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Angiogram necessary?
Jul 5, 2012

Hi Dr. Henry. I was recently hospitalized for observational studies due to experiencing shortness of breath, cold sweats, nausea, upper and lower jaw pain, pressure in the other words.....symptoms of a heart attack. My EKG, Echo-cardiogram and stress test were all fine. I was monitored with a halter monitor for 24 hours with no abnormalities. My current cocktail is Isentress/Viread and Viracept. Total cholesterol is 205 and "good cholesterol" is on the high side. No history of smoking. Mother died of a heart attack at 68 years of age. I am not on any cholesterol meds. My cardiologist has prescribed Metepolol and aspirin.My question is....should I progress to an angiogram test? My doctor felt ok with the negative results of the aforementioned tests so we did not progress with any further testing. However, I keep reading stories about people who passed all of the same tests I was put through (EKG, Echo, Stress test), however, only after having an angiogram did they discover that their arteries were blocked; so at this point I am not sure if I should have the angiogram or not. Any input regarding this matter would be appreciated

Response from Dr. Henry

Risk depends partly on history of blood pressure, diabetes, smoking, how low your CD4 count ever went. Other tests such as CRP levels can be of some help. If your Framingham risk score is low (ie < 5% 5=10 year risk) angiogram usually is not indicated (would discuss with your HIV doctor or cardiologist). Also may want to have them check your VACS index as well, KH

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