AboutDavid Richardson Expertise Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.
Experience Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.
Organizations Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..
Publications Circulation, American Heart Journal, Hypertension.
Education/Credentials M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.
Awards and Honors Gold Heartt Award from American Heart Association in 1995.
Question QUESTION: Iam confused- I have seen two cardiologists- in past 1.5 yrs- i have had, stress test, ct scan 64 slice, echo's - last month had an agio gram. 42 yrs old, all tests we're normal- ct scan exibited 25% narrowing-(neglible apparently) and angio gram only showed bridging at lad, no artery blockage. iam 6'3 240 lbs- prev athlete love to play sports- but last 2 yrs get very frequesnt chest squeezing, pain, almost daily- sometimes with exertion often cant complete treadmill lite workout0 have zero confidence as it all points to angina,...dr's have suggested mirovasculat angina. etc..nothing pinned down...iam on synvastatin, and a calcium channel block 2.5 mg, aspirin and starting niacin....low bp and hr rate normal--choelsterol is a bit high- at 190 but hdl and ldl are out of normal....?---i have 2 herniated discs in kneck- can any of these pains be associated with chest squeezing,,, am i in danger of MI- should exercise be stopped...very worried and no real answers...this happens almost daily and some times multiple times...other sym-ptoms are sometimes weakness , mild jaw pain, but that is more inconsistent... please advise..
ANSWER: Dear Paul,
Spasm of a coronary artery? file:///%20Cardiology%2012:07/%20Cardiology%2011:07/CAD/Coronary%20Trouble%20s%20Fixed%20Stenoses/%20Spasm%20as%20a%20Cause%20of%20ACS.html
Spasm is most likely if angina occurs at rest as well as with exercise,
A calcium-channel blocker can help. 2.5 mg seems a very low dose. Isosorbide may help. So may Viagra.
Microvascular angina should occur only with exercise. Herniated disks in neck should cause pain when turning head. Bridging rarely causes trouble.
Heart attack is rare, but possible. Continue mild exercise, taking a nitroglycerine if pain occurs. Try a nitroglycerine under tongue just before starting exercise.
Please write back if this note doesn't answer all your questions.
QUESTION: thankyou for the reply- I guess iam wondering with no known blockage other than myocardial bridging and neglible narrowing in LAD. Should I request another stress test? i want to resume a normal lifestyle but very hard too it feels- should i detect certain HR types when i exercise..strong pounding vs weak? any thoer suggestions?
tks
Answer I don't see how another stress test will help, Paul. It was normal before and will probably be normal again unless you get spasm on the treadmill. Use the nitroglycerine as above, Consider increasing the calcium channel blocker. What's its name? And consider starting isosorbide, and begin mild exercise, working up if all goes well.
