Suddenly Felt Tired And Shortness Of Breath After Walking. On Medicine For Bp And Cholesterol. Worrisome

Posted on Thu, 5 Jul 2012

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 5 Jul 2012 Answered on

Thu, 26 Jul 2012 Last reviewed on

Question : I recently walked about eight blocks, no hills, and suddenly felt very tired and short of breath. I had to rest after walking a few feet and leaning against a pole several times on the way home. Called doctor when I got home and next day took an EKG, which was normal. Went to my heart specialist who scheduled a stress test in a few weeks. I had two stents put in nine years ago, but never had a heart attack. I have been walking about 35 minutes three times a week and was never short of breath before. I take medications for high blood pressure and high cholesteral. I am a female, 77 years old.

Answered by Dr. Anil Grover (4 hours later)

Hi,

Thanks for writing in.
I am a qualified cardiologist and I read your mail with diligence.
Can you provide a little more about stents:
1. When were these implanted?
2. Which artery(s) these were implanted?
3. Were they bare metal stents or Drug Eluting Stents?
I am inclined to treat the episode which you eloquently described as angina equivalent. Your EKG is normal, that excludes myocardial infarction. Treadmill Test (TMT) as planned by your doctor will answer the crucial question. That brings in problem of stent re stenosis. We do not all what causes it. But the usual risk factors of coronary disease do contribute certainly (also in non stented vessels) in occlusion of coronary arteries.

At any age, following is the list of risk factors for future development of Coronary Artery Disease. Let me enumerate and you can place yourself the risk you are carrying ('*' means you have the risk factor, - not present, '+/-' means I do not know and about others you know better):-

A: MODIFIABLE RISK FACTORS
Diabetes -
Hypertension*
Smoking+/-
Stress*
Obesity and Sedentary Life Style*? You are overweight not obese.
High Bad Cholesterol and Lipid Component*
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: +/-
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
B: NON MODIFIABLE RISK FACTORS
Family History 0f Coronary Heart Disease +/-
Increasing age*
Being a Man (as opposed to women) till the age 45*
Folic Acid deficiency in elderly +/-

From the list, above you have some risk factors. Hypertension, increased cholesterol and possible sedentary life style you have. Therefore, I will strongly recommend consulting your doctor for TMT which you have done. We will work out a plan after the report.

It is never too late to change. With your weight everything you do will have to be under supervision. It need not be cardiologist but your primary doctor can guide your way back to health - I am happy to read that you have already lost 20 lbs. You may need drugs and he/she (or ask the dietitian) to advise you about diet low in calories and cholesterol, advise you on quantum of exercise. You ought to keep your weight under control for you do not want other attack. If you like non vegetarian you cannot take red meat but there is no bar (in taking certainly quantity had to be less) on egg white, roasted chicken and roasted fish.

Hope you found something useful in this answer. If you have any follow-up query I shall be happy to answer.

Regards

With Best Wishes.
Dr Anil Grover, Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anil Grover (33 hours later)

The two stents that were put in arteries near my heart nine years ago were regular, not with drugs in them. They were blocked 90% and 80%. Had angioplasty because I failed two stress tests. No heart attack, just calcifications seen near my heart on body scan. Passed stess test four years ago. Blood pressure 140 last time, with two medications. Cholesteral 180 with medication and rice yeast supplement. I also have fibromyalgia so I have just been walking for exercise, about three times a week, one and half miles in 35 minutes. Should I still be walking now before I take the stress test in a few weeks? I also have a two story house, but I haven't had any more shortness of breath.

Answered by Dr. Anil Grover (3 hours later)

Hi,

Thanks for details.
With blocked stents you have to restrict your walking to previous levels that is 1-1 &1/2 miles in 25 minutes. No competition even with yourself that you do not feel like but you have to cover this much distance in these many minutes come what may. Listen to your "heart" when it says you are tired take rest when you comfortable in carrying on carry on that is the best motto, I tell my patients of exertion angina. Let us see your TMT report and may be you need a repeat coronary angio. When was that the last coronary angio done? If you can reveal the complete written details with complete list of medicines you are taking, I may have a suggestion for you and your doctor.

It is good that two stories of house do not make you out of breath. Well. it good to keep bad cholesterol under control,

With Best Wishes

Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar