When Barbara Fleeman was in her late 50’s, she had pain in her heart. She felt exhausted with a chronic cough, shortness of breath, and terrible pain in her chest. Despite visiting several doctors, no one could find anything wrong. Barbara said, “No one would listen to me or think the problem was my heart. I needed someone to believe me when I would tell them ‘my heart hurts.'”
Every echocardiogram (EKG) and every blood panel, came back normal. A few doctors told her the cause was her sinuses or her esophagus and some implied it was her imagination. Barbara eventually visited a gastroenterologist at Cedars-Sinai in Los Angeles, Dr. Leo Greyzon. He referred her to a cardiologist. But again, after several tests, the cardiologist said her heart was in excellent condition. By now, Barbara had to cut back her hours as a professional caterer and chef because she was so tired.
Barbara was extremely frustrated but after research, she found the Women’s Heart Center at Cedars-Sinai in Los Angeles. Doctors immediately ordered a cardiac magnetic resonance imaging (MRI) scan. It revealed coronary microvascular disease (CMD), a condition of the heart’s smallest arteries that is more common in women than men and doesn’t show up in conventional tests. Further testing with cardiac catheterization and an angiogram showed that behind the CMD (coronary microvascular disease), there was endothelial dysfunction, which meant the lining inside her arteries was weak and her heart wasn’t getting enough blood flow.
Barbara met with Dr. Noel Bairey Merz, the director of the Preventive and Rehabilitative Cardiac Center at the Smidt Heart Institute, Cedars-Sinai. Dr. Bairey Merz (shown in the picture) told Barbara that the proper medications along with regular exercise would be critical to strengthening her heart and helping prevent future problems.
The interesting note about Barbara’s case is that she did not consider herself to be at risk for heart issues. She maintained high HDL cholesterol (the good kind), low LDL (the bad kind), low triglycerides, and normal blood pressure. She loved being active and cooking healthy foods. Barbara says, “You can have normal EKGs and excellent cholesterol and still have coronary microvascular disease.” Thank goodness she was persistent enough to continue looking for a good heart program.