MIBI test results for HEART Perfusion/ EXTREME HEART ATTACK RISK

[huldafolk]

I just got results back from a MIBI test for my heart. 2 to 3 years ago I had the same test and all was fine.  I have had no heart symptoms and all EKG recently have been fine.  The test from last week has had me removed from the transplant list until further tests can be done. I am being referred to the local heart specialist hospital in Winnipeg for ANGIOGRAM/ANGIOPLASTY/SURG. if required.  The MIBI report indicated a SEVERE and REVERSIBLE area with a lack of perfusion.  Severe and immediate risk of heart attack.  WTF!!!!! I have NO other symptoms of heart problems.  Not over weight. 50 years old/male. ESRD  bi-lateral nephrectomies 7 years ago. dialysis 3X/week for 7 years.  Anyone else have a sudden change regarding heart??

[MooseMom]

What a shock!  I have no answer to your question, but I just wanted to say that I'm really shocked on your behalf!  What exactly happens next?

[huldafolk]

Had an angiogram and this showed a 90% blockage of the Right Coronary Artery. A metal stent was placed and two other arteries showed partial blockages in the 40 to 50% range , theses areas were balloon angioplastied only.I had a critical post op bleed from the groin access site. I was in CICU for hours after the procedure to control the bleeding.  Had a HUGE bleed the size of a small seedless watermelon on my inner thigh/groin area. Hgb dropped off.  I am on ASA for the rest of my life and Plavix for at least 6 weeks. I and having trouble with G.I. bleeding now, so it would seem that the plavix will have to be stopped at 6 weeks and take what ever risk regarding the stent membranous coverage in order to allow the G.I.tract to heal. I am almost 6 weeks post angioplasty and should be almost back on the transplant list ( maybe a few more days at most).Seems like an endless line of hoops to jump through to stay on that transplant list over time.  Do they want to find something to take you off the list ??

[MooseMom]

OMG, you have been through the wars, haven't you?  I am so sorry to hear this.  I hope you get back on the list as soon as possible.  I know they make you do so many things to get on and then stay on the list, but in a way, it is a blessing in disguise because if it had not been for the required testing, you might never have known you had these cardiovascular problems, and I hate to think what could have happened!

Can I ask you something?  You posted that you've been on 3xweek for 7 years.  Has anyone said anything to you about receiving D over a longer period of time, ie nocturnal or daily hemo?  Are these options for you?  It's just that the current common modality of 3xweek seems to be so hard on the heart; we all know this, yet so many of us are forced into this sort of treatment.  What can be done for you to ensure that this type of thing won't happen again?

[Stoday]

Looks like I'm following in your footsteps, huldafolk. I had an angiogram last month which showed severe disease in the right coronary artery. Fortunately I didn't have bleeding problems. I do have a follow-up next Thursday when I have a myocardial perfusion test.

Anyway, I'm following your story with considerable interest...

[RightSide]

Wow, huldafolk,

you're really having it rough.
I feel for you.

I guess I wouldn't be surprised for the condition of the heart of a dialysis patient to change that much in a couple of years.  Remember that ESRD is a degenerative disease that affects the cardiovascular system.  Our cardiovascular system deteriorates much faster (maybe triple the rate) than in someone without ESRD. 

[huldafolk]

I am back on the Transplant list. Just need to decide how long to stay on the Plavix.  A risk both ways, > clot and heart attack, or vascular/GI bleed,  difficult choice.Any suggestions.  I have had 3 episodes of GI bleeding in the past 7 weeks while on Plavix/ASA/Coumadine(for preexisting clotting disorder(on lifetime).

[huldafolk]

I have only In Center as an option.  We can train for home self care, but I am not in to it,nor is my wife. I have far to many complications that must be followed very closely.  I am not a candidate for peritoneal Dialysis as I have had multiple intestinal surgeries with bowel resections/scaring.Colostomy at present.Tahks for the suggestion of more -longer treatment times to ease the load on my heart, but not an option. 

[Meinuk]

You need to make sure that you are listed with your transplant center as STILL LISTED/INACTIVE - call or write to them to confirm this. 

You can still accrue time on the list and be medically "Inactive" (not eligible for a transplant should one become available immediately) but you arelisted and accruing time.

Emergencies like these are terrible, but you should not be de-listed unless you become permanently ineligible. 

I was listed "Inactive" when I had some minor surgery, as soon as my body was healed, I was "Active" again. I never lost a day on the list - and no one should if their procedure does not permanently affect their status.

As far as your cardiac issues and dialysis, yes, there is a correlation, but you also have life to deal with as well.  dialysis is just an added risk to the risks that we have in getting older.  You heart complications could be a combination of both.  For me, after 10 months on bad incenter dialysis, and one year of High dose Home Hemo (NxStage) I had left ventricular enlargement (very common).

Are you in Canada?  They may administer their waiting lists differently, but you should fight to make sure that you time is still counted when you are again considered a viable candidate.

Good luck in all of your healing, and let's hope that the stents keep your heart profusing for a very long time!

[Stoday]

Just need to decide how long to stay on the Plavix.  A risk both ways, > clot and heart attack, or vascular/GI bleed,  difficult choice.Any suggestions.

I dropped Plavix when I started hemodialysis. It took 2½ minutes for my needle sites to clot off.

I restarted on Plavix a month ago. It still takes only 2½ minutes to clot off.

[kitkatz]

Te heart is often what the doctors are trying to keep going after we start on dialysis.  The fluid gains and retreats, the toxins and such are hardest on the heart. My EKGs show changes every year.  Sometimes I get popped into the hospital for the heart to be looked at.

[Stoday]

According to the Oxford Handbook of Dialysis, cardiac causes account for most deaths of patients with ESRD.

Most of these are sudden, due to arrhythmias related to electrolyte disorders or impaired cardiac function. Fewer than 10% due to MI. Death due to heart failure with left ventricular dilatation is more common & related to chronic fluid overload. I'm not at all sure what all that means.