Dear Sandra -
I am sorry to hear of what you are going through. I know that it can be very frightening.
Three years into my RSD I began experiencing strong chest pains, but no one thought it was cardiac in origin because I had just had a clean thallium stress test [nuclear medicine] a few months before and I had no established cardiac risk factors. Well, long story short, it was cardiac, only they just stumbled upon it a year later when they were following something else up, and once I had the second thallium scan (essentially the same thing you had done) I was not allowed to leave the radiology waiting room and was admitted a few minutes later through the ER. When I got an angiogram a couple of days later they found a "chronically 100% occluded Left Arterial Descending Artery." As it was, they were able to stent the major portion of the artery, but a small amount of tissue at the very end of the LAD had been lost, roughly 10% of the muscle mass around my left ventrical. I had had what is called a "nontransmural infarction," that is a heart attack in which both sides of the heart kept beating, probably one night a year earlier when I went by ambulence to the ER at 3:30 in the morning, but was discharged when I ran a normal EKG, the ******* doctor on duty having heard stupid me tell him that I had had a normal Thallium scan 6 months earlier and concluded that it was probably an esophagal spasm, all without bothering to run the very standard blood test that would have revealed telltale enzymes from the infarc. Fortunately, I had no other occlusions or, with a fully occluded LAD, my first heart attack would have been my last. And fortunately as well, I suffered no measurable loss of heart function. Still, if they had caught it a year earlier, an angiogram might have prevented the damage I did have . . . .
You did not say whether you had been given any nitroglycerin tablets by your doctor. You should get them without delay, as you should insist on receiving an angiogram. Let that be the moral of my little story.
Now, as to the link between Coronary Artery Disease and RSD there seems to be a link in a "pro-inflammatory cytokine" called Interluekin 6 [IL6]. A study that Dr. Schwartzman et al did about a year ago showed that in ALL of the RSD/CRPs patients studied, the level of IL6 exceeded the base sensitivity rate of the assay by a factor of at least 25, which I am told by my neurologist is huge. Secondly, IL6 is now being acknowledged as the most powerful risk of death from CAD. Here are two best references I have seen:
1. "Changes in Cerebrospinal Fluid Level of Pro-Inflammatory Cytokines in CRPS," G.M. Alexander, et al, Pain 111 (2005) 213-219 (finding of significant increases in interleukin-1ß (IL-1ß) and interleukin-6 (IL-6) in the CSF of patients with CRPS-I: the mean CSF value of IL-6 in the CRPS group was significantly more (P < 0.005) than that seen in the control group; CSF level of IL-6 in all patients exceeded the sensitivity (0.039 pg/ml) of the ELISA assay by a factor of at least 25). It's the lead article under the heading of "
Research" on the RSDSA Medical Articles Archive page, which you can download at
http://www.rsds.org/2/library/articl...ive/index.html
2. "Relative Value of Multiple Plasma Biomarkers as Risk Factors for Coronary Artery Disease and Death in an Angiography Cohort," Kenny W.J. Lee, at al., Canadian Medical Association Journal, 2006 February 14; 174(4): 461– 466 (in an 8 year longitudinal study, where they froze the blood serum from over 1,200 people up front, and then analyzed it after they knew who had lived and who had died, IL-6 was identified as the strongest independent predictor of CAD-related death) (free) full text pdf file at:
http://www.pubmedcentral.gov/ (just copy the name of the article into the search box and follow the prompts).
I have been going from pillar to post on this one, and have quite literally been to both the Mayo Clinic in Rochester MN and Johns Hopkins in Baltimore MD. but neither is yet testing IL6 levels in clinical patients. I was however given the name of one lab that tests this, and hope to have it done within the next month or so. After that, I don't know what. Probably try grape seed oil or the like, if I can figure out what are the therapeutic dosages. For a thread I put up a few weeks ago on a related anti-oxidant, Pycnogenol (French maritime pine bark) click here:
http://neurotalk.psychcentral.com/showthread.php?t=5162
The good news in that anti-IL6 meds are close to getting approval in the U.S. - if the rate of opportunistic infections isn't deemed too high - at least for Rheumatoid Arthritis and Chron's Disease. How much longer they take to reach the RSD or CAD communities - and whether a reduction of IL6 levels would actually benefit RSD patients - is anyone's guess. Think of it as an logical exercise in determining the direction of causality.
I hope I haven’t put you off with all of this. It's something that a lot of us are in together.
Mike