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Question:

Should we seek medical attention in a larger hospital?

My husband is 51 years old and had his first MI at 40 years of age. He then had 2 stents in the LAD, although at that time they had no idea what caused the MI. He had low blood pressure and no plaque. He has been on a cardiac cocktail, has watched his weight, salt and cholesterol intake since then. He started having sob, fatigue and some increased angina about 6 months ago and had an MI at the end of May that caused a spiral tear in the right coronary artery.  He still reportedly has no plaque. His cardiologist told him he is having spasms and actually watched them while repairing the tear with 7 stents.  He has continued having spasms and has been hospitalized two more times since then.  He is now on 1000mg Ranexa twice a day. He is getting very short of breath, with increasing fatigue and angina. He now has increased PVC’s and his blood pressure is rising despite medication. His EF is 38%. We live in a small town and are concerned. Should we be seeking medical attention in a larger hospital?

submitted by Carol from Lake Havasu City, Arizona 11/2/2012

Answer:

Surendra K. Jain, MDby Texas Heart Institute cardiologist, Surendra K. Jain, MD  

Your husband has had a very unfortunate and complex course, with acute MI at age 40 and then recently an RCA dissection - both treated with stents.
With recurrent hospitalization and an EF of 38%, he should and probably is being treated for ischemic cardiomyopathy. It would be prudent to have a second cardiologist evaluate your husband and make suggestions for his future treatment.     

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Updated November 2012
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