posted
I have tons of heart symptoms, and someone from another site suggested I look into microvascular heart dysfunction. I really think she's onto something, especially for those of us with bartonella, as bartonella is known to invade endothilial cells (which could cause microvascular dysfunction as I understand it).
My heart problems have gotten better on bart meds but are still really bad.
Anyway, this could explain why a lot of heart tests are negative when people have chest pain, shortness of breath, and certain other heart symptoms. Microvascular dysfunction only shows up in subtle ways on testing but can cause these symptoms.
It is sometimes knows as "cardiac syndrome x" and other names.
I wonder if anyone has been diagnosed with this, or ever discussed it with a cardiologist. And, if so, if the treatments (i.e. nitrates) have done anything helpful.
Posts: 929 | From Massachusetts | Registered: Oct 2007
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posted
What tests are performed for that? Would it show up on an u/s or a heart moniter?
I had all that great stuff and of course it was dismissed for aniesty because it wasnt there in PLAIN SIGHT.
*sigh* Where is doctor House when you need him? I think they should do an episode where they cannot figure out the symptoms of the patient and then at the end determine its lyme?! Maybe somone in the med prof will pay attention!
Perhaps we should all write in? HAHA! They would have to do it to shut us up! Posts: 171 | From the land of oz | Registered: Feb 2009
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sutherngrl
Frequent Contributor (1K+ posts)
Member # 16270
posted
They actually mentioned LD 2x on one of the episodes of House as a possible diagnosis! I thought how interesting that they would mention it when trying to diagnose a very serious illness; even though it is just a tv show.
I think my LLMD is almost a Dr House, except he is not mean! But he thinks outside the box like House does.
OOPs, didn't mean to get off the subject. The heart thing is interesting. I have had all kinds of heart issues since becoming ill, none of which have been considered serious.
Posts: 4035 | From Mississippi | Registered: Jul 2008
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posted
I guess microvascular heart disease is a diagnosis by exclusion, and it is relatively new, but some doctors are beginning to take it seriously -- it might at least convince some of them to give test results a second look if the symptoms are really bad. And yes, we ALL need Dr. House!!
It can show ischemic changes on some tests, which I think present as ST inversions (?) on EKGs. I think there is some other sophisticated testing that is not commonly done but I have to research it more.
Posts: 929 | From Massachusetts | Registered: Oct 2007
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I have all sorts of heart issues too. I have depressed ST waves on EKG's as well. Even had a cardiac cath. done and the Dr's. could not tell me what was wrong.
It's got to be Bart as my symptoms get better with Bart tx.
Anything for treatment we can do besides abx for this condition?
BTW Dr House did have a show on Lyme and that was the final mystery of what this gal had. He treated her with IV abx and she got better in weeks. No talk of chronic lyme or treatment difficulties either
Stacy
Posts: 476 | From Columbus, Ohio | Registered: Aug 2007
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SORRY THIS IS RATHER LONG BUT WORTH SHARING. SEE THE TONY BRAXTON INFO BELOW TOO.
Coronary artery disease may take a different course in men and women, which may explain why the rate of death for women has declined more slowly than for men, according to the October issue of Mayo Clinic Health Letter.
Several landmark studies published in the last year indicate that more women than men suffer from microvascular, or small vessel, heart disease, where the heart's tiniest vessels become clogged or narrowed, limiting blood supply to the heart.
These tiny clogged vessels don't show up on standard diagnostic tests, and doctors may assume that symptoms such as fatigue, light-headedness, or chest, neck or shoulder pain are caused by something other than heart disease.
Yet, for some patients -- more often women -- these symptoms can develop into recurrent chest pain, a heart attack or heart failure.
Mayo Clinic doctors recommend additional testing for people with coronary artery disease symptoms and no indication of clogged arteries on a coronary angiogram -- the diagnostic tool for visualizing narrowing or blockage in the large coronary arteries.
Additional tests include positron emission tomography (PET), a noninvasive imaging test that can suggest, but not diagnose, microvascular disease.
The gold standard test for microvascular disease is an endothelial dysfunction test, a special type of coronary angiogram. It involves placing a tiny wire called a Doppler wire inside a coronary artery and measuring blood flow.
Research on microvascular disease continues. Until more is known, be aware of heart disease symptoms. Seek diagnosis and treatment when symptoms occur and talk to your doctor about testing for microvascular disease.
Toni Braxton's Microvascular Angina: FAQ Singer Diagnosed Just Before Stint on Dancing With the Stars By Daniel J. DeNoon WebMD Health News Reviewed by Louise Chang, MD
Sept. 23, 2008 - Just before starting the demanding Dancing with the Stars competition, singer Toni Braxton came down with a new heart problem: microvascular angina.
It's not her first brush with heart disease. Last year, Braxton told WebMD about her 2004 brush with pericarditis -- inflammation of the tissue surrounding the heart.
People with microvascular angina, also known as cardiac syndrome X, suffer pain when doing strenuous exercise. Yet in her first appearance on Dancing with the Stars, 40-year-old Braxton was one of the top-rated dancers.
In an interview with E! News Now, Braxton said that after hearing of her new diagnosis, she planned to take a year off to let her body and mind heal. Then she changed her mind. Is that wise? What is microvascular angina? How will it affect Braxton's performance? Her career? Her life?
