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Won't Open a 50-60% Blocked Coronary Artery
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Current Postings on This Page (110): • LAD:is type 2.mild LAD has diffuse thrombus containing lesion amounting to 99%.distal LAD has two tandem diffuse disease of 90% and 99%.LAD near apex is of small caliber and diseasedRCA:is dominant and has mild diseasein its distal part.precrux RCA has 50% stenosis.PDA is normal.PLLV has mild diseaseIMPRESSION: CAD|RIGHT-DOMINANT SYSTEM|SINGLE VESSEL DISEASE|GOOD LV FUNCTION(echo) • My father is 60.He was a chronic drinker,but has left drinking completely for about 10 years.A recent CT Coronary Angiography reveals a "soft plague causing 30-40% stenosis in proximal LAD with preserved myocardial function at rest".Please give the problems associated. And its impact on the digestion ,as he has a bad digestive system. • I was told I had 50% blockage in 1 cartoid artery .What is the best way to reverse this without surgery? • This vinodh from india .. Age 28 ..I had an heart attack , before 8 months.. It was extremely painfull almost faced death unbreathable .. Doctors tested me and said I am under 60 % block on lad .. Right now I am taking tablets , ecospirin gold 20 mg n ramipril 1.25 mg , betaaloc 25 .. Doctors said that I should take tablets life time .. I am worried a lot , cause I am too young .. I was to 88 kg now 76 kg I have lost weight , I feel like no strength in body , I am getting tired if I do any hardworks , I have gastric and motion problem .“I am smoker” . I am reducing smoke day by day .. Kindly suggest me , what I am suppose to do now ..
• Just had a cardiac cath. Was a f/u to 2009 LAD stent placement. Two stents looked good. No restenosis. However, Distal LAD had a 50% narrowing before the vessel reached the apex. Doc did not open it up. Is this normal? Why would the doc leave a vessel that is half blocked the way it is? Why not open it while he is already in there? • I am 54 year old, diabetic. I had angina when I walk about half km. My Angiography showed blockages at 3 places. LAD - 99% proximal eccentric lesion LCX - Non dominant & normal. OM2 has chronic total occlusion RCA - Large Dominant & has 70% mid segment eccentric lesion. PDA & PLV is normal My Cardiologist has done successful Primary PCI to LAD on 28th June 2013. Is 70% lesion in RCA can be reversed with Life style changes & exercises. Please suggest. • a case of PTCA ONE STENT. Still having angina and SOB.TMT +VE POST PTCA.100% BLOCKAGE IN DIAGONAL ARTERY. TAKING MEDICINE PAN D, STAMLO 5, DEPLATT A150, TELMA40, ROSUVAS 10, THYROX 100, FROM 18 MONTH. ALSO HAVING PROBLEM IN COPD. I AM TAKING DRINKS MORE OR LESS EVERY NIGHT
• What is the meaning of type 3 vessel, patent stent in mid LAD with lumen loss in proximal part of the stent?
• I am 46 yr male. Just had CAG that revealed 70-80% stenosis in mid RCA and 70-80% stenosis in proximal LAD. I don't have a history of chest pain, dizziness. My father had bypass 2 yr back. Doctors have advised for early myocardial revascularization. What is that?? Is it the bypass surgery??
• My dad is 64 and has angina - heart disease runs in his paternal family. Last summer he had angioplasty and one stent put in. Last week, he had the dye test because he was experiencing angina attacks. During the test, they put in 6 stents in one branch and then the balloon broke causing a clot. He went into cardiac arrest on the table and flatlined. Today he is good, still in hospital waiting for an ultrasound on his heart. He still has two blockages of 70 percent in the lower branches. The doctor will not be putting in any more stents. He is being released from hospital tomorrow.. Does that sound normal??
• I am 37 years old. I had a chest pain. Then I do angiogram. I found 3 blockage. One is 80 to 90 percent, other is 40 percent. Doctor told me to do PTCA with stenting to proximal RCA. Plse tell me what to do.
