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Current Postings on This Page (34):
my age is 32 lmca 35% rca70% and have diagnals
thin vessels one cordiologyst told that your viens is very small that condition
is not comfort to cabg you continue old medicine. but what is the my heart
condition I dont know. now I have a any serious conition? please give reply
anybody for my doubt ramakrishna,uae.
what is my health condition, electrical, ras al khaimah, United Arab
Emirates,
August
18,
2010
Madmatt in Missouri -- Stents only
go down to a certain diameter -- we believe 2.25mm is the narrowest. Although
a balloon angioplasty can still be performed in a narrow vessel -- just
no stent left behind, so reclosure is a higher risk. Did you cardiologist
do a balloon dilatation? FYI, even after angioplasty and meds, a not insignificant
number of patients still experience angina -- there are anti-anginal medicines,
such as Renexa (Ranolazine) that may relieve the pain.
Forum Editor, Angioplasty.Org, June 30, 2010
I'm a 40 year old male quad bypass in 04' recently
I've had angina and pain in the back of my arms, my cardiologist tried
to perform a stent on a horizontal
artery, it was too small and is now treating with meds, I'm still having angina
and anxiety. I've been assured that this will pass as all other vessels seem
well. Question... when will the hurting stop? except for this small vessel
I'm great
but it's very frightening.
Madmatt, Independence, Missouri, USA, June 24, 2010
Carl Laurino, I sure would get another opinion
at one of the top notch hospitals in New York City. David Letterman and
Regis Philbin (sp) both used the same highly qualified group of doctors
at Cornell-Weill Teaching hospital there in NYC. I also see doctors at
a Cornell Weill based hospital in Houston. I also was told by cardio's
that I have an area in the distal LAD that cannot be stented or by-passed.
Some new smaller stents came out but were still too big for my tiny artery.
I am treated medically until a time comes that the best stent for me
comes on the market. I know how frustrating it is. No two cases are the
same
and I suggest you need another opinion at a large teaching hospital with
experienced cardiologists. We all deserve and need this. I wish you all
the best.
Kathy Laurio, Houston, Texas, USA, July 26, 2009
MB -- this is really a question for your uncle's
cardiologist. It may be a question of your uncle's clinical status --
that is, he may be too ill from other problems to withstand an operation.
This
situation is one where interventional procedures, such as angioplasty,
may help because they are far less impactful on the patient's system.
But perhaps the blockage or blockages are in difficult-to-access locations,
or are chronic total occlusions which are not able to be opened. Or perhaps
the blockages are in arteries that are too narrow. We'd suggest talking
to your uncle's cardiologist and asking more specifics so that you can
help your uncle understand, or perhaps you may want a second opinion.
Every
month newer and newer stents are being designed that will better stent
narrow arteries. Regarding speaking to the cardiologist, we recommend
to all our article, "You
and Your Physician". Let us
know what you find out.
Forum Editor, Angioplasty.Org, July 22, 2009
My uncle's cardiologist said my uncle was an
inoperable cardiac patient. Does this mean he would not be a candidate
for bypass and angioplasty or does
this
just refer to surgery, bypass?
MB, Massachusetts, USA, July 15, 2009
Eve -- you report that your artery was 95% closed.
Which artery is this and what did the cardiologist advise?
Forum Editor, Angioplasty.Org, May 15, 2009
I am a 63 year old woman with unstable angina.
The doctors did not take me seriously because I passed all the tests
with flying colors. Only when I asked what they would tell my family I
died
from did they take a look and found the artery was 95% closed. I continue
to have angina attacks that I really feel I am going to die. The doctors
can not find a problem. If it is the small microscopic arteries or hardening
of the arteries there is nothing they can do. Do I take my nitro until
I have a stroke or have an aneurysm. This is very scary and I
have no answers.
Eve, Michigan, USA, May 10, 2009
at 32 yo, i had 80% blockage of my LAD-stent was
placed. at 36, my cardiologist could not get into my 1st diagonal branch.
he said it is unable to be stented.
i have chest pain and sob. what do you recommend?
Karen, Monroe, Louisiana, USA, May 7, 2009
I just had an angiogram done and was told the
right coronary artery was too small to do angioplasty and that it would
compensate on its own. Is this
true or do I need to see another cardiologist?
