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• Hi Dr. Friedman. I'm a 35 almost 36 year old white male. 5'6 162 pounds. slightly overweight. No drinking , no alcohol. But smoke heavily. Pack a day for 15 years cholesterol 179 (6 months ago 231) triglycerides 177 (6 months ago 216) hdl 91 (6 months ago 38) ldl 53 (6 months ago 150) . HS-CR Protein test from 1 month ago 4.0 (my Doc did not seem at all concerned with that finding) . Blood Pressure Varies from mid 130's systolic to high 80's diastolic or even sometimes low 90's diastolic to 120's systolic and high 70's at times when i'm calm (which is very seldom since i'm a very high strung person) . 1st Echocardiogram performed 6/7/2007 showed Ejection Fraction of 60% . Then 2 months later another Echocardiogram performed on 8/15/2007 stated ejection fraction of 55 %. Now the most recent test which was a cardiolite stress test stated the following. "patient achieved 85% of target heart rate. No Areas of decreased perfusion identified. Calculated ejection fraction 49 % . Impression : No evidence of ischemia or infarction. Calculated ejection fraction is 49% . Now here is my question it seems like the ejection fraction first dropped with the consecutive echo studies done last year 2 months apart at 2 different facilities. and now seems to have dropped even further according to the stress test. 1. Which one of these studies should i rely on? the echos done 10 months ago or the stress test ? 2. Does 49% percent indicate cardiomyphathy? 3. Is this 49% percent EJ the reason for my possibly high diastolic readings? 4. Am i in the beginning stages of heart failure? 5. Can i improve my EF? i'm extremely worried and cannot get an appointment with the cardiologist for a month . thank you in advance for your help. Michael
  michael, forest hills, NY
• I am a healthy 50 yr old, maybe 10-15 lbs overweight, but eat healthy and exercise every day, alternating between cardio and weight training. I have healthy cholesterol numbers 68 HDL and 97 LDL, good blood pressure, but a high CRP- 7.3 Is it necessary to lower my CRP to decrease my heart risk, and if so, what is the best way to do it. My Dr. told me to take a daily aspirin.but I am a little nervous about the cumulative effects of the aspirin.
  Lisa, Tampa, FL
• I have had chest pains off and on for 5 years or more. They started back about 4 months ago. I also have pains in my right shoulder blade and it sometimes feels a little numb. When I yawn, it sometimes feels like the pain in your calf when you get a charlie horse but it's along the side of my neck. My heart beats fast sometimes and seems like it skips but goes back to beating ok. It feel like cold sputum in my chest sometimes and a heaviness in my chest. It seems like something is in the back of my throat as well. I've told these symptoms to my doctor 5 years ago and was given a stress test, an echo, and the nuclear heart test and all were normal. I'm seeing another cardiologist in the same office who says it is not my heart because if it were I would not be sitting talking to him and there would be other things like dizziness, tingling, sweating and shortness of breath. I'm at the point that I do not know what else to do. He told me if it persisted to come back. Well I went back two months later and they tell me the same thing. They have finally order a stress test for me, but at this point I feel so ignored that I am thinking about changing doctors. The doctor thinks it may be costochondritis, but I say other wise. I've asked for a ct scan or mri to rule out aortic dissection and other things, but they will not give me any test until I take the stress test. Can you help with your thoughts? Yahoo!- (God is able!) --------------------------------------------------------------------------------
  Rita Lewis, Lutz, FL
• I am a 63 year old male. I had 4 by passes 8 1/2 years ago. I have had two nuclear stress test in the past two years that showed mild to moderate blockage. Both times I went in for angioplasty and both times once I was on the table the Cardiologist said that there was not enough blockage to warrant putting in a stint. The last time he compared my current x-rays with the ones from 2 years ago and said that there was no change that he could see. I sometimes have chest pains during the night that wake me up. If I get up the chest pains go away in about 10 minutes at the most. Naturally this gives me some concern. The stress tests show something is wrong but when they do the angioplasty they say there is nothing they need to do. I am worried that if I DO have a heart attack I not react in time to get something done. I have been to the ER several times over the last 2 years and every time the EKG shows that there is no heart attack going on. This is really weighing on my mind and has got me worried.
  Joe, Dallas, TX
• for the last 4 days my heart rate has increased from 68 to staying at 80 beats and whenever I move around at all (walk up stairs, stay on my feet for 15+ min, walk dog, come from car to house) my heart rate spikes up between 100-150 beats a min. I am exhausted and a bit dizzy--I feel awful. I am 24 female. I went to immediate care since my insuranced recently changed and I do not have a family doctor yet (as a new patient no doctor would see me for at least 2 weeks) The doctor at immediate care gave me an ekg which showed no irregularities and my heart rate then was 80 although she only took it while I was sitting. She did not seem concerned, Is there a danger in letting this go until I can find a family doctor which will be about two weeks. I really can't do much because I am so tired and now I am a bit afraid that this will damage my heart. What do I do now. Wait, go to the emergency room? What would cause this.
  katie, mooresville, IN