• Due to a family history of heart disease, in April of 2012 and at the age of 53, I had a angiogram performed. This test revealed that I had one blockage and it was a 30-40% blockage in the proximal LAD. After this test was performed, I went through additional testing such as nuclear thallium stress test and echocardiogram to see if the blockage had any affect on the blood flow to the heart. All these test came back normal. My cholesterol has always been near the normal range and have always been a exercise fanatic. My cardiologist issued a prescription for 10mg of Crestor and 5mg of Norvasc and said he see me in a year. Since this time I have also went on a very strict vegan type diet. In January of 2013 I had my annual blood work performed and the cholesterol numbers are HDL-49, LDL-36 and total 99. My question is, can the blockage in this critical artery be reversed by lifestyle changes through diet and medications or will the blockage continue to keep progressing? Also how often should this blockage be checked and what non-invasive procedures are there to tell if the blockage has stabilized of progressed? • Please sign the petition i have started complaining about same thing insurance companies playing doctors and refusing treatment and meds http://www.change.org/petitions/medical-insurence-cover-medications-that-the-doctors-presribe
• I am not quite 55. Two and a half years ago I had carotid angioplasty with stent on my left carotid. At that time, blockage on right side was minimal. Now on right side I have three blockages. two are small, 15% and 25%, the third is at 60%. Dr says HMO won't allow stent until 80%. I have a strong family history of stokes on both sides. Are there any other measures, besides Plavix and aspirin and diet?
• What should be done when a coronary artery is having 99% stenosis and rest two are clear - this is a case of my father in law in India.
• My husband always kept a healthy lifestyle as he feared of Heart disease due to his Dad having the same, yet at 50 he got a heart attack and had to undergo angioplasty to treat the 100% blockage in left branch of an artery. He yet has a 40% blockage on one of his artery. He has a healthy lifestyle, however, what are the chances of the 40% blockage to grow with him as he always had good diet (motivated by Dean Ornish he is now considering plant diet) and medication (he takes Plavix, Metoprolol, Aspirin, Lipitor, Ramipril) What are the side effects of this medications? How long would this medication continue? He has bare metal stent so what are chances of restenosis? Please.
• I am 40 yrs male. Have diagnosed 50% blockage in LAD in the Year 2007. From then I am going on medication continuously. But I am suffering from mild chest pain since 2007 even in rest. Is it risky for me? Otherwise will it be best on operation or Angioplasty? • In response to some of the issues, I had an angioplasty done last Friday. I can tell you that I have and will continue to have a healthy diet along with quitting smoking. I had 99% of blockage in the Aorta, reading some of the responses on this web-site amazes me. Having any type of blockage is a serious matter, and how someone can continue smoking and not get on a healthier diet, amazes me. This is your life and you can take control of it, if you want to continue to live. It is will power, and you should have control of this if it is to make your life better. Good luck to all and Healthy Living! Eve
• Had an angiogram last may. Have a 60% blockage in left coronary artery and 20 percent on my right. I underwent FFR so angioplasty didn't push through. I was given a lifetime medication of micardis 40mg, Lipitor 10mg and aspilet 80mg all once a day. My worry is if i keep on taking Lipitor would it affect my liver? Should I stop taking meds and just change my lifestyle esp my diet? Or having to follow strictly my diet and lifestyle doesn't help me prevent from having a heart attack since I already have a blockage? I am really confused since some meds have side effects.
• my uncle has undergone the treatment on silent Heart Attack, and doctor has done the angioplasty and injected 3 stents (Xing) very first day,and then alternate day they have injected two more stent (all are medicated) now his heart is working on 30% stage. rest two arteries are also blocked 45%.is the procedure is OK or in case someone could advise the next course of action or tell us whether we are on right track or not. please also advise the precautions. • I am a 45 yr old female that just had a stress test and heart cath that revealed that my LAD is 100% blocked with natural bypasses developed already. Dr said that all other arteries are totally clean. Dr said no damage to heart done by blockage and is recommending only medications but everything I have read regarding blockage in this artery is so bad I am very scared to just leave it 100% blocked. I would like opinions on if this is wise. Would also like to know how the LAD could be 100% blocked but there be no other blockages of any kind that seems strange. • I had a Cardiolite test it showed 60% blockage..went for a catheterization ..said it wasn't bad enough to stent ..can you tell me anything to ease my mind about this ..i am 76 years old ..have no other diseases ..i have no shortness of breath or other problems ..what do you think ? ..thanks.
