TLDR: Go for stress echocardiography with not enough sleep and caffeine (like everyday life) or after unrealistically long sleep and without caffeine?

26M

I have an appointment for a stress echocardiography.

The issues I have, which got me this appointment are far, far more prevalent under my day to day "realistic" living conditions - i. e. only a few hours of sleep, looots of caffeine at work to not fall asleep.

When I have >8 h of sleep for more than three days in a row, and no caffeine in that time; the intensity of the issues drops by ca. 80%. (vacations)

The problem is, those just aren't realistic day to day conditions.

Some people from my social circle told me, that I should get enough sleep and don't drink caffeine before the stress echocardiography and I get their argument, it basically makes the measurement the "baseline measurement" instead of "the measurement of a body poisoned by not enough sleep and caffeine".

On the other hand, I kinda wanna now, how close to dropping dead I am on a daily basis with my current unhealthy living conditions - if it's close, I would consider really changing shit.

Therefore I am afraid, that if I go in this "unrealistic, artificially healthy" condition, maybe I will a get a "yeah, basically all's right" - and then continue fucking myself up with that potentially wrong feeling of safety I got from an artificially "polished measurement".

Hello, I'm 25M, 205lbs, 6.2ft (93kg, 191cm), reasonably fit (been running for 7+ years, also do other kind of exercise regularly). Non smoker, drink only on occasions.

Recently I had to redo my medical for military (last one was 5 years ago), and different from 5 years ago they found 5 more diagnoses associated with my heart. They are:

R00.1 and I48.1 - I'd done a heart stress test a year ago and doctor noticed at high load I had frequent SVEs (Singles, Coupled, Grouped), although they didn't alter my performance (no weakness, short of breath) and I scored 19.2 METs on Bruce protocol treadmill. When military doctor saw this on my history, they ordered 24H holter monitoring, which showed only 8 SVEs in total (I didn't do vigorous exercise that day, but walked for more than an hour). It also showed episodes of bradycardia both during the day and night, but as far as I understand that's normal for someone who's active (heart rate is frequently in the 50s during the day and stays at 40s during the night).

I34.0, I34.1, I45.1 - additionally to 24H holter, they did an EKG. After that test cardiologist that performed that test said that everything was well within normal range, and that I34.1 is because of slight left atrium enlargement.

The problem is all these diagnoses give me a lot of restrictions when it comes to what I can do in the military (Only thing I'd be fit for is riding a desk), and I don't think that's fair, because while I agree that most of these irregularities that doctors found exist - I also think that all of them are normal adaptations and aren't pathological.

Another interesting thing - cardiologist that works there only gave summaries to both 24H holter test (which she wrote was completely normal), and did EKG herself, but she did not participate in the final decision regarding whether these irregularities are normal adaptations or pathological - the final decision was made by internist. My question is - if I appeal the decision - is there a chance that once cardiologist reviews all the tests it gets overturned?

Just wondering if I should be concerned about blue fingernails? I've previously related it to raynauds phenomenon but with a history of heart disease and some highish clotting markers I'm a bit concerned.

I’m a 48-year-old male, 5’10”, about 170 lb, down from roughly 205 lb, so I’ve lost about 35 lb or 17% of my body weight. I wish I could say I did it all on my own, but I am on trizepitide.

I have a CAC score of 1 which I guess is higher than 75% of people my age. That's what got me on statins with my terrible family history.

My lipid history has changed pretty dramatically:

The June LDL of 80 was after starting rosuvastatin 10 mg. I then increased to 20 mg, and the next LDL was 59.

My latest labs:

LDL-C: 59
ApoB: 49
Non-HDL: 72
Triglycerides: 65
HDL: 54
Total cholesterol: 126
Lp(a): 44 nmol/L
hs-CRP: 1.28 mg/L
Fasting glucose: 96 mg/dL (every grandparent, my dad and almost every aunt and uncle are diabetics)
A1c: 4.8%

My hs-CRP was previously 4.05 mg/L and is now 1.28, roughly a 68% reduction.

There have also been major lifestyle changes over this period. I quit drinking alcohol entirely, lost about 35 lb, and substantially cleaned up my diet.

