cardiac ?

[brighton2272744]

hi all i have posted before just didn't get much response hoping someone can advise
me.
every other day sometimes every day for the last 9/10 weeks for a minute or sometimes longer up to half an hour (once it was for quite a few hours) i get a pulsating mild ache on the left side of my chest deep inside it radiates to my back and then down my arm feels like cardiac no palpitations i've had ecgs around 7 and 3 troponin blood the last one being 2 weeks ago all tests that have come back normal gp won't refer to cardiology unless my at home heart monitor shows anythink ( in a few days i pick this up (
what cardiac tests can i do privately that match this type of issue i'd like to go private with a good cardiac docotr in london possibly but not costing a bomb anyone know any or have any advice my day to day is ruined as i constantly have this on my mind i don't really suffer with anxiety i am an ex smoker ( stoops a few months ago.
thankyou all

How old are you? What triggers the episodes? Do they happen at rest or after exertion? What is your blood cholesterol level? Is there a family history of coronary heart disease? Even if bloods and ecg are clear there could be an occlusion causing these warning symptoms. I would say that either a CTA or angiogram would rule out (or confirm) any issues. I would go back to your GP and insist on a referral.

hi thankyou i'm 33 no history my dad has angina but got it in late age the symptoms come at any time or posture and when i exercise i feel fine
i've spoke to the gp twice do you think an at home monitor isn't enough i need to speak the the gp again this week or go private i think

Home monitor will only register ecg changes over a 24/48 (or whatever) period. Your symptoms are atypical but that is not uncommon in women. Smoking is one of the main causes of cardiovascular disease so well done for quitting! Again, push for a cardiac referral, but if you get nowhere and symptoms persist then echocardiogram and CTA are usually the next steps followed by the more invasive angio. Good luck - always listen to your body!

my docotr said woth blockages there woukd be some changes in the ecg or damage in the troponin blood test do you think that is incorrect i maybe schedule a call with a private cardiologist this week just need to research which ones are good and afordable
thanks

echocardiogram or angiogram or cts sorry wich one did you say was more acurate

ECG is not by any means foolproof. I have known young slim non-smokers who had normal ECG, bloods etc - all the tests until the angiogram revealed a narrowed coronary artery needing a stent. Not to undermine your GP of course who may have good reason not to be concerned.

CT Angiogram would be best and least invasive

A 24 hour ECG as your GP has arranged is a very reasonable first step for your symptoms.

thankyou can i ask your symptoms i may ask gp for this tom if declined i'll go private thankyou

thankyou can i ask your symptoms im going to ask the gp for this tom if declined will go private so you think this needs looking at asap rather than waiting for a long nhs referral

No me but patients of mine. Symptoms were atypical chest pain (deep crushing sensation in sternum area radiating to arms and esophagus) lasting up to 15 minutes brought on by exertion but also in rest. Increasing frequency. Frequently mistaken for indigestion.

I do think the GP is being reasonable here.

You are 33 (incredibly young in cardiac terms) and the only symptom you have is this random pain, which isn’t correlated to exercise or cardiac stress. Your ECGs and troponin have all come back negative.

Despite the above, you are being offered a 24 hour home heart monitor. Why not see what it says?

thankyou exhocardiogram cta and angiogram are three different things right how would i know whcih one to go for thanks

Which is your nearest hospital, a echo and an angio look at different things. What's your maximum budget., a doctor consultation will be £250 minimum plus any tests.

None of these tests will be valuable without cardiologist interpretation and direction - as you can see there are a lot of different cardiology tests and you need someone who knows what they are asking for and why.

Just an appointment with a cardiologist would be £250 to £300 without any further tests. A CT angiogram as mentioned about is £1.5K and may not even be something you need. And very unlikely they would let you book this direct.

As above, for the symptoms you are describing your GP's choice is very reasonable.

Do you smoke or vape?

Do you have health anxiety, OP?

hi i was going to schedule a call with a cardiologist but i'd like to know my stuff before i call them as much as i don't want to pay 1.5 k i am willing to rule out ant heart blockages

thankyou i'll book a consult this week and see what they suggest

i used to stop cigereets no vape

i don't believe it do

thankyou id like to see what that sais yes the home monitor but if i do have a heart blockage that can't always be picked up with ecgs like some people have mentioned why not relax my mind and pay x1.5 k for a more acurate test waiting weeks for a result from the home minister may jelordise my health possibly or so you think i am over reacting thanks

Troponin would show if you have any heart damage, so looks like you don’t and aren’t having a heart attack right now. ECG is also to check how your heart is.

Neither of these will indicate if you have a “blockage” issue.

As an ex-smoker myself who knows the type of pain you are describing I would suspect significant plaque in your coronary arteries.

I would reccommend a CT Coronary Angiogram (dye injected and then arteries scanned), and also getting a Coronary Calcium Score.

Calcium Scores are really only useful as a marker to check against a later Calcium Score to note change, so aren’t used much now because whilst you ideally want a zero calcium score, you can have a zero calcium score when you have lots of dangerous soft plaque that doesn’t have any calcium in it.

When it comes to plaque there are two basic types; plaque starts off soft (this is dangerous plaque) then it gets calcified and becomes harder. When hard it is stable and is much safer. It’s softer plaque that can erupt into an artery, clot and result in a heart attack or stroke.

With modern CT Coronary Angiogram they should be able to see soft plaque as well as hard. If you have significant soft plaque and make positive lifestyle changes (such as quitting sugar and flour) to help stabilise the soft plaque, your Calcium Score will go up but your risk in reality will go down.

You could also, perhaps more cost-effectively try to get a CIMT (Carotid Intima Media Thickness) ultrasound test - done on your neck. This is less invasive and if you have plaque/calcium in your neck arteries then you WILL have it in your heart arteries.

Between ecg and angiogram is usually heart ultrasound. I don’t know if the ultrasound detects everything but OP would you feel able to leave it if the ultrasound came back clear but you were still having the pains?
@brighton2272744 are you aware that angiogram is not without risk (including risk of heart attack stroke and death)?
Have you considered some kind of harmless inflammation of intercostal muscles?
It does sound a little like health anxiety in as much as otherwise healthy people of your age probably wouldn’t even go to the doctors for this let alone pursue hospital based testing.

hi thanks for your reply getting a canary calcium score woukd thst be needed if i just went for the ct angiogram