• I had chest pain in October 2010. Angio was positive for about 80 to 90% lesions in LAD and Circumflex vessels. Both were stented with bare metal stents as the lesions were small in length, I am not diabetic and young (age 38. There was also a lesion distal to the stented one in LAD (mid LAD) that was left alone. Since then I am walking, jogging and running for about 10 miles without symptoms. My Cholesterol is controlled (LDL around 80, HDL around 40,TGs around 80). Last week, I had chest tightness (No pain) that lasted 5 to 10 mins. Cardiologist suggested emergency angio. Stents were patent. No new lesion but the one graded 40% last time is still there. Cardiologists are divided in opinion, some say the disease has increased (50 to 60%) the other say it is static as it was 2 years ago (40 to 50%). FFR is not available in this part of the world. My Questions are: (1) how good nuclear stress can determine the ischemia. (2) my symptoms mostly at rest and not on exertion except mild discomfort when I run for more than 20 mins) can Stress test predict the reason for my symptoms. (3) could my symptoms be due to transient cardiac arrhythmia.
• hi my name is shannin and my mom has an enlarged heart and she told me that her heart is 60 percent clogged it is worry me can someone live with a 60 percent blockage. • I AM 76 YEARS OLD HAVE NO OTHER HEALTH PROBLEMS SUCH AS DIABETES OR ANY OTHER THING I KNOW OF ....HAD AN ANGIOPLASTY..I HAVE 60% BLOCKAGE IN MY LAD ARTERY THE DR. DID NOT PUT A STENT IN. I WAS SURPRISED...DON'T DRINK ..QUIT SMOKING 20 YEARS AGO ..I HAVE NO SHORTNESS OF BREATH OR CHEST PAIN ..I AM TIRED THO.... • I am 80 years...HOSPITAL COURSE; (Last week, angio) Electively presented for coronary angiography that revealed plaque in LM mild to moderate disease 50/60% in mid LAD, mild plaque in the mid Cx, Ectatic RCA with slow flow, but no significant plaque, normal LV. Advised medical management.....Follow up after one week with Cr, Na, K tests. Pls tell me in simple language whether I am clear of disease or require further procedure of any sort. According to my doctor Disease can b managed by medication. Let me your your views and if possible let me know the names of medicines. Presently I am on medicine ASCARD / {2]EXPLENDED [Rosuvastatin} {3} DIOPlus 5/80 mg {amlodipine besilate + valsartan}.Ur guidance will b much appreciated. • Is it normal to have >70% blockage in proximal LAD and no blockage at all in any of the other arteries? The CT angiogram has reported these findings. • I'm having an angiogram this Fri.. l have shoulder pain dizzy spells headache and cold sweats i am unable to exercise as i become breathless just climbing the stairs. iv been told if blockage is less than 50% they will do nothing . this is scaring me cause quality of my life is poor since Jan when all this started to happen . • IN august of 2001 i had 2 arteries that were blocked. One was 60% and the other was 55%.My doctor said that he doesn't put a stent in until 65% or higher. I was to quit smoking and change diet. Well i did nothing to help this matter and to be honest i smoked more and my diet got worse. I just didn't listen and now i feel really horrible everyday. My blood pressure is now really high,and it gets low while under exertion?.Is it possible that within a year i could have gotten a lot worse that now i am at 65% or higher?..can that happen within a year?.I have had diabetes since 2000 and it was not controlled for 12 years. I am watching it and controlling it for the most part. My question is can i have gotten worse with my blockage within a year? • Sir, I am of about 47. My angiography shows LAD 40 / RCA 60. PLEASE WHAT U ADVISE
• I'm 41yo from Manila, I just had a "trip" to fully utilize my health card last week and chose to check my heart via angiogram. I am an active person with at least 6hrs work out every week, thin since teens, now 150pnds, not a cholesterol addict, smoke a 5 sticks a day since 26, a deadly overnight drinker once every month respectively and having a religious monitoring of my health specially ecg once every 6months due to my anxiety with long history of family heart diseases. The angiogram found out that i have a 60 to 70% blockage on my LAD. SINGLE VESSEL ONLY. Cardiologist advice me of immediate angioplasty. Is there any other solution? I'm so depressed and i think I'm still too young to place foreign object to my body. • My father's (age 58) Angiogram report revealed LMCA – Normal, divides into LAD/LCX. LAD – Type 3, mild plaquing proximal – mid LAD, 1ST diagonal 50% proximal disease – fair sized. LCX- Non dominant, last OM small caliber totally cutoff seen by grade 1 homocollaterals.RCA – dominant, normal. Please suggest whether he needed angioplasty. • First off, Thanks for starting the most informational forum about CAD. My mom in law was diagnosed with various Artery blockage after undergoing Angio. Below are her diagnosis - 60% luminal narrowing in osteoproximal lad 70% luminal narrowing in mid lad50% osteoproximal RCA80% osteoproximal mid RCA She has cholesterol, High BP and Diabetes, The levels are now within acceptable range. Her cardiologist has assured the blocks can be reversed w/o any surgery or stent ,with the help of medicines and changes in lifestyle (healthy diet,exercise and stress free life) . But people in similar situation have always had undergone stent or angioplasty. Is is possible to cure w/o any surgery? Can you also tell me with the above readings how severe or mild is her blocks? Should we get a second opinion? Thank you for your valuable insights.