Susan C., Georgia, USA, May 30, 2008
Z.-- best person to ask is an interventional cardiologist
-- the specialist that does angioplasty and stents. Have him/her look
at your grandfather's angiogram. They will be able to see the coronary
anatomy and determine if stenting is possible and would be therapeutic.
Forum Editor, Angioplasty.Org, May 16, 2008
Hi my grandpa just had a heart attack they couldn't
do surgery because he had small veins/arteries. would a stent be an option
for him?
Z., Wisconsin, USA, May 14, 2008
C.S. in San Francisco -- if a 3mm stent was used,
that's not a "small" artery (small would be as you approach a
2mm diameter). If your heart attack was caused by a subtotal blockage in
your circumflex,
then the stent will keep that lesion open, preventing future episodes,
something that cannot be done via meds alone, etc. And the risks that you
read about are
small -- for example, late stent thrombosis is a very low frequency
event. All good practitioners are against putting in stents when they're
not needed, but it would seem in your case (and this is NOT a substitute
for a qualified medical opinion) it was needed. Furthermore many patients
who have had angioplasty and stents go on to continue full
lives -- our topic on Exercise
Post-Angioplasty has numerous posts from
bikers, marathon runners, etc. Prior to angioplasty (30
years ago) you would have been put on meds (which were primitive
compared to today's) and told to scale your life way back. Or you might
have had a bypass, which would have achieved the same result as your angioplasty,
with much greater recovery needed.
And Fady -- whether a stent is right and, if so, what
type (drug-eluting or bare metal) is a question you should discuss with
an interventional cardiologist. Make sure you understand what medications
(like Plavix) you may need afterwards and for how long. Each patient's
clinical situation is different, so advice cannot be given without seeing
the whole picture (and the angiogram). Are blockages like this dilated
and/or stented? Sure. But the question has to be is this blockage causing
you a problem? And will this treatment solve that?
Forum Editor, Angioplasty.Org, February 26, 2008
I HAVE A 50-69% BLOCKAGE IN MY PROXIMAL DIAGONAL
D1 BRANCH. MID ARE NORMAL AND IT IS A SMALL VESSEL , CAN STENT BE OK
IN THIS CASE?
Fady S., California, USA, February 10, 2008
i had a 3mm drug eluting stent placed in my almost
totally blocked circumflex
after a "mild heart attack". I'm 55, a 145 lb health nut and a runner (Or, I
was) Now I'm reading about all the long term risks of what's inside me and the
drugs I'm on for life. Will I ever run again? Also, everything I read about stents
says "...helps you live a longer life.." It never says a "long life". If I'd
had it explained to me before they did it, as it should have been, I'd have passed
and gone just for meds. Can I live a long life now, or is this just procedure
#1?
C.S., San Francisco, California, USA,
January
8,
2008
Maureen -- Hi I too am UK patient. Also I too
have had 2 stents fitted to 1xRCA and 1xLAD But still have chest pain
with only
v moderate workload, and
have tired legs after walking just small distances. I use Nitro Patches (5mg)
during day and no doubt that I get relief using them. I know I could increase
to 10mg per day but need to watch BP doesn't go to low But i also have atrial
fibrillation which might be causing some problem on top of the artery one.
However despite failing my last Treadmill Stress it is suggested that
I remain on Medication,
as the arteries further down the line are not too good either. So whether
what is actually happening is that they wait until the drugs don't work
anymore
and Bypass is necessary I don't know. (I don't imagine they would say)
But another
drug called NICORANDIL and apparently works like nitro, have you tried that?
I know its all a bit difficult, because no doubt you like me cannot get `fit`
due to getting tired and exhausted before you can do any good.
TM, United Kingdom, December 1, 2007
I HAD SURGERY LIMA TO LAD AND TEN DAYS LATER
I HAD TO HAVE STENT PUT IN BECAUSE THE SURGEON OVER-STITCHED THEM AND
BLOCKED THE BLOOD FLOW. HAS THIS
HAPPENED TO ANYONE?
Andrew, Florida, USA, November 29, 2007
A.C. -- curious as to what test showed the blockage?
An angiogram would have not only shown the 70% blockage, but would specifically
have shown whether or not there were blockages farther down the LAD (left
anterior descending). Not sure why stents may not be possible because the
LAD is usually one of the largest arteries in the coronary tree and stents
are manufactured down to size at least 2.0mm in diameter. But the decision
as to whether surgery, stents or medical therapy is the best treatment
is something you need to do with your cardiologist. If you have questions,
make sure they are answered. The COURAGE Trial showed that medical therapy
PLUS lifestyle changes alone can achieve quite good results -- but if a
patient doesn;t react well to the drugs, or has continued angina, OR is
judged to be at high risk for an adverse event such as a heart attack,
then a more aggressive approach may be warranted.
