Cardiologist hasn't seen or heard of it!

iVillage Member
Registered: 05-08-2003
Cardiologist hasn't seen or heard of it!
5
Thu, 05-08-2003 - 7:16pm
I have a few problems and they all seem to be intermixing, so I hope I don't put anyone to sleep with this post, while I explain.

I have Bipolar Disorder; the most treatment-resistant form of it. In addition to the other meds I take for it, I was also prescribed 2X the maximum daily dose of a tricyclic-antidepressant. Even at that dose it was only partially effective, but it was the only drug available at that time that I didn't have some weird or allergic reaction to. During the first few years I was also taking cimetidine for ulcers. This didn't cause a problem initially, but in the end there was a reaction and my serum level of the antidepressant was suddenly as high as if I had taken a month's worth of pills in one day. I was hospitalized immediately and had to go off all meds until it was out of my system. Afterwards I went back on the same meds, minus the cimetidine, for several more years.

From the time of my diagnosis with Bipolar, I had to start having blood work done every six months. It was always very consistant--severe hypoglycemia (<60) and cholesterol levels below the normal range. This was accompanied by blood pressure so low that it was often unreadable and and a soft slow pulse that many nurses just gave up on. Then I turned 33 and my next blood test showed a glucose level over 400--Type II Diabetes. No amount of diet and exercise worked and I was put on medication within months of diagnosis. That worked for a short time, but I soon had to go on insulin. Within two years of developing diabetes, my cholesterol was almost off the chart; my blood pressure was severely high and my resting pulse rate was 137. I now take medication for all this too.

About five years ago, I started having some mild discomfort in my chest. I ignored it. It gradually got a bit worse, came on more frequently, lasted longer, and began affecting my jaw. I continued to ignore it, just resting during the worst episodes until around three years had passed. I finally told my GP about it, minimizing it as much as possible. She ordered an ECG, which showed that I have Bundle-Branch Block. An overdose of the precise antidepressant I was taking almost guarantees this exact type of heart damage and when I was hospitalized for toxicity, the doctor said I had many times the lethal dose in my blood. But since I wasn't complaining much about my chest the GP didn't see any reason to be too concerned at that point.

The chest and jaw pain continued to get worse, more frequent, and harder to get rid of. But even when it reached the point that I couldn't do a simple household task without resting in the middle, I did not want to admit it to the GP or anyone else. Then a few months later I didn't take my antidepressant for a couple of days and the chest pains were milder. I restarted the antidepressant (to make sure it wasn't a fluke) and the pains got worse again. Normally, I would have waited to talk to the psychiatrist first, but I just stopped taking the antidepressant at that point and told her at my next appointment. She said I can't ever take that antidepressant or any other in its class ever again. Over about the next month, the chest and jaw pain completely went away and the problem seemed solved.

A few months went by before I had another episode. It started out real mild like it had before, but over the next few months it worsened again. The episodes also became more erratic, sometimes real mild sometimes not. They also started happening when I wasn't doing anything--I could be laying on the couch and it could start. This time I figured it was probably time to be more forthright with my GP. At that point she diagnosed Unstable Angina, prescribed Nitrostat, and ordered a nuclear stress test.

Now I've had the nuclear stress test, angiography, a second nuclear stress test, and I have an echocardiogram scheduled for the 19th when I see the cardiologist again. The first stress test showed a small section of tissue is dead and that the bottom of my heart wasn't getting adequate blood flow when stressed, but the second stress test didn't show any lack of blood flow when stressed. The angiogram showed virtually no build up in any of my coronary arteries. Some "very odd thing" that the cardiologist "has never seen or ever even heard of!" did show up in the angiogram though.

It took me at least 40 hours of reading about coronary artery abnormalities before I found a single mention of this "thing," but I did finally find out what it is. The "thing" is called a coronary artery fistula. They are rare, so I can understand the cardiologist not being familiar with it. According to the medical journals, they account for only 1 out of 50,000 congenital heart defects. This fistula is an atery that isn't supposed to exist. It branches off the right coronary artery, a short distance from where the coronary artery branches off the aorta, then it weaves out a bit and loops back, emptying directly into the right atria. Basically the heart pumps blood out and this little artery dumps some right back into the heart. No wonder I never get anything done, even my blood is running around in circles. ;0)

I'm not really sure what to make of all this. Almost makes me wish I'd kept my mouth shut about it!