• I am 61 year old male, my angiography was done on 26 Apr 2012, findings are: LMCA: Normal, LAD: Type III Normal, LCX: Non dominant, Distal LCX has 30-40% Lesion, RCA: Dominant, Proximal RCA has 70% lesion, Mid to Distal junction has 70% lesion. LV ANGIO: Not Done Clinical diagnosis: TMT+ve, T2DM, HTN Procedure Detail: Through right radial artery approach, Coronary angiogram done using right and left judkins catheter. Kindly advise us whether we should go for angioplasty with two STENT. Regards, Sharad Saxena Allahabad
• I have had a heart attack two weeks ago. I am 42 year old male and all vitals signs were ok, no BP, no cholesterol (187 mg/dl), not diabetic and 69 kgs weight. Dr. immediately did PCI (stent) to proximal LAD (which was 100% blocked) using 3.0 x 18 mm DES followed by post dilution using 3.0 x15mm non-compliant balloon with residual stenosis. Now other blockages found is that LCX Mid 70%; distal 90%(small caliber vessel) RCA Mid 70 - 80% long segment. Dr. suggested to do PCI (stent) for both LCX and RCA. Please advise if this is necessary to put stent or can it be cured thru medication? • Hi , my father (58 year old, smoker and hypertensive) just had Angiography. The Angiography reveals LAD-Mid has 90% obstruction, LVG EF 60% and LCX with plaque. After Angiography, The cardiologist who has done my Father Angiography has advice for Angioplasty (PCI with one DES). I have taken a second opinion from another local cardiologist who said that the blockage reveals in Angiography can be cure without Angioplasty with combination of proper Medicines, control diet and regular exercise (Medicines suggest to my father by second cardiologist are (Herbesser (diltiazem hcl) 30 mg 1+1+1 , lowplat (clopidogrel) 75 mg 1+0+0, Concor 5 mg 1+0+0, Disprin CV (once in a day) and Rovator (Rosuvastatin) 10 mg 0+0+1) Based on above two opinion from two different Cardiologist, I am quite confused and unable decide as to whom advise should I follow i.e. should we need to follow fist Dr. advise and go for my father angioplasty or continue with medicines as advice by second cardiologist.
• I am a male of 60 years of age. I have a heart attack on 24th Oct. 2003. Then i was on medication & was absolutely yucky did not have any complain. On 26th.of Jan.2012, I had another severe heart attack. I have gone through a an angiogram test. Dr. told me that my main left artery is 100% blocked & 70% other 2 branches are blocked. Right side is absolutely ok. Dr.who has done angiogram has advised me surgery but the other doctors has told me that angioplasty can be done, but echocardiogram is required to see the heart muscles condition. My doubtamine echo stress has been done & another echo also carried out , I will get result tomorrow. My question is that as DR. has told me only one stent will be placed. Then what about other blocked veins? Kindly guide me in this regards.
