Tests for Heart, High blood pressure issues

[Chadnik]

I would like to get some cardio and coronary tests done in January due to being over 60 and  history of high blood pressure. 

 

Can anyone recommend a few tests that will really give me a picture of my heart / coronary health? I'm not looking to spend a whole lot of money on this and would like to perhaps avail to any packages offered by eoy by bkk hospitals.

 

I've had a few EKG done for a hernia operation last year. Dr said nothing. During the recovery I had a lot of heart challenges as gas in my body was extremely painful and moving around was challenging for my heart due to the pain and drama I'm getting in and out of the hospital bed. I was in pretty good shape last year when I had that done.

 

The high blood pressure which I believe is largely metastatic although some of it genetic. I believe this because when I was monitoring my blood pressure I was getting fit I noticed it was definitely dropping and found a new equilibrium much lower

 

Overall, I'm in good health and people often guess I'm five and even ten years younger than I am.

 

My alcohol intake is now quite limited.

 

I have a history of smoking cigarettes, but that stopped thirty years ago although I did smoke randomly through the next 15 years. I can hold my breath for about a minute freediving to 15m with fins. I walk about an hour a day / 7500+ steps minimum M-F

 

There's nothing in my life currently or in the past it would indicate to me that I have any heart issues or coronary blockage. Finally, i have had random pathology tests done over the years and nothing indicates disease, admittedly these are more liver, kidney and random tests.

 

- Sugar is on the higher side of normal

- Cholesterol has always been fine.

 

Diet is ok. I could eat more leafy greens and less fried Thai food and quick ham sandwiches but oh well

 

Probably more information than you need 🙏 Thank you

 

Bangkok hospital, labs only if also recommending location

 

EDIT

Estimates on reasonable cost for exams and procedures would be greatly appreciated

Edited September 14 by Chadnik
EDIT

[scubascuba3]

CAC Test (Coronary Artery Calcium)

 

In UK, Triple A test on NHS for over 65. Aorta test. Abdominal Aortic Aneurysm (AAA) screening.

 

My brotherinlaw just had a heart attack, 60ish, although very fit, doesn't drink, arteries were blocked, needed a stent, bypass considered, had family history but didn't get it regularly checked

[Sheryl]

Have you had a recent check up that included lipid oanel and Hb1Ac? As if not, shoukd -- these being the midifiable risj factors.

 

CAC will give you an idea of the current  heakth of your coronary arteries and can be useful in decifing whether or not to treat mild dydlipedemia.  Stress test gives very useful info on overall cardio fitness and how well your heart handles  increas3d workliad.

 

There are packages available that combine these with blood tests so please indicate if latter are needed.

 

Also are you onanh meds, if so which? (Some would interfere with stress test) 

[Chadnik]

1 hour ago, Sheryl said:

Have you had a recent check up that included lipid oanel and Hb1Ac? As if not, shoukd -- these being the midifiable risj factors.

 

CAC will give you an idea of the current  heakth of your coronary arteries and can be useful in decifing whether or not to treat mild dydlipedemia.  Stress test gives very useful info on overall cardio fitness and how well your heart handles  increas3d workliad.

 

There are packages available that combine these with blood tests so please indicate if latter are needed.

 

Also are you onanh meds, if so which? (Some would interfere with stress test) 

 

Hi and thank you

 

I think Hb1Ac may have been included in my last pathology clinic tests but uncertain.

 

CAC - ok, thanks to you both.

 

dydlipedemia .. no idea. But my cholesterol checks never been out of norm. Then when I was drinking more than I probably should my liver kidney tests always within range as well.

 

Im on 20mg enalapril which I was in process of cutting in half before i had to change exercise routine.

 

So, can i just shop for CAC and stress cardio and see what comes of that??

 

BMI is 22

 

Absolutely nothing has ever happened to me that would give me the belief that I have heart or coronary issues.

 

My major concern is that my blood pressure can be high without the medicine hitting 140+/90. Normal with. Moderate exercise beyond walking i know i can bring it down. Currently walk about an hour a day.. dedicated, just shuffling about.

Edited September 14 by Chadnik

[BarraMarra]

I have undergone a triple heart bypass lucky for me the heart specialist asked for an Angio Gram that identified blocked arteries and I was quickly operated on.  I had no prior Symptoms   of heart failure all i suffered was short breathless which i put down to my age and the heavy Engineering atmosphere i worked in. Only an Angio or an Echogram will identify potential heart problems. 

