Chest Pains 10 years MDS-RARS
 

My dad -76, diagnosed with MDS RARS in 2006. Visits oncologist yearly and knock on wood, no treatment received for disease to date.

He is a heart patient, quad bypass in 2000 and pacemaker in 2001. In recent weeks he complained of minor chest pains albeit short lived when he is on the treadmill. He stops, waits for them to stop and starts his exercise program again.
< insert me wanting to hit him with a wet noodle here >

I tell cardiologist... he orders stress test and it shows significant ischemia in one artery. He has a heart cath yesterday and we went in thinking he was going to get a stent.

Cardio doc is amazed that his bypass grafts from 16 years ago are so "pristine". He could find NO evidence of any blocked arteries. There was nothing for him to stent. GREAT NEWS. No plaque whatsoever. Stress test was a false positive or somehow picked up something related to low oxygen from anemia.

But....still no answer as to why the chest pain experience while on the treadmill (exertion). Cardio doc says we need to take it up with the oncologist as the "plumbing" is darn near perfect.

Next oncologist appt. is in October. Do we wait? Does he just stop his new found exercise routine? He does NOT want any more meds (heart currently) nor does he want to start transfusions. His numbers have remained stagnant for 10 years. Only reds affected. Oncologists says with these numbers and for as great as dad expresses he feels that he personally would not want to "rock the boat".
RBC- 2.94
HGB- 10.4
HCT - 31.4%

Any ideas? I am leaning towards getting in with the oncologist sooner but it might be a hard sell for dad who is now in recovery mode with a sort of time-out for a week after yesterdays procedure.....which apparently he didn't need!

I think you should tell him you're worried and you would very much appreciate him laying off the exercise... at least until his oncologist appointment! It sounds cardiac to me. I'm a cardiac nurse. Did he try gtn spray when pain came or did it stop as soon as he stopped exercising? Sometimes there are little annoying arteries that can cause angina. Not necessarily the grafts from bipass surgery. Anyway if it keeps happening I'd still treat it like cardiac and STOP exercising. Lol good luck :-)

He states the pain is minimal but noticeable. While on treadmill at 3.4 MPH it happens....slowing down to 2.7 MPH it stops (or he goes to small weights with no issues).
Cardiologist cleared him to exercise, no restrictions. I uncleared him! At least for the next 7 days so I have a little time to come up with a plan B.

Hi -
Did the cardiologist do a CBC - are the blood counts you provided recent or a few months old?

I had MDS - when my Hgb dropped to 10 and lower I would have shortness of breath and chest discomfort on exertion (turned out I also had some other cardio problems) -- Given the clean bill of health from the cardiologist I'd suspect the discomfort is from the anemia - but I am not a doctor -

Sounds like he is otherwise doing great. If his numbers are still relatively good, not rocking the boat sounds like a reasonable plan.

Best wishes,
Paul

Yes, the numbers listed are recent, actually have remained these and pretty stable since DX 10 years ago.
Sorry to hear of your cardio problems.
Dad visited the gym today for the first time since heart cath and took it easy but had a small amount of pain. He moved on from the treadmill and the discomfort went away.
Assuming he doesn't take a turn for the worse we are waiting on the oncologist visit in Oct.
He says going to the gym makes him feel better both mentally and physically (he feels stronger). Aside from that little "chest pain thing!!"
As long as he is happy and enjoys his life I am not going to force him to stop.

Another Update:

Since initial onset of "mild" chest pains dad has had a stress test, heart cath and cleared of any blockages.
Pacemaker check found a new problem A-FIB. Started Eliquis for this and taken off Plavix. Was told that A-FIB does not cause chest pains.
Seen oncologist.....
His numbers are not low enough to warrant a confirmed diagnosis of his anemia causing the chest pains.
Cardiologist says plumbing all clear it must be related to MDS.
Electrophysiologist says what he is treating isn't causing chest pains.
Oncologist says must be heart related!

Meanwhile dad has stopped exercising for fear of the pain returning or possibly getting worse. Pains can come at any time now, even while sitting just watching TV. Not enough pain to bother him aside from the not knowing. Nothing like when he thought he was having a heart attack in 2000 and ended up with a quadruple bypass. In my mind ANY chest pain is significant and cause needs to be found. I can't believe they are all passing the buck.

Driving me crazy.

Sometimes the chest pain can be something as simple as the way a person breathes. Mouth breathers can get a chest pain from getting too much air in the digestive system.

What about esophageal spasming?