• My husband had a heart attack over 10 years ago and has a 100% blockage which they have recommended to leave. But he has had a little shortness of breath and tightness of chest again and had an angiogram done which they discovered a 90% blockage (LAD) and a couple of 40% which were irrelative. So we were told that he would be called to put a stent in soon. But now we have got a call saying he has been turned down for a stent as the blockage is too long? and may have to have open heart surgery for one artery! The cardiologist is sending his file to a state of the art hospital with new techniques, but we don't understand why they don't do overlapping stents or some other procedure, in this forum I have not heard anyone mention this, any advice or thoughts would be welcome. And how long is too long before it can get to the point of another heart attack? • I have already had 2 heart attacks and 5 stents total. Two of which were replacement ones. My heart cath on 9-1-11 showed that I have a 60% 3 centimeter blockage in my right coronary artery. In that blockage are two stents that have been replaced once already and can't be replaced again because the artery won't take a larger stent. My doctor said that he wouldn't touch it and I am suppose to see him again the first part of December. I also have a 50 to 60% blockage in my left coronary artery. My question is why is by-pass being discussed at this point. The report said the one is clearly a trapped vessel. Any insight would be helpful. Thank you.. • I just had a chemically-induced nuclear stress test. The cardiologist says I am okay but I am still not sure what the widowmaker is and if the nuclear stress test can show if the LAD is blocked. I am really concerned because I have CHF and I am swelling in my arms and legs even though I take all these water pills and heart medicine. Please advise me on anything else it could be. Thanks! • Is it true that bypass cannot not be performed if blockage is located low? Recently had nuclear imaging performed, indicated issue with blood flow. Next catheterized procedure performed, indicated 100% blockage right side, attempted stent, unsuccessful due to blockage. Now told cannot perform bypass as blockage is too low on the heart and being treated with medicine.
• I have 60% Blockage on the right internal Carotid Artery and 39% on the left internal Carotid Artery. I have had a Carotid Doppler Ultrasound and a MRI and MRA test completed. I do not have the results back from the MRI and MRA. Is this all the tests that should be conducted so far with the above listed results? What is the standard treatment with the above findings? I am 47 years of age have excellent cholesterol (tested in June 2011) and do have Blood Pressure (2 1/2 years) that currently is running 140/90 with daily med of Metoprolol, 81 mg aspirin,furosemide, and a potassium pill daily. I have no other health issues I have never smoked tobacco or drank in my life. What other tests should be run? and what are my treatment options with above findings as of today? • I had small heart attack 2 weeks ago. Am about 100 pounds over weight, lost already 100 plus pounds. Doc tried to do an angioplasty while in hospital last week, but said RCA 100 blocked. Talked with cardiologist today and they said also center artery 50% narrowing. I am on aspirin, blood pressure medicine, Renexa 500 and Crestor. Is this my life now? I am 58, just retired this year and now a heart attack. Is bypass an option for me. Docs want to treat with medication now. I do not want to be a sleep, tired and bruised all day. Any help or suggestions for me. Very scared and do not want to live this way if bypass can fix or eliminate meds and give me back a quality life I am up for the risk and rehab. Thanks. • I had a heart attack on 29 April 2011. I had left coronary artery 50% blocked and another left distribution 30% blocked. I had a stent for the 50% blockage. I am on medication to bring down my blood pressure and heart rate. My BP and heart rate is 95/65 and 60. Before my heart attack, my BP is around 115/70. Is my current medication bring my BP and heart rate too low? Should I see my doc to adjust my medication?
• I was wondering about terminology and I guess the eventual conclusion of of what a term means. Is a 100 percent block- of the RCA considered the Widow Maker or does that only apply to the Left? Thanks. • Don in Michigan -- the functioning of the heart
muscle is usually measured as part of an angiogram -- it's called the ventriculogram
and
contrast dye is injected directly into the ventricle and the resulting image
as the heart expands and contracts yields information about how well the
heart muscle is moving. This measurement is called the ejection fraction
(EF). This can also be seen to some extent in a echocardiogram. If there
has been
damage
to the
heart,
one of these tests would show it. The heart muscle can actually withstand
an hour or more of complete blockage before it starts to die, which is why
it is important during a heat attack to get to a hospital that does angioplasty
ASAP. • I have read some of the Editor's posts where
he/she commented about 'reduced' blood flow to the heart [muscles I assume]
as blockage develops and increases. I had a overlap stent(s) put in my LAD
which was 99% closed. The doctor said, "I think your heart is ok." I had
erroneously thought as long as an artery had any blood flow at all there
would be no damage to the heart. Are you able to give us some idea how
much heart
muscle may be weakened as blockage approaches 99%? • HopelessinNC -- Your post here is sort of off
topic, but we'll try to answer. It's not clear from your post if your husband
had
an angiogram done. That would be
the only
way
that
his
cardiologists
would know how much and where the plaque in his arteries is. If there is
plaque in many places in several arteries, what is known technically as "diffuse
disease", then angioplasty is probably not the recommended therapy.
