Q:
Three weeks ago, I woke up with blurred vision in my right eye. Last winter I had a problem with this eye (faces on TV screen “split”) for a couple of hours and had an MRI/MRA of my brain, normal results. I went to the ER after the latest incident, attending couldn’t find anything alarming, referred me to ophthalmologist, he didn’t find anything and suggested I “might” want to have a carotid artery ultrasound at some time in the future, so I asked my primary care physician to order one. I had it last Thursday. Today, primary care physician’s nurse (he just had bowel resection surgery, won’t be back until next month, his partner MD read the results) called and said I should talk to my primary care Dr. about a statin at my next appointment (which isn’t until mid March). I asked her how “bad” the results were; she said the other Dr. had not mentioned that, merely suggested I talk to my primary care Dr. at my next appointment. I am now freaked out.
I had a stress echo a few months ago, everything absolutely normal (heart action all rated #1, no abnormality). I exercise regularly (30 minutes, 2 miles, 4X weekly). My diet isn’t extreme, I eat a lot of whole wheat pasta, veggies, some beef and pork (very infrequently). Now I’m worried that the eye disturbance might have been related to the plack. I have hypertension but well controlled (170/80) at Dr. visits (was 150/80 at ER). Should I have an MRA of my carotids? Frankly, I don’t really trust this Dr., I asked my primary care Dr. if I should have a carotid ultrasound more than 6 months ago, he said “NO”, my cholesterol values are under 200, I exercise, etc., so I’m thinking I should call them on Monday and tell them I WANT a carotid MRA. What do you think? What’s my risk of stroke or other horrendous outcome? I’m 63, female, in great physical shape, look and feel not much different from when I was 50.A:
Why not ask specifically for the results of your carotid ultrasound? You “own” it, and the doctor’s officer has an obligation to tell you the results, just like they have an obligation to cover a partner’s absence. I cannot explain your eye symptoms, but from everything you have told me your risk for coronary artery disease, stroke and Transient Ischemic Attacks (TIA) is very low. Anyway, the ultrasound will tell whether you have a carotid blockage or not. Another reason for a TIA, is a small clot from w/i your heart as happens with patients who have atrial fibrillation. Doesn’t sound like you either!
You can read more about these things here (and calculate your risk):
http://www.cardiac-risk-assessment.com/heart-information/coronary-artery-disease
http://www.cardiac-risk-assessment.com/app/risk-assessment.php
Hope this helps,
Dr T
http://www.cardiac-risk-assessment.com/