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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pain In Chest, Shoulder, Arm, Dizziness, Fatigue. EKG Showed Heart Infarction. Any Help?

Do enzymes have to be present in the blood to indicate a heart attack? Last Sat. I felt like some one had kicked me in the chest and I had a severe burning pain on the lower part of my rib cage on my left side. The pain changed into my my chest and shoulder and down my left arm . I got sick and felt like I should seek help. I did not. The pain subsided after about 15 min. and I felt dizzy and disoriented. My wife drove us home and I felt fatigued. I continued to have some chest pain on Sun. so my wife called my doc and I went into to see her on mon. The Doc. hooked me up to an EKG and it showed that I had had a heart infarction . She ordered tests and I went home. On my way home I had 3 sharp stabbing pain that extend from just left of my groin to my chest and felt vary Fatigued and light headed so again my wife had to drive us home. The next morning I woke up with more chest pain and the more I moved the worse it got so we called the Doc. and she told us to come in. When I got there she hooked me up to the EKG and said i was having another heart infarction and she called for an ambulance. When i arrived at the Er they gave me glycerin and some other stuff to help take the pain away and drew blood. When the blood tests came back they said there wasn t a presence of enzymes to indicate a heart attack. I can assure the pain is vary real. I felt like the lower part of my ribs where being crushed and they burned and my chest hurt like hell like some one was stabbing me with something dull. Any help on this would be appreciated. Thanks for your time. My family has had 4 people die from massive heart attacks below the age of 50 and my brother had a heart attack when he was 25.
Mon, 16 Sep 2013
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

Elevated enzymes mean a recent event.
In threatened episode or old attacks, enzymes can be normal...
You have not stated your personal habits, co-morbidities or your age ...they could influence the diagnosis and outcome...

You need to be investigated for Coronary Artery Disease.
     TMT (Treadmill Exercise ECG) is necessary to evaluate ischemia. If positive, the next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
     If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this.
CT angio is non-invasive study for the anatomy. If positive, you will need catheterisation, anyway.

See a Cardiologist..

Take care     
Wishing all well
God bless
Good luck
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Pain In Chest, Shoulder, Arm, Dizziness, Fatigue. EKG Showed Heart Infarction. Any Help?

Hi friend, Welcome to Health Care Magic Elevated enzymes mean a recent event. In threatened episode or old attacks, enzymes can be normal... You have not stated your personal habits, co-morbidities or your age ...they could influence the diagnosis and outcome... You need to be investigated for Coronary Artery Disease. TMT (Treadmill Exercise ECG) is necessary to evaluate ischemia. If positive, the next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this. CT angio is non-invasive study for the anatomy. If positive, you will need catheterisation, anyway. See a Cardiologist.. Take care Wishing all well God bless Good luck