Why they feel bypass is too risky we can't say. Have you talked with a cardiac
surgeon? Perhaps a second opinion is warranted.
You'll want to make sure to have all his records, including any angiograms.
As for Plavix, if your husband is already on Coumadin, then that is a blood
thinner -- the addition of Plavix, another blood thinner, would increase
the possibility of bleeding complications. And Plavix is not a magical "plaque-preventer".
It
keeps the
blood platelets slippery so they don't clot. We assume your husband has
done everything possible to lower his risk factors (taking
meds,
diet,
exercise
and stopping
smoking,
if he
does). • My husband was sent to our infamous "heart
institute" here in NC. Needless to say, he was supposed to have an angiogram
or plasty, I can't remember, last september. They prepped him and took him
down for his echocardiogram. When he was brought back, the team of cardiologists
came in and said there was no way they could perform the angio due to the
amount of plaque and come to find out, blood clots. Why can't they perform
Bypass Surgery to correct this. They won't even give him Plavix or something
to help with the plaque, says its too dangerous. He's 49 had 2 strokes, a
heart attack..only we don't know when. They left us
with saying he was a "walking time bomb" and to continue taking the cholesterol
meds and of course...COUMADIN!!! Does anyone know what would be the problem
with a Bypass??? They said his level of oxygen is running between 50 percent
in the
main arteries and less other places. Can
someone help with some information PLEASE!! • Buffaloconcerned -- Sounds like the original
angioplasty from 10 months ago was a "kissing stent" situation,
where two stents are used at a branch (a.k.a. bifurcation), often the
LAD/LADD (Diagonal). Although we obviously
can't be sure. Bifurcation stenting is somewhat more prone to restenosis,
because it is a complex anatomy. We can't say why the 40% progressed
to a
90% in one year but, as you say, the increased lipids may be contributing.
Sounds like you are doing everything you can. Did your cardiologist have
any further recommendations as to the prognosis of the 90% lesion and
any effects if it closed? Yours is a complex situation, both medically
and
anatomically. Your current cardiologist may be absolutely correct, but
you might want to
seek a second opinion from either another interventional cardiologist,
or even a heart surgeon, to see your options. Let us know. • I had angioplasty 10 months ago and had two stents placed below a congenital
malformation at the branch of the left anterior descending artery. There was
a 40% blockage in the top of the second branch which was considered non eligible
for stenting. A follow up angioplasty two weeks ago found a new blockage below
the two stented ones. The cardiologist stented it. The previously unstented 40%
blockage had grown to 90% and could not be stented. This has occurred despite
dietary changes, medications including fish oil, statins, etc... HIV medications
seem to have increased lipid and tryglyceride levels but not to extreme levels.
I am overweight but losing and did cardiac rehab. What do you suggest? How do
I deal with the 90% blockage and do the HIV drugs indicate that I may have a
severely shortened life span due to the elevated lipids? Please help. • had angiogram performed and was told there
were 2 blocked arteries that were not repairable mechanically and medicines
were the preferred treatment. what does that really mean? i have had
4way bypass done years ago along with followup stents years later. this
was
done the other day. • Sharon from
St. Paul -- check out our Forum Topic on "Carotid
Stenting". Also read our interviews with Dr.
Christopher White and Dr.
L. Nelson Hopkins - Part 2. • Juniper- I just returned from having an ultra
sound done on my right carotid artery. My Left carotid was diagnosed as
100% blocked 2 years ago. What options might be presented to me to address
the current levels of plaque buildup (69%) now on the right side under
the circumstances. • Tina -- If you are not feeling secure with a diagnosis,
it's always a good idea to get a second opinion -- if only to feel secure
about the recommended course of action. Diabetics are at higher risk
for stent restenosis, so drug-eluting stents are the device of choice.
Some
studies have shown that paclitaxel stents (Taxus) may inhibit restenosis
in diabetics better than others -- although this is not a hard fact.
