DR MARTIN SCURR answers your health questions –

I recently went to the hospital with a complaint of chest pain, but I was discharged. I have to go back for a myocardial perfusion scan that requires an injection of a small amount of radioactive tracer. I’m 81 years old and in good health, but that’s what I’m worried about.

Colin Buckley, King’s Lynn, Norfolk.

It must have been a little confusing to make sure everything was alright enough to get you fired, it just needed more research.

The good news is that a heart attack is out of the question. Another common cause of chest pain is angina, a spasmodic condition that occurs when the heart muscle runs out of blood, usually with exertion, such as exercise.

This is a sign of problems with blood flow in and around the heart – that’s what this scan is looking for.

While the words “radioactive tracer” may sound alarming, this is a safe test and will not harm you. The amount of tracer used is small and has no side effects (allergic reactions may occur in some people, but this is rare).

It is usually injected into a vein in the arm and returned to the heart through the bloodstream, where its flow is monitored by a special camera. This is done while walking on a treadmill and resting again.

Depending on the results, other tests may be required, particularly a coronary arteriogram, which involves injecting a fluid that can be seen on X-rays through a catheter placed in the heart.

It is used to detect severe blood flow restriction.

Myocardial perfusion scanning is a smaller study and I think it would be wise to do so. I hope this calms your concerns.

About 60 years ago, at the age of 13, I had mastoid surgery. Since then, I regularly go to the hospital for waxing. Two years ago, I had an infection that took a year to heal despite repeated treatment. I was told that I would probably continue to have an infection in that ear, but I was discharged from the hospital.

Christine Groom, Terrington St Clement, Norfolk.

Antibiotics made the surgery you had as a child unconventional, so few doctors today will be as familiar with patients who have had it, or the long-term complications that are common, as in your case.

The condition treated with this surgery is mastoiditis, which is a serious infection of the mastoid bone behind the ear.

Bone has honeycomb-like air spaces called mastoid air cells that can become infected or inflamed as a complication of a middle ear infection.

In the past, patients had to have surgery to remove these cells, but this leaves a space in the bone where wax, water, and dead skin cells can accumulate, creating ideal conditions for bacteria to grow and cause infections.

The risk with mastoiditis is that the infection enters the brain and is life-threatening.

More effective antibiotics from the late 1950s resulted in fewer patients with chronic mastoiditis.

In your longest letter you describe a chronic discharge from that ear where you were given additional antibiotics. But the key is to take precautions by keeping the mastoid space clean.

This means that you should protect your ear from moisture by using a cotton ball containing petroleum jelly while showering or washing your hair. Always do your best to prevent shower water from getting close to your ear.

My opinion is that you should be examined and treated by an otolaryngologist once or twice a year for life.

After visiting my GP with a loud pounding in my ear and high blood pressure, I was given blood pressure tablets and statins. I have now been diagnosed with fibromuscular dysplasia and am waiting to see a specialist.

Provided name and address.

This condition is believed to affect 3% of the population, but we still know very little about it.

Fibromuscular dysplasia (FMD) affects the arteries, often the blood vessels that supply the kidneys and brain, making them fibrous.

They shrink and become less flexible, which can lead to hypertension, so controlling it with medication may help.

It’s not entirely clear what causes foot-and-mouth disease, but some cases are genetic and may be related to hormones.

One or both arteries are affected in a very small number of patients, but in 90% of cases this condition affects most of the body’s main arteries.

The sound of the pulse in the ear causes turbulent flow as a result of narrowing of a nearby artery, possibly a branch of the main artery in the neck, and the sound you can hear is what we call the “highlight”.

Most GPs will know nothing about foot and mouth disease. The best advice will come from a multidisciplinary team, including a vascular surgeon, a kidney surgeon, a cardiologist and possibly a neurosurgeon, who can bring together the necessary care as needs vary from patient to patient.

They shrink and become less flexible, which can lead to hypertension, so controlling it with medication may help. A

write to scer

Write to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London, W8 5TT or email drmartin@dailymail.co.uk – provide your contact details.

Dr. Scurr cannot access personal communications. Answers should be taken in a general context and always consult your doctor if you have any health concerns.