[oldestswinger]

Buy a blood pressure monitor (they're not expensive) and test yourself every day for BP and pulse.

[Chadnik]

1 minute ago, oldestswinger said:

Buy a blood pressure monitor (they're not expensive) and test yourself every day for BP and pulse.

 

Thanks. I have one. The post is really about larger issues. My BP is fine under meds. I'm looking to find out long term potential, serious issues.

[Wuvu2]

I had a cardiac workup at BPH last year. Dr visit and lab work cost about 7k.  They put me on a haltar monitor at home for 72 hours which cost another 6k including the dr visit to read the results. I didn't shop around. 

 

I started with one of those health checkup packages at Jomtien Hospital which is part of the BPH group but doesn't have a cardiology department. Those packages are used to make referrals to their specialists. I knew I had a heart issue and one other health concern. I ignored the rest of the referrals.

[Chadnik]

I've put together a list of tests I believe I should have related in/directly to my high blood pressure and concerns for my heart as well as testosterone check (that I'll get around to doing one of these years).

 

Maybe could help others as well..

 

I've placed an asterisk after tests I believe are generally a la carte or non-standard outside of more expensive packages or special cardio packages. Most of these tests don't look too prohibitively expensive. CAC in US is apparently 1-400usd

 

Do you think possible to show up to the hospital with a comprehensive pathology work up done in a clinic and then add the cardio stuff at the hospital. Will the doctor evaluated or require their own set of overpriced Hospital tests?

 

 

TESTS 60yo+

 

Standard Blood Work:
Liver enzymes (ALT, AST)
Hb1Ac (better than fasting blood sugar)*
BUN and creatnine
C reactive protein
Complete blood count
Lipid panel (HFl, LDK, triglycerides)

 

Heart:
CAC / CT*

ECG*
Exercise stress test*

 

Prostrate:
PSA path test
Manual prostate exam (DRE)*

 

Liver:
Fibroscan*
Ultrasound upper abdomen

 

Testosterone:
Total*, Free Testosterone*, SHBG*

Edited September 16 by Chadnik

[Sheryl]

3 hours ago, Chadnik said:

I've put together a list of tests I believe I should have related in/directly to my high blood pressure and concerns for my heart as well as testosterone check (that I'll get around to doing one of these years).

 

Maybe could help others as well..

 

I've placed an asterisk after tests I believe are generally a la carte or non-standard outside of more expensive packages or special cardio packages. Most of these tests don't look too prohibitively expensive. CAC in US is apparently 1-400usd

 

Do you think possible to show up to the hospital with a comprehensive pathology work up done in a clinic and then add the cardio stuff at the hospital. Will the doctor evaluated or require their own set of overpriced Hospital tests?

 

 

TESTS 60yo+

 

Standard Blood Work:
Liver enzymes (ALT, AST)
Hb1Ac (better than fasting blood sugar)*
BUN and creatnine
C reactive protein
Complete blood count
Lipid panel (HFl, LDK, triglycerides)

 

Heart:
CAC / CT*

ECG*
Exercise stress test*

 

Prostrate:
PSA path test
Manual prostate exam (DRE)*

 

Liver:
Fibroscan*
Ultrasound upper abdomen

 

Testosterone:
Total*, Free Testosterone*, SHBG*

why a fibroscan?Do you have history of hepatitis or cirrhosis?

[Chadnik]

17 minutes ago, Sheryl said:

why a fibroscan?Do you have history of hepatitis or cirrhosis?

 

Not that I'm aware of. I was drinking a few whiskys at home each night and out to pub once a week.

 

About 10+ yrs ago I was told post scan that at the beginnings of fatty liver.

 

I'm now down to drink a one whiskey at night twice a week and out to the pub once a week for 4-5 bottles of beer.

[BarraMarra]

I Have to take 10 tablets everyday for life i have had a Defibrillator inserted into my chest that Monitors my heart due to my heart failure. I never had any chest pains or had a Heart Attack most sadly do not know there hearts are failing only short breathless and problems walking distances are signs something is not right. I played Rugby and football from 15 to my late 30s and put down my sporting injuries and wear n tear on my Ankles and knees' but i was getting short of breath and as a Smoker i knew something wasn't right. You can do all the test you like such as ECG blood pressure tests regular this will not identify heart failure. As you age so does your blood and Circulation A definite test is an Angiogram and an Echogram I was very lucky without these tests i would not be typing this post now it happened to me don't let it happen to you 2 tests that could save your life.   

