Cardiac Spasms Diagnosis

I had been in the hospital for my heart recently. It really wasn't a biggy, had such been I would have called my Mom and Uncle letting them know that I was now part of their Heart Club of cardiac bypasses in the Family. The year was 2000 when my Mother had a 4 heart bypass. Additionally; at this time the Cardiac Surgeon preformed a triple loop with one of her veins to the heart, a procedure that supposedly had never been done before. Shortly afterwards - maybe within a few years; my Uncle had a one heart bypass. As CAD (coronary artery disease) continues to spread throughout the Family, my Uncle telephones others to welcome them to what he calls "The Zipper Club". Though currently with the rapid advancement in medical technology, some heart surgery patients are now glued with incision down their chest.

Well knowing our Family heart tradition and not wanting my Little Sister to have to blindly attend to my affairs with all my Sis had and is going through, I prepared my Living Will. Something I would like to encourage everyone to do, even if you aren't planning on going into the hospital any time soon. Especially since things unfortunately happen unexpectedly in life. These unfortunate events are called accidents, tragedies, etc. And it is the Family whom must deal with your affairs and the Doctors. A Living Will is NOT a will about your personal belongings, property, etc. - rather a Living Will is simply a "DECLARATION OF A DESIRE FOR A NATURAL DEATH" that basically consists of:

INSTRUCTIONS CONCERNING ARTIFICIAL NUTRITION AND HYDRATION


INITIAL ONE OF THE FOLLOWING STATEMENTS:

If my condition is terminal and could result in death within a reasonably short time,

______ I direct that nutrition and hydration BE PROVIDED through any medically indicated means, including medically or surgically implanted tubes.
______ I direct that nutrition and hydration NOT BE PROVIDED through medically indicated means, including medically or surgically implanted tubes.

INITIAL ONE OF THE FOLLOWING STATEMENTS:

If I am in a persistent vegetative state or other condition of permanent unconsciousness,

______ I direct that nutrition and hydration BE PROVIDED through medically indicated means, including medically or surgically implanted tubes.
______ I direct that nutrition and hydration NOT BE PROVIDED through medically indicated means, including medically or surgically implanted tubes.

(Download your Free Living Will).

I'm not sure about a DNR (Do not resuscitate), that would also need to be a personal decision. Bear in mind however; that a DNR is a choice made by you that includes a written DNR Order by you and/or from a doctor that resuscitation such as CPR should not be attempted if a person suffers cardiac or respiratory arrest. This includes No resuscitation from paramedics. You might want to only decide on a DNR Order if "resuscitation would not alter the ultimate outcome of a disease, and will prevent unnecessary suffering."

Having made my Living Will, I knew that I've had an undiagnosed heart problem since the first onset in March 2003. Heart palpitations sent me to the emergency room then. Conclusive only for an unexplained high pulse rate. However; the stress test was inconclusive because I had an asthma attack during the test. Then the paper work from the ER Doctor that recommend I wear a Holter monitor for 24 hours - had gotten lost in the process, so I just never followed through. Until April this year when I was at the emergency room twice in one week for chest pains.

The EKG (electrocardiogram) showed NO heart attack, however; I did test positive on the D-dimer blood test for a blood clot. An IV contrast CAT Scan (CT Angiography (CTA)) of my lungs fortunately showed no clot in the lungs, so I was diagnosed with a possible 10% heart blockage. Still I refused to be admitted to the hospital. However; I did want to follow-up with their recommendation for a cardiac nuclear stress test. Only to learn what it is like to be laid-off, unemployed, uninsured, and living in America. Finally I got in the back door of a local hospital at MUSC Ashley River Tower (Specializing in Heart & Vascular Disease and Digestive Disease), to at least have the test done.

My Primary Physician saved me money by calling - instead of scheduling an expensive consultation with her. She stated I needed to see a cardiologist STAT because my stress test was positive (abnormal). Unable to get approved for MUSC Cardiologists, I was fortunate to find a private Cardiologist to work with me financially. So happen the same Cardiologist a Friend of mine has! This Cardiologist stated the stress test showed Ischemia, a lack of oxygen to a certain part of the body. Fortunately though, the heart scans showed a healthy undamaged heart! However; based on our Family history of CAD (coronary artery disease), my high cholesterol, my smoking, shortness of breath, etc. the Cardiologist wanted to look further. So Wednesday I went in for a Coronary Catheterization at Roper St. Francis Hospital. It was an in and out (the same day) procedure that took about 8 hours.

They used an Angio-Seal vascular closure device that "quickly seals femoral artery punctures following catheterization procedures, allowing for early ambulation and hospital discharge. The device creates a mechanical seal by sandwiching the arteriotomy between a bio-absorbable anchor and collagen sponge, which dissolve within 60 to 90 days."

Had the Doctor found anything wrong with my heart such as a blockage, etc. I would have remained in the hospital for the procedure. Fortunately; the Cardiologist only found cardiac spasms (coronary artery spasm) which apparently he found amusingly interesting like I was some kind of video game to play with as he showed me the heart spasms on the monitor. The Doctor doesn't seem to concerned and feels that though rare, my migraines may be the contributor. He muttered some kind of medical word for it to me while I was highly medicated. So far I found this on the internet to best recall my memory of his muttered words, Migraine and angina pectoris:

"A migrainous patient who experienced chest pain attributed to angina pectoris by coronary artery spasm during a migraine attack."

I'm to see this Cardiologist for a follow-up appointment in July. However; as I said he doesn't seem to concerned about the cardiac spasms. Whereas my search on the internet says different:

"Angina is caused by Ischemia (oxygen starvation) of the cardiac muscle. Coronary artery spasm produces ischemia by narrowing the coronary arteries. The narrowed artery is incapable of delivering the necessary blood volume to the working muscle. Ischemia ensues, and the resultant pain is called angina."

My concern is in further research I have learnt that Ischemia being a "lack of oxygen can resultant damage or dysfunction of tissue or organs". And something as simply as Calcium channel blockers can help. So if this Cardiologist doesn't seem concerned about any possible future damage, or give me any medicine for this condition, I may get a second opinion from a Cardiologist at MUSC; who has since approved me to be seen.

For now my current Cardiologist has prescribe me Nitroglycerin, so if I get more chest pains - instead of assuming it is from the migraines I am to take up to three sprays within 5 minute intervals, if that doesn't stop the pain I am to get to an emergency room.

If anyone knows more information on Migraine and angina pectoris, and/or Coronary artery spasm Please inform me and/or send related links. Thank You!

Meanwhile; here's to the 90 days of currently mild pain, discomfort, and finally the Angio-Seal magical evaporation!


Related articles: Women's migraines linked to higher stroke, heart attack risk CNN.com





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