Two days ago, a doctor cut a hole in my femoral artery, put a small tube and camera into it, and pushed it almost 24 inches upward into my heart, and then looked around for damage.
I was in the hospital for 3 days and nights (Sunday, May 15-Weds May 18). I was as afraid as I’ve ever been, but my fiance was there with me, and that allowed me to be more at peace in my fear.
I’m a 46 year-old man and, last Friday and Saturday, I had felt a light pressure on the left side of my chest, and sometimes my upper left arm. Not an overwhelming pain or pressure (1 or 2, on a scale of 1-10), but after a couple of days, even a light pressure in that area is something that you know is not normal. It didn’t change or get worse with exertion, but since I have high blood pressure (treated), it is something I worried about. Which also increased my blood pressure. Which made me worry about it, which ...
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So, Bobbie (my fiancé and love of my life) took me to the ER heart center on the west side of Norman (Oklahoma) on Sunday afternoon. They checked my vitals: High blood pressure and heart rate. They gave me an ECG (EKG), and it appeared normal (with a mostly “sinus rhythm.”) Negative for a heart attack.
They gave me nitroglycerine tablets which, if a person is experiencing a heart attack, can reduce the pain.
They took my blood and examined it for a variety of things, including substances/enzymes that the heart produces during a heart attack due to tissue damage. There was no evidence of those enzymes. Negative for a heart attack.
They then admitted me into the hospital until a heart stress test the next day (Monday). They had me fast (no food or water) from midnight until at least 8am, in case additional tests were necessary. They put 5 or 6 heart and electro sensors on my chest, which were wirelessly connected to the heart monitor on the wall. They checked my blood pressure and vitals every 3 hours, night and day.
The heart stress test involves two main parts: The treadmill test, during which an EKG/ECG is taken while the person is inducing increasing levels of exertion. The physical part went ok – there was some exhaustion, but no pain.
The other part of the heart stress test involves nuclear medicine. A radioactive substance is introduced into the blood stream while the patient is at rest, and then the patient undergoes several (8) imaging tests (similar to x-rays) that view the flow of blood through the heart and arteries. The patient then performs the treadmill stress exercise, after which, more of the substance is put into the blood and eight more radioactive chest images are taken, to show how the blood flows while the body is pumping blood more vigorously.
The test result was positive for heart bloodflow blockages. Plural.
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The nuclear test results showed a “reversible perfusion defect” (a treatable bloodflow defect) in the septal wall of my heart, and two “fixed perfusion defects” (non-correctable bloodflow defects) in the anterior and inferior walls. This doesn’t mean a heart attack is happening now, it means it has already happened. In the case of the “fixed perfusion” defects that the machine said were present in my heart, it meant those areas can no longer can receive bloodflow. In the reversible perfusion case, it meant that a stent can be used to open the artery (a stent is kinda like a little pop-up tent they can use to expand a clogged artery. www.integrishearthospital.com/...). How do they get the stent in there? They use a tube and a balloon, gah.
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The doctors still needed to verify the blockages that the nuclear test said I had, though. So they said they would do it- and said it would require an angiography of the heart – to do that requires putting a little tube in your largest artery (the femoral, next to my groin – but sometimes they can do the larger artery in the left wrist – the radial artery), then putting a camera in it, and then pushing it nearly two feet up into your body, into and around your heart: www.youtube.com/....
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There was a lot of time in between. Hospital treatments involve a lot of waiting… so I did some work, and I don’t think my employer even noticed my semi-absence, since I was returning emails and completing some work as necessary. (I’m a remote worker.)
At this point, the doctors and nurses were not saying anything about mortality/death. Just “major life changes.” My heart seemed to be performing well, despite the hurdles: Any blockages could, especially during exertion, cause a heart attack. Also, with some diagnosed bloodflow blockage to my heart in an area that could be corrected with a stent, it would be better. And since my heart was performing as well as it was (despite the two “fixed perfusion defects” – aka dead areas), those areas were either small and/or my heart had grown to produce blood around that area. Or else my heart would not still be performing, at all.
