Heart Attack?

[john999]

I went to the VA today for regular visit. They did ECG on me. On the result it said I had inferior infarct. I never have had a heart attack that I know of. I think the VA has mixed up my records again. Once they told me I had a stroke which was untrue. I am going to go to a real cardiologist to get this thing checked. I don't really think there is anything wrong with my heart, but it there is I am going to get a new rating since I am RVN vet. The VA has come up with some really weird findings in the past. I trust them zero percent.

John

[jbasser]

John, If you are diagnosed with Coronary Artery disease it is presumptive as per schedule with the rating based on your Ejection Fraction. People use the term mets.

Check the schedule for IHD or Cad.

J

[Berta]

John, anyone can have a 'silent' heart attack that would cause an inferior infarct ,revealed on a EKG due to some medical cause.

But it is unusual.

Diabetics ,however are far more prevalent to having this type of heart attack,due to their diabetes.

"I am going to go to a real cardiologist to get this thing checked."

GOOD. VA did a EKG minutes after my husband collapsed on his job at the VAMC. They sent him home with Sudafed saying he had a sinus infection.and gave him three days off work.There was no chest pain before he collapsed but when I looked up one word in the discharge cert, and looked up a few medical acronyms on the certificate, after I filed FTCA/1151, I KNEW they had malpracticed on him that day, and those errors set the stage for his untimely death.

They never told him the EKG results. If they had, I have no doubt he would still be here.

But this sure could be a wrong VA interpretation of the EKG.

[georgiapapa]

John,

Berta has a good point about "silent heart attacks."

According to an article I just read, silent heart attacks have been associated with several medical issues including emotional stress, diabetes, smoking, etc. I know you have diabetes and you were really stressed about your neighbors a couple of days ago. Don't delay going to your cardiologist.

Also, silent heart attacks occur more often in the elderly.

Take care of yourself.

[Navy04]

Over the last 6 years, I have been misdiagnosed so many times, and almost had a Hernea surgery once, and at the last minute the Doc wanted to do an testicular ultrasound and I ended up having Testicular surgery instead. Just be careful and wish you the best

[john999]

I would not let the VA fix an ingrown toenail, so no worries about me letting them cut me open. I had two surgeries in the last 6 months. I am sure the doctors did EKG's on me and I was cleared for surgery no problem. I was not on the cutting board for 8 hours but I was out with a breathing tube down my throat. The heart issue started when the VA did a CT scan on my left leg and found some calcification in the arteries. Since I have DMII I pushed the issue and filed for artery disease. Somehow that got classified as CAD down the road. Heart disease does run in my family so I let it ride, but I spoke to a cardiologist anyway. He said the tests the VA gave me were pretty useless and only the wire into the groin procedure could really tell if I had blockage. That has risks all its own so I declined.

John

[Chuck75]

I would not let the VA fix an ingrown toenail, so no worries about me letting them cut me open. I had two surgeries in the last 6 months. I am sure the doctors did EKG's on me and I was cleared for surgery no problem. I was not on the cutting board for 8 hours but I was out with a breathing tube down my throat. The heart issue started when the VA did a CT scan on my left leg and found some calcification in the arteries. Since I have DMII I pushed the issue and filed for artery disease. Somehow that got classified as CAD down the road. Heart disease does run in my family so I let it ride, but I spoke to a cardiologist anyway. He said the tests the VA gave me were pretty useless and only the wire into the groin procedure could really tell if I had blockage. That has risks all its own so I declined.

John

A cath is the most definitive test. It also presents a possible opportunity to do something other than surgery.

That said, it's also true that a cardiologist makes money doing such things as caths and stint implantations.

[Berta]

John said:

Since I have DMII I pushed the issue and filed for artery disease. Somehow that got classified as CAD down the road. Heart disease does run in my family so I let it ride, but I spoke to a cardiologist anyway. He said the tests the VA gave me were pretty useless and only the wire into the groin procedure could really tell if I had blockage. That has risks all its own so I declined."

"classified as CAD"??? could they have possibly meant PAD instead?

PAD=Peripheral arterial disease is separate from PN and VA has to rate it separately.

When Dr. Bash did my DMII IMO, he also stated my husband had PAD. I never claimed it but maybe I should have.

Any form of diabetic neuropathy means the nerves have been affected in such a way that pain can be diminished to the point that a silent heart attack can cause no pain.

[georgiapapa]

I have had a mitral valve prolapse for years and I get a check up from my private cardiologist every year. In July 2012 I had a chemical stress test, echo, EKG, xrays, etc. and my cardiologist said my heart was fine.

Fast forward two months later to September 2012, I had chest pains and a cough. Since I just had what I thought was a thorough heart exam two months earlier, I did not think my chest pains were related to my heart and I went to my private PCP who diagnosed me with bronchitis and bursitis. My PCP gave me some medications which did not stop my symptoms so a week later I went to my pulmonologist who also said I had bronchitis. I went home and about seven hours later I started having even more severe chest pains and my wife called an ambulance. My cardiologist came to the hospital emergency room, ran some enzyme tests which were only slighted elevated and said "just to be on the safe side, I would like to do a heart catherization to see if you might have a blockage."