[Sheryl]

1 hour ago, Chadnik said:

 

Not that I'm aware of. I was drinking a few whiskys at home each night and out to pub once a week.

 

About 10+ yrs ago I was told post scan that at the beginnings of fatty liver.

 

I'm now down to drink a one whiskey at night twice a week and out to the pub once a week for 4-5 bottles of beer.

Fibroscan is not needed for fatty liver.

 

Regular abdominal ultrasound will show  that if desired.  But if you are not overweight, your alcohol intake is as stated, and assuming liver enzymes (ALT/AST) come back normal I see no reason to get that done, either.

 

Reverting to your prior list and question,  different hospitals offer different test packages and it is always possible to add on additional tests.  Some hospitals have specific heart packages; others have check up packages that include stress test.

 

Fopr you, I suggest thios one, includes both EST and Calcium score

https://www.bangkokhospital.com/en/package/tune-your-heart

You'll need to add on the PSA and testosterone

 

 

[Chadnik]

20 minutes ago, Sheryl said:

Fibroscan is not needed for fatty liver.

 

Regular abdominal ultrasound will show  that if desired.  But if you are not overweight, your alcohol intake is as stated, and assuming liver enzymes (ALT/AST) come back normal I see no reason to get that done, either.

 

Reverting to your prior list and question,  different hospitals offer different test packages and it is always possible to add on additional tests.  Some hospitals have specific heart packages; others have check up packages that include stress test.

 

Fopr you, I suggest thios one, includes both EST and Calcium score

https://www.bangkokhospital.com/en/package/tune-your-heart

You'll need to add on the PSA and testosterone

 

 

Thank you Ms Sheryl 🙏

[4MyEgo]

On 9/14/2024 at 2:46 PM, Chadnik said:

So, can i just shop for CAC and stress cardio and see what comes of that??

 

 

I had my heart attack almost 2 decades ago, stent inserted, meds since.

 

Cardiologist said, diet, exercise, maintain a healthy weight, don't smoke, don't drink, and you will live 20 to 30 if not more years.

 

I have done that just that and no issues thus far, that said, I would visit him every 2 years for a check up at my wanting to, then 3 years when returning to my home country after moving to Thailand, and he would want an echocardiogram stress test every 5 years, all good.

 

I asked him about a CAC test and he said, I wouldn't worry about one, and that he didn't recommend them for his patients, unless very old with complications.

 

Make of that what you will. I thought he might be trying to save the system $'s as Medicare might have paid for it, and I told him that I would pay for it, and that I could even do it when I returned to Thailand, he looked at me, and said, look, I have been seeing you for almost 2 decades, your blood work is good, your weight is good, your diet is good, save your money, but if you want it, then it's up to you, but as I said, I don't recommend it to my patients, unless they are very old with complications.

 

Perhaps it's best not to know, if you don't have any issues, who knows what one will find if they look into it....LOL

 

I haven't done one based on his professional opinion.

 

Sorry that I can't offer you any advice on it.

 

Edited September 16 by 4MyEgo

[DogNo1]

Angiograms are expensive but they are the definitive test for cardiac artery blockages.  Many hospitals like to add the charge of inserting a couple of stents.  You can’t argue about them once they’re installed.  You just have to pay.   So be aware that you will probably be paying for more than the angiogram.

[Sheryl]

2 hours ago, DogNo1 said:

Angiograms are expensive but they are the definitive test for cardiac artery blockages.  Many hospitals like to add the charge of inserting a couple of stents.  You can’t argue about them once they’re installed.  You just have to pay.   So be aware that you will probably be paying for more than the angiogram.

Angiogram is never indicated for routine screening in asymptomatic people.  It is  done only if other tests (or symptoms) indicate the likelihood of significant coronary artery disease. So no relevance to this thread.

 

There are clear-cut indications for stent placement. Usually discovery of >70% blockage. It is not a matter of the hospital "liking" to add them, and the devices themselves are expensive for the hospital to buy. So naturally their insertion comes at an increased cost, this is not any sort of "padding" by the hospital.

 

The ability of inserting a stent on the spot is a key reason for doing an angiogram (though not all angiograms will lead to stent placement). At the time of discussing an angiogram with an intervention cardiologist, should clearly ask about not just the costs of the procedure but the cost per stent if required. Usually this nformation is volunteered, but if not - -ask.