a single glowing line depicts an EKG and then an anatomical heart

Enzymes and Anxiety: Part 2

Editor's note: This is Part 2 of a two-part series. Part 1 is titled 'Anxiety and Enzymes: Part 1'.

On the afternoon of July 8, 2020, I went to the emergency room of my local hospital because I was experiencing symptoms similar to when I was diagnosed with coronary artery disease in 2010. I was admitted after a blood test revealed troponin in my bloodstream and my EKG was abnormal.

Echocardiogram and more anxiety

The next morning another blood sample was taken and I had an echocardiogram, which is described as “a test that uses ultrasound to show how your heart muscle and valves are working. The sound waves make moving pictures of your heart so your doctor can get a good look at its size and shape.”

A few hours later a cardiologist gave me the results. While there was still some troponin in my bloodstream, it had dropped from the night before and was at an acceptable level. No abnormalities were revealed by the echocardiogram. He ruled out congestive heart failure but said that I should have a nuclear stress test. It was scheduled for four days later and I was sent home with instructions to take it easy until then. My anxiety was relieved by the good news, but I knew I wouldn’t be completely comfortable until the nuclear test.

What is a nuclear stress test?

Mt. Sinai describes a nuclear stress test as “an imaging method that uses radioactive material to show how well blood flows into the heart muscle, both at rest and during activity."1 A radioactive substance is delivered through an IV and a special camera will observe your heart to see how well the substance traveled. You will then likely be asked to walk on a treadmill where your blood pressure and heart rhythm will be monitored while moving at various speeds and inclines. More pictures will be taken and then compared to the first round's.1

I was relieved but eager

I did well on the stress test and the cardiologist who supervised told me he would get back to me within twenty-four hours if the data revealed a problem that needed immediate attention. Otherwise, I would get the results at an appointment with my personal cardiologist the following Monday. I was relieved when I didn’t hear anything in the first twenty-four hours, but eager to get the results. I was still experiencing some symptoms, but happy to hear from my doctor that all my results were good and she didn’t feel the need for anything invasive, that is, an angiogram.

Next stop is 80!

So what was the cause of the symptoms and my discomfort? We talked about a couple of things. My resting pulse rate is 49 and my blood pressure is 120/70. It could be that I’m experiencing occasional sudden drops in my blood pressure which would partially explain the symptoms. I have pre- ventricular contractions (PVCs), which might also mimic my CAD symptoms. I should make sure I stay hydrated at all times, but especially when exercising or during hot weather.

So I left the office comfortable in the knowledge that I most likely had no new blockage or any other new heart issues. I don’t regret carving out time over eight or nine days to get what turned out to be an extensive check-up. I can’t afford to be casual about symptoms that might lead to a bigger event that I had in 2012 when I had a mild heart attack. With my anxiety relieved, I said
to my wife, “Good for another 100,000.” I’m seventy-one. I’ve had ten good years since my diagnosis. Next stop is 80!

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