My cardiologist performed the heart catherization which revealed I had two blockages in my LAD of my heart. One blockage was 99% and the other was 80%. As a result, my cardiologist implanted two stents in my LAD. According to my cardiologist, the LAD is often referred to as the "widow maker" because blockages in the LAD are often fatal. My cardiologist told my wife if she had waited and not called the ambulance when she did, I would probably be dead.

My cardiologist was surprised my heart tests in July did not reveal any signs of blockages and she stated in the future when you have serious chest pains she would have me taken straight to the cath lab and perform a heart catherization rather than relying on other tests. She was true to her word when two months later in November 2012, I started having chest pains. I called my cardiologist and she contacted the hospital and told me to meet her there. When I arrived, I went straight to the cath lab, had another heart catherization and my cardiologist implanted a stent in my RDA due to an 80% blockage.

Same story in August 2013 but different results. I had chest pains, heart catherization but no blockages. False alarm but better to be safe than sorry (or dead).

John, there are some risks with all medical procedures, including a heart catherization, but as Chuck said "a heart cath is the most definitive test" to find out if you have blockages and about to have a heart attack. At a minimum, I would at least have your cardiologist do the heart enzyme blood tests and if they are elevated then do a heart cath. JMO

[john999]

I made an appointment with a private cardiologist. I think he will want to do a heart cath. Do I have to be knocked out for that? I have had two operations in the last six months where I was knocked out. I am getting a little bit scared of going under too often. However, my mother and father both died from heart disease and my sister has already had two heart attacks. My poor brother has CLL. I believe in preventive medical, so if justified I will do what has to be done.

John

[georgiapapa]

John,

They numbed up my groin area and I never felt any pain during the insertion of the Cath needle in my groin. I was placed under "conscious sedation" for all three of my procedures. I was in and out of consciousness during my procedures but I honestly never felt any pain or discomfort. If your cardiologist finds a blockage, he/she will probably implant a stent if the blockage is 70% or more. You will not feel anything when your cardiologist implants a stent. If you do not have any blockages, you will have some peace of mind knowing your heart is ok. After you have had one heart catherization, you will not have any apprehension about having another one. This is my opinion based on my personal experiences.

Good luck to you.

Georgiapapa

[georgiapapa]

John,

You may want to shave your groin area thoroughly on both sides right before you go for a heart cath. If you don't do it, someone at the hospital will do it for you. The first time I had a heart cath, a nurse came in lifted up my hospital gown and thoroughly shaved every part of my privates. It was interesting.

[Chuck75]

A heart cath is less troublesome than in the past. Normally, you end up with a small circular area on the inside upper leg that is a bit tender afterwards.

The old method was to make an incision about two to three inches long. With that method, pressure had to be maintained on the incision for some time afterwards,

and the resultant hassle with stitches and so forth.

The reason for prepping both sides is that it's remotely possible that two caths might be necessary, depending on the location and severity of a blockage.

One cath can be used to remove the blockage, and the other to implant a stint, as an example. Or the second can be used to filter possible debris that might be caused by

the stint implantation or blockage removal. Balloon angioplasty can also be done. The right groin is usually the preferred entry point, and the left used for a second simultaneous cath, if needed.

Anesthesia can vary from "knocking you out", to leaving you conscious, with reduced but not eliminated momentary pain/pressure from the cath insertion.

If the latter is the case, you may know exactly what is occurring, and not be able to "move a muscle" or speak. It's arguable as to which is better, although

less anesthesia is usually far less risky than more.

If conscious, you may actually be able to see the cath end and so forth via a monitor screen as it's used, as well as any dye used to

trace circulation and so forth. The cath can also be used to measure local pressures, pressure waveforms, and flow if needed.

"Been down both roads", albeit reluctantly! Have another one scheduled via "fee paid" with my non VA cardiologist.

Edited January 10, 2015 by Chuck75 (see edit history)

[john999]

I also need a colonoscopy. I had an endoscopy about 6 months ago. The VA has really messed up my records in the past. There is another guy with my name on my Alpha Team at the Tampa VA. They get our records mixed up even with different SSA numbers. I will also ask my cardiologist if my DX for CAD could cause my OSA. I think indirectly my OSA is caused by my AO induced PN for sure since I have gained weight because I can hardly walk some days and I sit around a lot more than I did before the PN. I am also SC'ed for CAD and I am not even sure I have it. I don't argue because that is how I got "S". With the OSA I just really want to be cured which is why I had the Inspire surgery and implant.

John

[georgiapapa]

John,

Did you have anesthesia for the endoscopy? I have a endoscopy every two years as a result of multiple stomach polyps. I have a colonoscopy every three years now because they found polyps on previous colonoscopies. They use propophol to sedate me during both procedures.

My PN pain woke me up at 3:15 this morning and I could not go back to sleep. Taking Gabapentin and amitrypline but they provide very little relief for the burning and sharp pains in my feet. Is there any type of surgery or other treatment methods for severe neuropathy pain?