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what other tests can I look into to evaluate my heart?

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Dr, I am a 46 yr old male. 244 lbs 75.5 ", prev exercise regularly, have had thorough angio work up over 3 year period. incl. angio gram, ct 64 slice can, echo- echo stress, reg stress test. etc.
most of these have been ok, angio gram exhibited mild narrowing 30% of LAD, w myocardial bridging. my bp avgs 129/85... cholesterol is mod elevated. tryglicerides 211, hdl-35 ldl-88
total - 165 meds- (metoporol, synvastain)

question- i have limited cardio capacity much less than I used too, I get weak on feet, short ness of breath feeling, and limited to approx 30 min exercise, balance of walk and run...I am always short of breath thru the day. always,,, unless lying down or sitting...even mild walking gives me this sensation..

have had full MRI of brain as well, (normal) I also have dengenrative spine issues(neck) (mod-severe)
this causes some issues. My cardiologist will not do further tests. says its not my heart, I just dont see how it couldnt be..all other issues have been checked...what other tests can I look into to eval heart..i realize unless yo do angio gram its a crap shoot in some cases....

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Category: Family Physician-GP
 21 Doctors Online

Thank you for asking your query.

I assume that the tests - echo , angiogram , the 64 CT etc has been done recently. In that case the culprit for the limited aerobic capacity may not be your heart at all.

There are some other possibilities I would consider  as a cause of this. One reason could be your body is not acclimatized to exertion. This can happen if you have been sedentary for a while and then restarted the exercise. The workaround is the do aerobic activity for tolerable duration and then increase it by a couple of minutes every day.

Do not exert to the point where you are gasping for breath. Another cause could be in your lungs. It could be an exercise variant asthma or hyperactivity of the airway. In that case all the imaging tests will be normal. You may need a pulmonary function test to find the exact cause of it. The third possiblity I would consider is a Thyroid hormone related problem. A hypothyroid state can make you easily tired. I recommend a Thyroid function tests.

I assume that you do not have any other symptoms like chest pain or swelling of legs. In that case its prudent to rule some non cardiac causes of breathlessness as told above. That said, there could be a cardiac element for this breathlessness. Since there is an 30%LAD, it could have affected the cardiac walls. It could be too early to show in an Echo. As a part of the standard care you will need periodic Echo monitoring too.

Hope this helps

Thank you

Dr. John Monheit
Category: Family Physician-GP
Residecny: North Colorado Family Medicine
Medical School: The Chicago Medical Center
Dr. John Monheit and 4 other Medical Specialists are ready to help you

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