Symptoms of coronary artery disease with a normal MIBI
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Dear Ask The Doctor: Dear Doctor, In May 2009, which is just last year, I did a MIBI test (heart perfusion study: radioactive IV + gamma camera). The MIBI test is negative for ischemia at Stage 2 Bruce. LVEF is 64%. So everything seems fine. The cardiologist told me I have no heart or artery disease. But from Oct 2009 until now (May 2010), the following physical symptoms progressively appear: 1) Aching in the upper left of my chest since beginning January 2009 90% of the time, sometimes it may migrate to the right side 2) Shortness of breath from time to time 3) Palpitations in the last few days (I can feel my heart beat very hard and irregularly) 4) Muscle aches in the hands and legs, sometimes my hands will cramp 5) Involuntary movement of fingers/thumbs occasionally 6) Facial spasms occasionally 7) Sometimes I will feel my body "vibrating" 8) When I tried to measure the pulses on my wrists, the pulses will "disappear" after a while 9) Sometimes when I am just about to fall asleep, I will get a sudden jerk or have a feeling that I am about to fall off 10) giddiness/dizziness/light-headedness from time to time How could I have developed such a very sudden onset of heart or artery disease? How could it progress so rapidly from absence of heart/artery disease to the above-mentioned symptoms in such a short period of time? This is all very very strange. Could it be some other problems instead? Please advise. Thank you very much.
If you had a normal MIBI scan then the chance of this being coronary artery disease is low. The only definitive test is a coronary angiogram. This provides an image of the coronary arteries by an injection of contrast under x-ray guidance and will show up any narrowing of the blood vessels that supply the heart muscle. There are some risks associated with this <1%, therefore it is important to discuss the risks and benefits of this procedure with your cardiologist. If the coronary angiogram is normal, then an alternative diagnosis for your symptoms should be sought by your family doctor. |
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Last Updated ( Wednesday, 26 May 2010 )
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