Q&A – Question: panel changes after heart attack

I am M56, 152 lbs. Has anyone who has had a heart attack compared their blood work pre and post-attack? If so, what did you find? I had an NSTEMI about 8 weeks ago and had bloodwork done just before that. I had another test done (CBC with differential) a couple of days back. When comparing the two Anaemia results, I noticed several changes. For example, my neutrophils went up from 50% to 64%, lymphocytes dropped from 40% to 28%, and hematocrit dropped from 45 to 40.

Most importantly, there was the presence of promyelocytes, acanthocytes and poikilocytosis. From what I understand, these should never show up in peripheral blood, but they did! I have follow-up blood work scheduled, but I was curious if anyone had observed changes in their blood results after a traumatic cardiac event,

Thanks, everyone! Get checked regularly and stay healthy!!

Answer:

When you say pre-heart attack, do you mean the bloodwork they run when you are having a heart attack?

On the day of the heart attack, all cardiac markers were elevated, with a higher-than-normal platelet count and abnormal MCV. Two days later, the CBC test reported that red blood cells, haemoglobin, etc., all dropped below normal levels, with MCV in the normal range again. I’m assuming that is because of the clot buster and catheter procedure. At the three-month follow-up, all bloodwork was normal again.

—–

Question:

Monocytes Value

Age:33 Sex: F Height:5’2” Weight:125 Race: Caucasian Duration of complaint: Going on for about a year and a half or so. Location on Body: Arm/hand/fingers/leg/foot, all on the right side of the body. Existing relevant medical issues: adult-onset asthma. Current Meds: Gabapentin, singular, Flovent

I’m currently undiagnosed. I have been having symptoms of neuropathy. I have an EMG scheduled for next week from a neurologist. Currently have had bloodwork, X-ray, and MRI with no Anaemia diagnosis.

My primary did bloodwork to try and find an underlying reason. She said my bloodwork came back fine. After reviewing the CBC results, I saw that my monocytes show a value of 11.8%. Is this something that should have been looked into further? From what I gather, normal results are below 8%. It was towards the bottom of my results, so I wonder if she overlooked it. Should I bring it up to the neurologist? Could the monocyte level help find the underlying issue?

Answer:

That sounds frustrating, especially when you’ve been dealing with these symptoms for so long without a clear answer. Here’s what might help:

  • About the Monocyte Level: A monocyte level of 11.8% is a bit above the usual range. However, slightly elevated monocytes aren’t uncommon and can happen for many reasons, like recent infections or inflammation. It’s often only a concern if paired with other abnormal findings.
  • Does It Connect to Neuropathy? Neuropathy isn’t usually linked to high monocytes, but if an underlying cause—like an inflammatory or autoimmune issue—it could explain a slight increase. So, while it may not be a direct clue, it could still be a helpful piece of the puzzle.
  • Mention It to Your Neurologist: It wouldn’t hurt to bring it up, especially since they might want to investigate inflammatory or immune causes of your symptoms. They can let you know if it’s worth exploring further or if other tests are more useful.

You’re doing the right thing by keeping track of these details. Sharing everything with your neurologist can help them get closer to figuring out what’s happening!

—–

Question:

All my levels are normal, and I feel defeated.

I should probably not let this bother me, as I still have to go through an echocardiogram and the tilt table test (and based on measuring my heart rate at home, I imagine I’ll get a POTS or OH diagnosis)…but I had a TON of Anaemia bloodwork done, and everything is normal, besides my slightly elevated hematocrit.

My cardiologist checked for a bunch of autoimmune issues, electrolytes, a CBC panel, a catecholamine test (I think?) and some other stuff I don’t remember off the top of my head. I know (I think?) POTS itself doesn’t show up on bloodwork, but I was hoping maybe if that’s what it is, my CBC bloodwork would give us a hint as to what type I have or if I’m dealing with something else entirely. And maybe it is helpful for my cardiologist, even if everything is normal. I don’t know. It just sucks seeing everything marked “normal” when I feel like I can barely function and when it was genuinely a ton of exams that were hard to get through (it took multiple phlebotomists and half an hour of being poked for them to get enough Anaemia test blood…they were super nice but it was exhausting).

Answer:

I remember the first time I was told everything was normal. So, I was confused. I had alpha in 2020, and my PCP said it’s been too long since your covid was diagnosed; you have to go to the ER to get checked out. She figured something else was happening. It was POTS and dysautonomia.

I’ll never forget exactly what the doctor looked like when he said everything was normal. I felt so ABNORMAL. And I couldn’t walk down the stairs or read and concentrate. I was sleeping for 14 hours and could barely shower.

It took 1.5 years for me to be diagnosed with anything. It’s a fight, and it’s hard. I’m sorry. After I did get my diagnosis, I was also surprisingly sad. I want to be normal, but I also want the diagnosis to show people, look, I AM SICK.

Have you looked into chronic anaemia condition counselling? It was very helpful. It felt like I was fighting my body and waiting to be “normal”. My counsellor helped me accept my illness, and I swear, I got better because of it. Not normal, but vastly improved.

Author:

Yeah, I feel this. Thankfully, my CBC Cardiologist very immediately affirmed that I’m not making it up and that he believes me, so I do have that going for me (after being misdiagnosed back in 2019 with fibro and basically told I was on my own/they couldn’t do anything 🙃). So I’m in good hands. Just scared when things look normal, and also grieving being sick.

I’m in Anaemia trauma therapy, and we’ve been talking about chronic illness a lot recently. I think the grief of it and the trauma-related feelings it brings up connect enough that it works, if that makes sense. Plus, my therapist is incredible (and it took literal years to find her, and now I never want to leave her, lol).