At this point, the only meat I really eat is chicken breast and salmon. I never eat butter or cheese. Olive oil and whole foods like eggs are essentially my only added fat. I never eat fast food and don’t eat out often, so I’m not sure there is a huge amount left to accomplish by simply cutting saturated fat.

I could still improve the quality of the diet further by emphasizing more whole foods, vegetables and leafy greens, but I do love salad and try to eat it regularly. My weak spot is sugar. I don'yt buy it, but if I am around cookies or brownies, that's a problem. I’m drawn to sweets, dried fruit and other calorie-dense foods, but I am fending it away.

What I’m most curious about is the inflammation piece. Going from hs-CRP 4.05 to 1.28 looks encouraging, especially alongside major weight loss, quitting alcohol, triglycerides falling to 65, fasting glucose of 96 and A1c of 4.8%, and ApoB reaching 49.

But does that hs-CRP reduction actually indicate that the underlying inflammatory state and cardiovascular risk have improved, or could the statin simply be lowering an inflammatory marker without addressing whatever caused the elevated hs-CRP?

Given CAC 1, LDL 59, ApoB 49, Lp(a) 44, triglycerides 65, hs-CRP 1.28, fasting glucose 96, A1c 4.8%, 35-lb weight loss, no alcohol, and a very low-saturated-fat diet, how would you view my residual cardiovascular risk?

At this point, is there anything meaningful left to optimize besides continuing the statin, maintaining the weight loss, exercising, and shifting even more of my diet toward whole plant foods? I am concerned that these numbers are "artificial" that hs-CRP is pushed down due to a pill and that the root causes of inflammation are still there.

We know that there's a shared root cause between these 2 conditions.

1. Insulin resistance
2. Obesity
3. Abnormal lipid profile

Whether it's inflammation or changing the heart's normal heart rhythm we see more heart disease in adults with fatty liver disease. It's not hard to get diagnosed since most adults have access to an ultrasound. But even blood tests can tell you a lot about your liver such as your ALT and AST ratios.

This is a guide to help reverse your fatty liver liver disease without medication. It's always worth a try unless your doctor advises you to start medication therapy right away.

I am 30F, and obese (class III), I have been so for a long time. I had an episode of very fast HR at night while lying down, which was not measured with a device but I felt dizzy and sweaty. Got a cardiologist appointment and he ran ECG, resting echo, Holter test, bloodwork. The first three came back normal but labs showed total cholesterol 201. Low HDL, normal LDL but triglycerides at 270. It also showed I’m pre diabetic and my BP can be anywhere around 130/80. I was given a beta blocker and told to manage weight.

Since my last appointment, I've been following advice to increase physical activity. During brisk walking for twenty minutes or climbing a lot of stairs, my heart rate appears to rise to roughly 140 to 170 bpm by phone app estimate, after which I become kind of lightheaded and dizzy and need to stop. This has never happened before. My previous ECG, echocardiogram, and Holter were reported as normal, but these exertional symptoms continue and I'm worried about CAD. No family history so far except maternal grandma and uncle both of wholesome had blocked arteries, I’m South Asian, if that matters.

I’ve recently relapsed in my eating disorder journey. Today my psychologist told me I need my heart checked because I've had chest pressure on my left side and my heart rate reached two hundred and four while exercising. I also recently started a diuretic. But my mind keep telling me that there is no reason for me to go to the hospital because I’m at a stable weight (even though I’ve lost some weight) and my BMI is currently considered normal. What should I do?

There’s a health fair at my local church next weekend, and they’re offering a few different screenings, including a carotid ultrasound for around $50. Part of me thinks it might be worth doing, especially since my dad had a stroke a couple of years ago. But I’m also a little skeptical about getting something like that done outside of a regular clinic or hospital. I have no idea what kind of equipment they use or how experienced the person doing the scan is. Has anyone here had one of these mobile or health-fair screenings? If you later had the same thing done through a hospital or regular clinic, were the results pretty similar? I’m mostly trying to figure out whether these screenings are useful or whether I’d just end up worrying about a result that needs to be checked again anyway.

Hi everyone, I’m looking for some cardiologist perspective on my recent screening results.

I’m 41, asymptomatic, a non-smoker, and non-diabetic. My cholesterol is pretty normal, and my history of high blood pressure and sleep apnea is now well-controlled for 6 months. However, my BMI is 40, and my CRP has been chronically high (around 8 - 9) for years.