Avatar for cl_themummy2001
iVillage Member
Registered: 03-19-2003
Thu, 05-08-2003 - 9:41pm
Hi, anomolous.....and welcome to the board!

Well, you've certainly been through a lot! I'm hoping that you've found a cardiac specialist who HAS heard of your condition.....you'll most likely need some careful monitoring.

Keep us posted on how you're doing and make sure you tell your cardiologist about any new symptoms you may have, okay? Thanks you for sharing your story with us!

Welcoming (((hugs))),

Linda.

iVillage Member
Registered: 05-08-2003
Fri, 05-09-2003 - 8:23pm
Hi Linda, thanks for the welcome!

I will post an update when I find out anything new. I haven't found any specialist to go to and am not sure what I should do yet regarding that.

Thanks again!

Avatar for cl_themummy2001
iVillage Member
Registered: 03-19-2003
Fri, 05-09-2003 - 9:51pm
Hi!

I had an idea regarding finding a good cardiologist who may know about your unique condition. Are there any major medical centers close to you? Ones that have an extensive cardiology department? If so, you could call that hospital and ask for a list of their practicing cardiologists....call those doctor's offices and ask if that particular cardiologist has dealt with your problem in the past. If the answer is yes, make an appointment to see that cardiologist. He or she can always refer you to another doctor who DOES specialize in your particular problem. Just a thought! Let me know what you think, okay? Good luck!

(((hugs))),

Linda.

iVillage Member
Registered: 05-08-2003
Sat, 05-10-2003 - 3:59am
Hi Linda,

Since I live near the state capital, in the midst of the most populated area of the state, it could be reasonably expected that I could find a cardiologist here familiar with it, but I'd rather not hold my breath on it. This general area has a population of over a quarter of a million people--total number of cardiologists: 20. Other medical areas are just as bad. The biggest problem in medicine here isn't not having insurance, it's finding a doctor in the first place! If it weren't for the blessing of Nurse Practitioners, a great many of us would be devoid of any regular medical care.

This situation frustrates me even more because I can't really say I care too much for the cardiologist I'm seeing. He is supposed to the be one of the best in the state, but I don't feel like I'm seeing one of the best. Maybe it's just me, but it seems like when he doesn't cut me off completely, he isn't really listening. I may be totally off here, but I think my family history and a couple of other things should be considered in more detail than a yes answer on his checklist. My mother had her first heart attack when she was 10 years old and several more before she died at 50. I know at least three of them resulted in full arrest and it took some time to get her back. Her mother dropped over dead at 42 with no history of coronary disease. From what I know, this would indicate that we may dealing with something not related to the typical heart disease. I know I'm not a Dr and can't say whether this info is pertinent to my case, but I feel like the cardiologist should have the info so HE can decide whether it has any bearing.

I just wish the 19th would hurry up and get here, so the echocardiogram would be done. I think that's the last of the cardiac tests available and maybe when he has the results from that, he'll be more inclined to discuss something. If not, I'm telling on him to my GP on the 22nd LOL!

:0)

iVillage Member
Registered: 06-02-2003
Wed, 07-02-2003 - 1:12am
Hi,

I feel your pain. I have a very misunderstood condition myself.

My sister suffered from severe anxiety attacks and was diagnosed as bipolar, however, she's found help here: http://www.alternativementalhealth.com/. At least for her, getting enough nutrients and exercising are the only things that keeps her from going totally insane. Prozac made her suicidal and other meds didn't work after a while or made it worse.

Also consider seeing a specialist. I've been to the Mayo Clinic and there is just nothing like it anywhere. You won't believe how incredible they are. mayo.edu or mayoclinic.com.

Take care,

I