Ischemic Heart Disease

[GuaymasJim]

Before I begin, I want to admit that these are probably dumb questions. As a geek, I have spent many many hours trying to research and understand, but I just must be dense because I haven’t met with any success.

Here goes:

A medication which I receive from the VAMC for the service-connected condition that underlies my 34 year-old TDUI P&T VA rating and SSDI determination is known to cause some patients to experience Myocardial Ischemia. During the past several months, I have been experiencing a severe pain that feels like someone has reached under my ribcage grabbed my heart and is squeezing so hard that it feels like my heart is about burst open. Accompanying this pain is a burning sensation under my ribcage along a line starting just above my right nipple and extending to my left armpit.

The two pains can and do occur separately. The “heart pain” can happen anytime including when I am asleep and usually lasts for several hours. The “burning pain” sometimes last for days. If I use the VA medication as directed, the “heart pain” starts within about 10 minutes and lasts longer and is much more intense than when it happens without the medication. During the “heart pain” without having used the medication my blood pressure rises dramatically 140-150/85-90; and with the medication my BP goes off the charts into the very dangerous zone (155-161/102-110). In the absence of both the medication and the pain my normal BP is 90-100/65-75.

Two recent ECGs show “possible atrial enlargement.” All prior ECGs (ten years worth) are normal.

Here is where my confusion begins: Is myocardial ischemia just one type of Ischemic Heart Disease (IHD), or is it a separate condition? If it is IHD (I believe it is but am not sure) how would I claim it? IHD is an Agent Orange presumptive (have confirmed stressors and combat decorations) and damage done by VA medications can be the basis of a valid claim.

I would appreciate any input!

[RonP]

My personal direction would be to seek out a Very experienced Cardiologist.

He will give you an independent view, yes you will have to pay.

Ask him the question directly after the answer he gives you.

Then ask him to write an opinion on his letterhead.

Contact your VSO, if the DR. said you have a form of IHD then you can step forward to claim.

Are you an Agent orange vet ? Did you have boots on the ground ? If so and all is yes you have a right to claim it.

Ask the cardiologist for a prescription for Nitro for your heart pain you take it under your tongue and let it melt....if pain still there take 1 more wait five minutes . If pain persist, take 1 more and got to VA

or a private hospital if you have insurance. I am 100% for IHD , these are things I do. I cannot give you medical advise ...but the Cardiologist CAN !The cardiologist will recommend an angiograhm, a medical procedure, injecting dye into your heart arterial system. Don't mess with it , check it......

My 3 cents

[GuaymasJim]

Thanks Ron! Believe me I am going the doctor route! Unfortunately, nitro provokes the attacks that I take the medication for. Sort of an ugly circle!

My question is whether or not myocardial ischemia is considered IHD by the VA. If so I want to get it service connected in order to protect my family in the event it kills me.

[Sergent Emmons]

myocardial ischemia and Ischemic Heart Disease (IHD) are one and the same...one can get this heart problem for many reasons myocardial ischaemia, is a disease characterized by ischaemia (reduced blood supply) of the heart muscle, usually due to coronary artery disease (atherosclerosis of the coronary arteries). Its risk increases with age, smoking, hypercholesterolaemia (high cholesterol levels), diabetes, and hypertension (high blood pressure), and is more common in men and those who have close relatives with ischaemic heart disease.

Symptoms of stable ischaemic heart disease include angina (characteristic chest pain on exertion) and decreased exercise tolerance. Unstable IHD presents itself as chest pain or other symptoms at rest, or rapidly worsening angina. Diagnosis of IHD is with an electrocardiogram, blood tests (cardiac markers), cardiac stress testing or a coronary angiogram. Depending on the symptoms and risk, treatment may be with medication, percutaneous coronary intervention (angioplasty) or coronary artery bypass surgery (CABG).

It is the most common cause of death in most Western countries, and a major cause of hospital admissions.^[1] There is limited evidence for population screening, but prevention (with a healthy diet and sometimes medication for diabetes, cholesterol and high blood pressure) is used both to prevent IHD and to decrease the risk of complications.

The medical history distinguishes between various alternative causes for chest pain (such as dyspepsia, musculoskeletal pain, pulmonary embolism). As part of an assessment of the three main presentations of IHD, risk factors are addressed. These are the main causes of atherosclerosis (the disease process underlying IHD): age, male sex, hyperlipidaemia (high cholesterol and high fats in the blood), smoking, hypertension (high blood pressure), diabetes, and the family history.^[2]

Hope that helped

[RonP]

Try this

http://en.wikipedia.org/wiki/Ischaemic_heart_disease

A VA Opinion will be from a RATER......Do you know any

According to the above

IT IS IHD

Good Luck

[GuaymasJim]

Thanks SE and Ron,

The wiki reference was my first stop. It has been my experience that wiki isn't well accepted as a legal reference, so I went to almost all of the locations provided by SE.

I could never replicate the wiki statement:

Ischaemic or ischemic heart disease (IHD), or myocardial ischaemia, is a disease characterized by ischaemia (reduced blood supply) of the heart muscle, ....

Sorry guys, but my being a detail fanatic has its downside!

A private MD has made a tentative diagnosis of the unstable variety conditioned on a stress test and angiogram. It is his opinion that two + years of undertreated hypothyroidism more than likely concealed the IHD symptoms because I was too fatigued to be very active physically. The symptoms presented and increased in lockstep with the efforts to control the hypothyroidism. The thyroid problem is under control for the time being, and the symptoms I mentioned in my original post have surfaced with a vengeance.

No, ron, I don't know any raters, so I do want a clear, accurate, and supportable diagnosis in my VA and private medical records!

Again, thanks guys!

[RonP]

Call Stanford or Mayo Clinic

Describe

Make sure you are asking for a second opinion teleconferance.

State your case.

Either will give you a valid oral but not conclusive opinion.

Tell them you are bedridden at this time

\ My met was 26 anything under 30 wins 100% but you are trying to protect your potential need for suit, your estate, you are now 100 % , sound like a true legal question if you get a yes from the second opinion

do not mention any word concerning law they will shut up and hang up.

This is my last shot at answering the question.

God Speed