WebMD consulted with top heart doctor William O'Neill, MD, executive dean for clinical affairs and professor of medicine and cardiology at the University of Miami Miller School of Medicine. We asked O'Neill:
* What is angina? * What is microvascular angina (cardiac syndrome X)? * How do doctors diagnose microvascular angina? * Did Toni Braxton's previous pericarditis cause her microvascular angina? Might her doctors have misdiagnosed her microvascular angina four years ago? * How is microvascular angina treated? * What is the outcome for people with microvascular angina? * Is there a lesson here for other people? http://www.mayoclinic.org/ What is angina?
"The term angina means chest discomfort. It is the medical term for a symptom: heart pain. It is brought about when there is a lack of blood supply to a portion of the heart muscle.
"If this happens, the person feels discomfort. People feel this differently. Nobody has exactly the same feeling with angina. Some feel it as a pressure or a burning. Most people do not feel true pain. Usually it is described as an elephant sitting on one's chest, or as if a giant hand were squeezing your chest.
"Some people don't feel it at all. People with diabetes are notorious for not feeling angina. This is called silent ischemia. The other thing that is very common is that people get very short of breath -- without pain -- as a manifestation of angina. They say, 'Doc, I feel fine, but every time I climb stairs I get really short of breath.'"
"When anything blocks blood flow to the heart, the heart has to start pumping harder, and that part of the heart becomes ischemic and you start having pain. " What is microvascular angina (cardiac syndrome X)? "In 95% of cases, lack of blood flow to the heart is due to blockages in one or more of the three main coronary arteries. Somewhere under 5% of the time, instead of major artery blockages, people have atherosclerosis in very small arteries.
"Picture the heart as the trunk of a tree. To get blood to the muscles, the tree roots branch out into smaller and smaller vessels. When these little vessels get diseased, as you exercise, you can't get enough blood to the heart."
Toni Braxton's Microvascular Angina: FAQ Singer Diagnosed Just Before Stint on Dancing With the Stars (continued)
How do doctors diagnose microvascular angina (cardiac syndrome X)? "Cardiac syndrome X is a diagnosis of exclusion. We don't have equipment that does microscopic dissections of these small blood vessels. So this is mainly diagnosed by symptoms.
"To diagnose this, we try to bring on pain in a stress test. We have patients walk rapidly, so the heart beats very fast. If there is angina, we do a coronary angiography to look for blockages in the major arteries. That is probably what happened to Toni Braxton. If she had angina and no blockages in major arteries, that's probably when they diagnosed microvascular angina."
Did Toni Braxton's previous pericarditis cause her microvascular angina? Might her doctors have misdiagnosed her microvascular angina four years ago?
"Pericarditis could not have led to microvascular angina. There are definite changes on medical tests that lead to a diagnosis of pericarditis, so it is hard to conjecture as to how that diagnosis was made. But let us assume she did have pericarditis: That is not going to lead to angina."
How is microvascular angina treated? "In my armamentarium, I use drugs to dilate the coronary arteries: long-lasting nitrates such as the nitroglycerin patch; then calcium-channel blockers such as verapamil [brand names include Calan, Covera, Isoptin, and Verelan] or diltiazem [brand names include Cardizem, Cartia, Dilacor, Diltia, and Tiazac].
"Then the other new drug which is really promising is Ranexa, which works by a totally different mechanism on the metabolism of the heart. It is an incredible anti-angina drug but does not have FDA approval for that indication. I have shifted a lot toward use of Ranexa for these patients. [O'Neill has no financial link to the makers of this drug].
"Exercise is also a good thing to do. What I tell people is to exercise to the threshold of symptoms, then cut back. So if you get angina after running three miles on the treadmill, cut back to two miles, then gradually build up. The more you exercise, the more you are able to exercise."
What is the outcome for people with microvascular angina? "Microvascular angina is not dangerous. Fortunately, people with this condition live just as long as those without coronary artery disease of any kind.
"The quality of life is affected because patients cannot do the things they want to do because they get this feeling in the chest. But there is no risk of heart attack and no risk of sudden cardiac death."
FIND THAT INFO DIRECTLY ABOVE NOT ACCURATE
Is there a lesson here for other people? "The value of people learning about microvascular angina from Toni Braxton is that middle-age women just don't believe they have heart disease. They feel pain with exercise, and don't do anything about it.
"The message here is if you have discomfort when exercising, that is abnormal. There is something wrong and you should look into it.
Overwhelmingly, this turns out to be coronary artery disease, but occasionally it is cardiac syndrome X. It would be good if more women knew about this."
Stacy
Posts: 476 | From Columbus, Ohio | Registered: Aug 2007
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Marz
Frequent Contributor (1K+ posts)
Member # 3446
posted
Anyone have a pericardial effusion as a result of lyme?
I had a minor one, but it disappeared after antibiotic treatment. At least I think that's the reason and don't think it's there anymore.
Last couple of days, I feel out of breath just moving around the house. I do treadmill and light weight workouts 3 times a week so don"t understand why. Also have dull pressusre headache, so maybe a flare up of symptoms.
I got a little panicky and would like to go to urgent care, but have no pain. Just kind of heavy feeling in chest.
Seems I'm always coming up with false alarms, so will wait this out over the weekend.
Does microvascular heart dysfunction show up listening with a stethascope?
Posts: 1302 | From USA | Registered: Dec 2002
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
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Here's a thread with many links (and video) for some of the cardiac dysfunctions that can affect many patients with fatigue.
Of course, infections must be handled. However, there are other considerations, too, and things that can help along the way.
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