Forum Editor, Angioplasty.Org, October 25, 2007
my left anterior descending artery is 70% blocked
near the top and may have other blockages further down. Stents may not
be possible because of artery size and bypass may not be possible because
of blockage through artery. How effective is medicine in this case.
A.C., Maryland, USA, October 23, 2007
I just had an angiogram done due to a mibi showing
ischemia of the lad. They have found that my arteries are very small. I
suffer from angina and can have an attack from cleaning the house or walking
up a flight of stairs. Can anyone relate and give some help as I just had
it done and have yet to see my
cardiologist
again.
L.K., British Columbia, CANADA, October 22, 2007
Maureen -- you are not alone and there are therapies,
such as anti-anginal drugs, alternatives like eecp and others. What you
are describing is the subject of our interview with Dr. Robert Engler in
our Angiogenesis
Center. There is a clinical trial currently enrolling
in the U.S. to see if angiogenetic therapy might be helpful in situations
like yours.
Forum Editor, Angioplasty.Org, July 17, 2007
I have angina and after having angiogram which was negative they have
told me that its the small arteries which are causing my angina. I cannot even
walk a mile and are very tired. Medication doesn't seem to do the job and have
been told its called syndrome X because there is nothing they can do because
its not the main arteries. I suffered from pain my my legs. Does anyone have
the same problem.
Maureen, UK, July 17, 2007
my friend had somewhat similar to your case and
his doctor advised for bypass. i don't know what happened, whether the
bypass surgery was indeed carried out or not.
M., USA, September 25, 2006
Tom -- as we always ask, have you discussed this
with your mother's cardiologist? Some blockages are hard to navigate to
because the artery is too tortuous or twisty. Whether or not that blockage
is causing a problem is something that may be told by use of a "functional" test,
like a stress test, which measures not just whether there is a blockage,
but whether that blockage is causing ischemia. Pain is very subjective
-- there is also the possibility that a drug that has been prescribed is
causing fatigue or muscle cramps (a side-effect of statins). Again, every
patient is different. Your cardiologist has access to the angiograms and
should be able to guide you further. Let us know what the cardiologist
says.
Forum Editor, Angioplasty.Org, August 21, 2006
My mom just recently had an angioplasty procedure
performed and a coated stent inserted. She also had another artery blockage
that the doctor said he could not get to. So, basically, she still has
one blockage but the more pressing problem is that she cannot do much of
anything without getting tired very quickly and especially her legs get
tight when she tries to walk. Her knees, calves, tighten and start to ache
and she can feel her heart pounding away. When she stops and rests, the
ache seems to go away. She was, before the procedure, a very active woman,
and I am trying to get as much information as to what can be done and whether
the other blockage is causing the problems with her legs and getting tired.
I have not been able to find much information about this.
Tom Ross, Houston, Texas, USA, August 20, 2006
A news note: Medtronic just received FDA
approval for a small (2.25mm - 2.75mm) bare metal stent,
the Micro-Driver, made of a cobalt alloy which ostensibly makes it
possible to have a stent with thinner struts, making it more flexible,
without sacrificing strength.
Forum Editor, Angioplasty.Org, May 2, 2006
Susie -- coated (or drug-eluting) stents have
performed very well in narrow arteries which are at higher risk for restenosis.
But placement of a stent in an area that has no plaque is not something
we have heard of -- guidelines
from the AHA & ACC state that interventions should not be done
in vessels less than 50% blocked. That being said, we are not medical doctors
and every patient's clinical picture is different -- this may be a unique
situation and there may be some good reason why this is being suggested
(we're assuming this was suggested by an interventional cardiologist).
Ask questions why and find out to your satisfaction, get a second opinion
if you're still concerned, and definitely post your findings to this Forum
to help other readers.
Forum Editor, Angioplasty.Org, April 24, 2006
A friend has had it suggested to have a coated
stent implanted in a non-obstructive but narrowed area of his very small
vessel off the LAD. Vessel form is congenitive and does not have any plaque.
Is procedure necessary?
