Question: Would you please write about variant angina? My sister, 30, had this. She had a heart attack and was hospitalized. Afterward, she had another attack and had surgery. The condition did not respond to medicine, and she had two more spasms. She almost died, but is now recuperating. The doctor said her heart arteries were not blocked.
- C.E.
Answer: Your sister had a most uncommon experience. Most variant angina patients do not have such a rough time. I am glad things are turning back her way at last.
Standard angina pectoris does result from heart artery blockage, but in the variant kind, the arteries go into spasm. In either form, the warning sign is sudden chest pain.
Most often, heart circulation is quickly restored as the spasm leaves. Your sister's spasm lasted long enough to damage some of her heart muscle. That is a heart attack.
Variant angina's setting distinguishes it. That is, it almost always occurs at rest and not during activity, the way ordinary angina does.
For a person who has had such a serious encounter with variant angina, the first six post-heart attack months are the important ones. Chances of fatal heart rhythm disturbance are greatest then. After six uneventful months, the patient can be considered out of the woods.
We cannot pin down a cause of the vessel spasms associated with the problem.
I presume control drugs are now working for your sister. Nifedipine and diltiazem are examples.
Question: A few months ago, my husband had a routine physical. They found blood in his urine. After several hundred dollars in tests, including a probe of the bladder, no reason could be found. No follow-up was arranged, but my husband is not the type to go back, anyway. He is 50, a heavy smoker and drinker. Otherwise he seems to be in good shape, except that he still has blood. Any comment?
- R.S.
Answer: Your husband is in limbo, with persisting symptoms and no explanation for them.
He might need another level of testing, including a biopsy of kidney tissue, which can reveal an elusive bit of evidence to form a diagnosis.
The most important cause - although not the most common - is cancer, and as scary as that prospect is, it is something you want to know about as soon as possible.
Please try to persuade your husband to pursue the matter. Although he has already had extensive testing, new testing is appropriate.
Question: A dear friend gives blood plasma as often as possible. How often can she give?
- C.L.
Answer: A normal, healthy person can donate plasma twice a week. Generally, up to 15 liters of plasma donation is permitted in one year.
Contribution limits can vary or change with other factors, including the person's weight. A person who is not feeling well should not donate as often as allowable, if at all.
Plasma donation involves removal of the liquid from whole blood and subsequent return of the red cells.
Question: My 10-year-old granddaughter is only 3-foot-9 and weighs 80 pounds. What do you think?
- M.P.
Answer: Your granddaughter is at the lowest ranking for height and near the highest for weight. She really needs an evaluation by the family doctor to see if she has a hormone deficiency.
On the other hand, she might just be a late bloomer. She could shoot up overnight.
As for the weight, she really should be watched for that. Is she getting sufficient physical exercise?
I would want this young lady to have firsthand professional evaluation.