This was Monday night, and we were facing the likelihood of the stent. Which meant the angiogram/heart catheterization (cutting open the second largest artery in the body, putting a tube in it, pushing it into the heart) and then also that stent thing.
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So, Monday night they had me fast again, with no water or food from midnight until at least 8am, because it was expected we would go to the Heart Catheterization the next morning. Which meant the tube in the artery and, if necessary, the balloon and the stent.
On Tuesday morning, we waited. And I had actually taken that day off of work with paid time off. (I have a great private employer, and great bosses.) Then my fiancé Bobbie had to go to work, and I waited out the rest of the day, watched some tv, and I also worked some that day to make up for Monday… Then the fasting time ended and I ate, then read, and fiddled around on Facebook and games and news websites (I had my tablet and cell phone). Nothing happened, as far as medical procedures, on Tuesday - then they said it was scheduled for the next day: Wednesday morning at 7am.
So, Bobbie game back and we cuddled and she stayed with me. I fasted from midnight until they woke me up at 3am to double check my blood type. At 3:30 to check my blood pressure and vitals. And then at 4am to connect the second (backup) IV line. Then had me sign eight disclaimers. Then woke me at 5:30 to check vitals. Then added a new wrist bracelet tag in case I needed an emergency blood transfusion.
Then at 6:30, they had me put on the hospital gown (I had managed 2 ½ days wearing my own clothes, but with electrode wires sticking out, and wearing slippers. Then they gave me Valium and some un-rememberable pills and wheeled me around and down the hospital, and into the procedure room.
Did I mention that the nuclear portion of the cardiac stress test, during which radioactive elements are pushed through the blood while x-rays are taken – can have false positive results?
During the procedure, my cardiologist and her team cut a hole into my femoral artery on the right side of my groin, placed a catheter inside it, with a camera in that, and pushed it 2 feet up that artery and into my heart. They viewed the inside of that artery and others, and the inside of my heart.
The reason for the first-hand doctor view is because there can be false positives.
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The cardiologist said, after looking inside my heart, that there were no blockages in my heart – and no “dead zones.” Those were false “artifacts,” similar to the way a piece of metal can block an x-ray, and the only way to verify is for a doctor to view it with their own experienced eyes. She said I don’t even have notable cholesterol plaque, and that my heart is actually healthy. (I do have plaque in my carotid artery, but that is a different issue, and is being treated.)
No stent was necessary (or the angioplasty “balloon,” either). A tube and camera into my heart was enough, thank god. They used a somewhat new artery closure device that sealed the entry wound into my femoral.
The cardiologist and her team then sent me into a specialized care unit until my sedatives wore off, then sent me back to my room for a few hours. I was discharged around 3pm on Wednesday. And it was really nice to take a shower — not to mention the wonderful knowledge that I did not have a heart attack.
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Modern medical science is an amazing thing, and technology makes it so much faster than it used to be, but it still provides more than ample time for the patient to sit, wait, fear, cry, pray, repent, tell loved ones they are loved, while also warning them of the worst potential outcomes.
In short, being in the hospital makes you sicker than you are, or makes you fear that you are. And if one of your illnesses includes high blood pressure, then the anxiety can drive up the pressure, which ramps up your anxiety in a cycle that can cause real medical problems.
I am so thankful for my fiancé and her kids (one brought me a bag of clothes, picked me up and helped another time), for the doctors, and even for my 3 days and nights in a hospital, when my heart issue wasn’t as bad as it seemed to everyone.
I still haven’t found the actual cause of my light chest/arm pressure, but am following up with my cardiologist and a neurologist next week.
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So, no. I did not have a heart attack. But damn.
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(The images and links used in this post are not from my hospital or my own treatment, they are only used as examples.)