Susie M., Indiana, USA, April 24, 2006
My cardiologist is keeping an eye on some small
diameter DES products which he says should be on the market within 1 year.
Had CABG 2 years ago. 1 of the grafts failed so they may have to stent
a very narrow and long artery. Am diabetic but in good health and waiting
to see what happens.
Richard Zammito, Clearwater, FL, January 29, 2006
My cardiologist tried to stent a artery that was
too small (2mm) to stent. He made a tear in my artery wall causing me to
have a heart attack, while in the cath lab. Has anyone had this happen
to you. Lily
Lily, Monticello, Kentucky. Wayne, January 23, 2006
I had a balloon procedure in the branch
off my RCA. Doctor said because it was too small for stents. Have you
asked about the balloon procedure?
Dana S., Fremont, CA USA, December 05, 2005
Carl: You do seem to have a problem, especially
if your cardiologist is right about bypass surgery being too extreme
for your condition. I previously suffered from angina symptoms (shortness
of breath and pain) and ischemic heart disease and I'm much better today
as a result of a FDA approved, Medicare reimbursed, non-invasive treatment,
Enhanced External Counterpulsation (EECP) Officially, it's supposed to
be used only when a patient is no longer a good candidate for further
invasive revasularization procedures... That sounds like it might be
you... But I received my EECP treatment only after studying it thoroughly
and then going to a cardiologist and specifically/firmly requesting it.
I was also careful to refuse an invasive angiogram because I agree with
the new school of thought that believes that heart disease is most often
the result of systemic vascular disease which is thought to be caused
by inflammation and constriction ---- which results in many vascular
lesions throughout the entire vacular system. Those lesions, in an attempt
to heal, develop plaque (like a sore develops a scab) which can often
be unstable. An angiogram performed with a catheter can bump a lesion
which may have their plaque protruding (some do, some don't) and cause
chunks of it to break free into your blood circulation and can add to
your blockages worsening your symptoms and sometimes it is bad enough
to have to rush a patient into heart surgery immediately. And, it happens
often enough that angiograms are only performed at hospitals capable
of performing emergency bypass surgeries, CABG's, etc., where you are
always required to sign a release giving them permission to operate immediately
if you should lose consciousness from the "a problem". 1 out of every
thousand patients will die from this allegedly innoculous procedure!
If your doctor has already explained this to you, pat yourself on the
back. Many doctors do not. Many performed angiograms could and (IMO)
have been done with the much less expensive and much safer non-invasive
ultrasound procedures. Again, the patient has to ask (firmly) for these
non-invasive options and be prepared to assert your patient's right to
say "No" if your doctor should insist otherwise. Best advise: Go the www.vasomedical.com and
learn what you can about EECP. If it makes sense to you, tell your doctor
you'd like to try it. He'll most likely oblige you. It's safer than anything
else I know of and it costs less than the sales tax for a bypass operation.
Feel free to contact me personally at my email address: postman23_2000@yahoo.com
Gerald Oros, OrosCo Product Specialties, Collinsville, IL, November
30, 2005
There is not much info you are providing to provide
a clear answer. The worse case scenerio would be that you are covered by
an HMO which owns and operates the facility and have decided they cannot
provide a life extending procedure and recoup the cost. This could mean
you are elderly and/or have other problems which will lead to continuous
care at their expense. Of course this would be absurd, but to some, who
may not understand, I am sure this thought has crossed many minds. Or,
your arteries are too small, too frail, inoperable or too high a risk for
either procedure, where they feel not intervening will give you a better
chance to live longer. I would not assume the worse, since the doctor bothered
to go in, it is most likely he is telling the truth. I know people in their
50's that have some branches completely blocked and are doing fine. Your
heart will be, is, or has been providing "collaterals" to supply the portion
of heart tissue that is being blocked off. I have 15 stents in my chest,
and probably because my arteries and branches are pretty huge. I also have
many collaterals. Excercise is probably your best bet now, but ask your
doc. Good Luck.
RayZ, San Diego CA, November 28, 2005
I have a 95% blockage of the LAD and an 80%
blockage of the diagonal branch. The doctor told me that he couldn't find
a small enough stent to insert in the arteries so he didn"t complete the
event. My cardiologist agreed and he also said bypass surgery would be too
extreme. Something is wrong here. What do you think? Help! I have no pain
and I perform most work except running, etc. I think I need stenting or bypass
Carl Laurino, Valley Stream, NY, September 02, 2005
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