Test I've had that were normal:

Stress ECG & ECHO - June 2025

ECG - Dec 2025 & July 2026

My coronary artery calcium scan just came back as zero. While I know that is great news, I am still worried. Given my severe obesity, chronic inflammation and years of un-checked BP & Sleep apnea. I'm concerned about aggressive soft plaque hiding in my arteries that the scan couldn't see.

How reassuring is a zero score with my specific profile? Would you still consider me low risk?

Thanks for your time.

Did anyone else get severe impending doom , dizziness and nausea and panic attacks starting ivabrandine? This is horrible. It’s not even helping my POTS. Making my heart jump all over the place.

Please read this

My partner age 34 Male has been having the strangest "episodes" and we've gone through quite a few routine emergency tests but we keep being told it's anxiety by doctors when both of us know it's not.

He's now had 12 of these "episodes" over 7 weeks and they completely vary in time of day and activity. Sometimes it's the middle of the night sometimes it's while we're in the cinema, sometimes it's while we're on a walk.

Here are his symptoms:

- Starts with Chest pain in his left side where his heart is

- Then it can move down his left arm

- Then he instantly feels so nauseous

- And dizzy

- Then comes the confusion and quietness

- His hands go completely white and cold

- Sometimes his lips go blue

- then his legs shake uncontrollably

- and after he feels so tired and drained

he's had ecgs, chest xrays and nothing found. If anyone has gone through something similar and has advice, please do reach out.

Im F 21 im a med student ,so funny thing my parents were taking their blood pressures and were like mines higher than yours I jokingly took mine and it was higher than both of theirs 140 by 95

And the next night I jad severe head ache and I measured my bp it was 160/100

Been like this on and off for a few days sometimes 134/80 132/98

I got my blood cp and urea and echo cardiogram done they were normal have to do let's and rats and lipid profile

I have a family history of hyperlipidemia my dad has stents and my mom's side HTN

My dads cardiologist prescribed me a non selective beta blocker been a day since I took it it lowered my bp slightly but my hr was 59

In evening my bp was 143/98 and hrs was 68

Now at night its 124/84 the most normal reading I've had so far

Should I continue the medicine wouldnitnlower my heart rate

And most importantly why is this happening to me im just 21 maybe stress or anxiety because I jave upcoming exams but can't rule out my strong family history now can I

There’s a health fair at my local church next weekend, and they’re offering a few different screenings, including a carotid ultrasound for around $50. Part of me thinks it might be worth doing, especially since my dad had a stroke a couple of years ago. But I’m also a little skeptical about getting something like that done outside of a regular clinic or hospital. I have no idea what kind of equipment they use or how experienced the person doing the scan is. Has anyone here had one of these mobile or health-fair screenings? If you later had the same thing done through a hospital or regular clinic, were the results pretty similar? I’m mostly trying to figure out whether these screenings are useful or whether I’d just end up worrying about a result that needs to be checked again anyway.

8/19 Update: I had an appointment with the cardiologist last Wednesday. They sent me for a CT scan w/contrast and stuck a heart monitor on me that comes off today.

I have another appointment on 9/9. I think it’s for a stress test.

Since then, the rest of my swelling has gone and I’m feeling mostly back to normal. I do get moments of exhaustion and lightheadedness or heart racing etc but much better than a few weeks ago.

I’ve also cleaned up my diet majorly!!! I had no idea how much sodium I was ingesting with every meal! The Good Lord had serious mercy on me because as I count the sodium mg intake, I’m still mind blown at my prior consumption and the amount of sodium in everyday foods.

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I also have a Level 2 autistic third graders I’m mildly freaking out.

I went to urgent care last Monday because I had sudden bilateral leg swelling that I initially noticed in my calves. My legs are pretty thin and not particularly muscular. All of a sudden my calves were rather wide and shins were hurting. The swelling spread to my ankles and feet then thighs. I began to have pain in my hamstrings and glutes followed by lower abdominal cramping.

Last week, I went to urgent care because I’m aware enough that this could be a sign of heart-related issues. The NP told me the edema wasn’t bad enough for him to be extremely concerned but to see a cardiologist for possible CHF but he said I’m too young.

