which showed no abnormalities), a chest X-ray (which indicated normal heart size), and a 24-hour Holter monitor (which revealed occasional atrial arrhythmias with about 400 missed beats).
My initial complaints were shortness of breath and frequent sharp chest pains.
After the examinations, the doctor prescribed me medication for anxiety, but the dosage has been increasing, and despite this, my symptoms of shortness of breath and chest discomfort have not improved at all.
Someone recommended that I undergo a cardiac catheterization, a less invasive procedure for treatment, but I have no understanding of this procedure and am unsure if it will alleviate my symptoms.
Will I still need to take medication afterward? What are the potential side effects? What does the procedure entail? I apologize for my confusion regarding the treatment, as I am completely lost on how to proceed.
My shortness of breath seems particularly pronounced, as I struggle to breathe even during brisk walking, yet my LVEF is normal.
I hope you can explain this patiently and in simpler terms.
Thank you!

Diann, 10~19 year old female. Ask Date: 2011/03/13

Dr. He Dongjin reply Cardiology

Hello, you may be able to find a nearby cardiologist to adjust your medication without the need for a cardiac catheterization, as it is unlikely to improve your symptoms.
Most of the tests mentioned are normal, and your shortness of breath does not correlate with the findings, while the sharp pain is mostly not heart-related.
It is advisable to adjust your medication first without too much concern.
Changhua Hospital cares about you.

Reply Date: 2011/03/13

More Info

It sounds like you are experiencing a complex situation regarding your cardiovascular health, and it's understandable to feel confused about the next steps in your treatment. Let's break down your concerns and the potential options available to you.

Understanding Your Current Condition
From your previous tests, it appears that you have several cardiovascular issues, including mitral valve prolapse with regurgitation, tricuspid regurgitation, and moderate pulmonary hypertension. You also mentioned experiencing symptoms such as shortness of breath and chest pain, which can be quite distressing. Your exercise stress test indicated a high heart rate and elevated blood pressure, which may suggest that your heart is under stress during physical activity.

The Role of Cardiac Catheterization
Cardiac catheterization is a procedure that allows doctors to examine how well your heart is functioning and to assess the condition of your coronary arteries. It involves inserting a thin tube (catheter) into a blood vessel in your arm or leg and guiding it to your heart. This procedure can help identify blockages or other issues that may be contributing to your symptoms.

#
Benefits of Cardiac Catheterization:
1. Diagnosis: It provides a clear picture of the coronary arteries and can identify any blockages or narrowing.

2. Treatment Options: If blockages are found, the procedure can also allow for immediate treatment, such as angioplasty (widening the artery) or stent placement.

3. Guidance for Future Treatment: The results can help your doctor determine the best course of action moving forward, whether that involves medication adjustments, lifestyle changes, or further interventions.

Concerns About the Procedure
It's natural to have concerns about undergoing a procedure like cardiac catheterization. Here are some points to consider:
1. Risks: While generally safe, there are risks associated with the procedure, including bleeding, infection, or an allergic reaction to the dye used. However, serious complications are rare.

2. Recovery: Most patients can go home the same day after the procedure, but you may need to rest for a day or two. Your doctor will provide specific instructions based on your condition.

3. Medication: Depending on the findings from the catheterization, your doctor may adjust your medications. Some patients may require blood thinners or other medications to manage their heart condition more effectively.

Next Steps
1. Consult Your Cardiologist: Discuss your symptoms and concerns with your cardiologist. They can provide clarity on whether cardiac catheterization is the right next step for you based on your current symptoms and test results.

2. Lifestyle Modifications: In addition to any medical interventions, consider discussing lifestyle changes that can improve your heart health, such as dietary adjustments, regular exercise (as tolerated), and stress management techniques.

3. Follow-Up Care: Regular follow-up appointments are crucial to monitor your condition and adjust treatment as necessary. Make sure to communicate any new or worsening symptoms to your healthcare provider.

Conclusion
In summary, cardiac catheterization can provide valuable insights into your heart health and help guide your treatment plan. While it’s understandable to have concerns, discussing these openly with your healthcare provider can help alleviate your fears and clarify the benefits of the procedure. Remember, managing heart health is a collaborative effort between you and your healthcare team, and it's important to feel comfortable and informed about your treatment options.

Similar Q&A

Understanding Post-Stent Care: Addressing Patient Concerns and Communication

The system seems to be malfunctioning. My email is correct, yet I am not receiving replies and cannot select satisfaction ratings. Regarding the previous question: 1. Currently, my physician, although not the original attending doctor, possesses expertise, and I have always belie...

Dr. Li Han reply Cardiology
Hello Mr. Lee, I have not received a response to your previous inquiry, which I find puzzling. However, I will reflect this matter from the hospital's side regarding the persistent chest pain and elevated blood pressure that have been troubling you. I can imagine your anxiet...

Understanding Cardiovascular Issues: A Patient's Journey Through Diagnosis and Treatment

Dear Dr. He, I apologize for my unclear writing, which may have caused some confusion. I have some questions that I feel uncomfortable asking my doctors, even though I know it's my right as a patient. At the age of 29, I first visited a cardiologist, who discovered that I h...

Dr. He Dongjin reply Cardiology
Dear Dan, I am not sure which hospital you visited before. Have you been to National Taiwan University Hospital? With antibodies and vasculitis, it is likely that you are concerned about the inflammation of blood vessels, which can make them more fragile and difficult to heal a...

Understanding Cardiovascular Blockage: Treatment Options and Risks

Dr. Lin: Hello, I have concerns regarding cardiovascular blockage and would like to seek your advice. My mother is nearly sixty years old and has diabetes. In recent years, she has frequently experienced unexplained chest tightness and pain, with several instances severe enough t...

Dr. Lin Xinjing reply Cardiology
Hello: Generally speaking, the heart has three coronary arteries. After a detailed examination, if there is a blockage, balloon angioplasty with stent placement or coronary artery bypass grafting (CABG) may be performed. In general, the prognosis is good. However, for diabetic pa...

Understanding Post-Heart Attack Care: Essential Tests and Treatments

Last December, a family member experienced a myocardial infarction, resulting in the blockage of two blood vessels. The first vessel had a stent placed with health insurance assistance, while the second vessel was treated with a procedure that the doctor described as similar to a...

Dr. Cai Guiqin reply Cardiology
We recommend that you: 1. Discuss the above situation further with your attending physician. 2. Consider consulting at a medical center. Wishing you good health. Thank you!