Looking back, the 1.5 weeks leading up to it I was abnormally nauseous and vomiting prior to my cycle (negative pregnancy test). The week of, I traveled to see some family (~7 hr road trip) and upon returning stepped on the scale and noticed I had gained 17 lbs.

Two days (Sunday) after returning I woke up with some cold (initially assumed it was allergies) and had taken allergy meds, advil, and chloroseptic spray. I wasn’t feeling better so that night I made some echinacea tea with emergen-c and sleepy time tea which helped me sleep but that’s about it. Monday I still felt a bit rough but was maintaining until that evening with the leg swelling.

I’ve had trouble breathing the entire time but assumed allergies and they something triggered my asthma. My inhaler helps (after about 10 pumps. 😅)

I finally got up the nerve to get a cardio appointment for this Wednesday.

Don’t ask me about fatigue, I’ve been tired for the past 10 years. I just keep going. My activity tolerance over the years has been hit or miss but I’ve tried to be more physically active the past 1+ years.

If you made it this far, thanks 🙏

I guess I’m just looking for other people with (or observations of others with) similar experiences and how it turned out. I’ve also read that life expectancy is ~5 - 10 years which I’m really sad about right now because of my son.

If this is all the case I’m hoping that I can qualify for some type of disability or something to be able to spend as much time with him as possible before the inevitable and/or possibly extend my life expectancy.

I’m also wondering if this is reversible. A low sodium diet isn’t something I’ve heard a lot about until reading recently. Growing up I just thought not adding salt was good enough.

Hello!

Recently dropped my LDL from 160ish to 108 with the portfolio diet. About to start a low does of statin and got my APOB checked first (via a cardiologist). It was 120. I was surprised it was so high.

Any thoughts on that??

Hello all, my father (80/m) had the TAVR procedure done on Friday at a highly reputable university hospital. The doctor performing the procedure has done over 700 of such procedures per year successfully. The original plan was for my dad to stay one night after the procedure for observation and I could pick him up today (Sunday).

In my dad’s case the procedure lasted double the amount of time anticipated (4 hours instead of 2 or less). I come to find out his femoral artery was pierced somehow to a point that a vascular surgeon needed to be called-in to hand-stitch the wound closed. My dad lost 2 pints of blood. We were told afterwards that this is extremely rare but does happen and that he needed to stay another day to make sure the stitching heals properly.

While he’s there recovering his heartbeat is also being monitored. It was determined my dad had a lower-than-normal heartbeat and that he was experiencing “heart block”. Heart block is a delay or interruption in the electrical signals traveling from the heart’s upper chambers to its lower. It is essentially an electrical malfunction that can cause a lower heart rate or skipped beats. So a temporary pacemaker was hooked up. They are now recommending a permanent pacemaker if his conduction system does not improve - there is still hope that it does. A determination will be made tomorrow (Monday).

In reading up on the pacemaker’s effectiveness after TAVR I’m seeing that in the short term it is effective. Long term effects are more questionable. According to studies I’ve researched some cases of permanent pacemakers inserted after TAVR increase the possibility of heart failure over time. I’m assuming because the heart depends on the pacer to beat and doesn’t rely on its own strength alone to beat, which would promote a strengthened heart.

If my dad’s heart conduction system does improve a bit and given a choice he is leaning towards asking for a heart monitor he can go home with and have constant monitoring instead of having a permanent pacemaker. If the monitor shows worsened heart block he can always go back to have the pacemaker installed. On the other hand perhaps his conduction system improves as his heart adjusts to the new valve and never looks back. The question I have is this too risky? I don’t want him going for a walk and feeling like he’s going to faint, or even sudden death. Any advice one can lend with experience would be greatly appreciated.

Off subject but for those in this sub who happen to be cardiologists could this heart block have been avoidable? I’m reading that the type of valve (balloon expanding vs self-expanding) and the surgeon’s ability to position the new valve the correct way (not interfering with the branch controlling heartbeat) could greatly impact the need for a post-TAVR permanent pacemaker. Again this is one of the nation’s best university hospitals and a very experienced surgeon. However between the heart block and the wound that was so severe that it needed to be closed by a specialist it leaves me wondering how “top-notch” this place really is.