However, all drug-eluting stents require Dual AntiPlatelet Therapy (DAPT)
for at
least a year -- consisting of Plavix (clopidogrel) and aspirin. With
the allergy to aspirin and the complication of bleeding ulcers, your relative
is at higher risk for bleeding complications -- a definite side effect
of DAPT. Is your relative experiencing pain, angina?? The decision not
to stent or do bypass may be related to which arteries are blocked. Also
how were these blockages determined. Through an angiogram? • 75 yr old diabetic relative with 3 blocked arteries:
50%, 70% and 100%. Passed echocardiogram, Nuclear Stress, EKG. Allergic
to aspirin: docs decided to not do stents (due to aspirin allergy + history
of bleeding ulcers) or full by-pass. Is this conventional care? Or should
we ask for a second opinion from
another cardiologist?? • Donna -- This topic is about coronary artery blockages.
You might want to check out our Forum Topic on "Questions
about Carotid Artery Stenting (Angioplasty)". While we cannot
give you medical advice per se, a 30% blockage in a large artery like the
carotid is not critical, but you've got warning signs which, with correct
medications and lifestyle changes, may be able to be brought under control.
Not sure plaque can be reduced, but the progression can be slowed or halted. • I just returned from the doctor who confirmed
that I have bilateral carotid artery stenoses as shown on the doppler ultrasound.
The degree is less than 50%
which I take it to be in the 30% range I guess. She continued my cholesterol
meds and added a couple of supplements that when together they work to reduce
the plaque. I do not have insurance currently so my family doctor is treating
me. Does this sound normal? • blue72 -- Your husband's condition
is complex and your question is
not something that can be answered long-distance. You should ask his
cardiologists to explain fully what they are doing and why. • husband had tread mill test done friday, fell
down after test had to use paddles twice to bring him back, he has 100%
blockage in one artery, 95% 70 % in other two, they want to put in defibrillator
in on monday, what are his chances
of surviving with this action. • John in Indiana -- First off, nothing on this
Forum should be used as a substitute for medical advice from a doctor.
We can suggest that you consult an interventional cardiologist with your
records and your angiogram and see what he/she says. Single vessel disease,
if that's all you have, is ideal for interventional treatment (angioplasty,
stent, etc.). Open heart surgery is seldom done these days for just one
blockage. We would
guess
that your surgeon's plan is to deal with both the blockage and the
aortic aneurysm in the same operation. But if your aneurysm has not progressed,
perhaps that can be put off. Again this is not advice, but just a suggestion
to get a second opinion from an experienced interventionalist. He/she
may concur with your surgeon, especially when considering the aneurysm...or
not. • I recently completed an angiogram after
my cardiologist found tissue in my heart was not getting enough blood
supply during a tread mill test. The angio confirmed a 60% blockage
in the widow maker artery. I am 69 years in age good health, quit heavy
smoking 30 years ago, have shortness of breath climbing one flight
of
stairs and have heart disease as a factor from both parents. Otherwise
I walk playing golf and function normally without pain or discomfort
in the chest area. I have been treated the last three years for an
aorta aneurysm which has not grown according to MRIs on a yearly basis.
A consult
with a heart surgeon resulted in being advised to have open heart surgery
and not angioplasty. My
questions are: • Tim -- atherosclerosis can develop and/or
progress quickly sometimes. The biology of plaque in vessels is complex
and, while
more is being discovered daily, the precise answers to your questions are
not totally known. When they are, doctors will have come close to actually
preventing coronary artery disease. What is known is that heart attacks
can be caused by so-called "vulnerable plaques" which may not be large
in thickness, but may be at high risk for rupturing. These typically are
called TCFAs ("tik-va") or Thin-Cap FibroAtheromas -- they
are a pool of lipid-rich material contained by a thin layer of fibrous
plaque. If this plaque ruptures, the lipid-rich material leaks into the
blood stream in the artery and causes clotting, sudden reduction of blood
flow and often a heart attack. Patients who have had a previous MI are
often put on antiplatelet drugs, certainly aspirin and often Plavix,
to lessen this risk. As for progression of your blockages from 50% to
two
higher grade ones, it's hard to say. It's possible that the original
cath was not accurate or that this artery, which was the cause of your
small
MI became thrombogenic and more prone to closure. One imaging technology
that we at Angioplasty.Org have been writing about, and which many feel
is more accurate than angiography alone, is the whole area of intravascular
imaging and measurement: IVUS and FFR. You
can read
about
these more in our Intravascular
Imaging Center. • I had bilateral knee replacement mid March. I
had a chemical stress test done and was told everything looked good 4
weeks before. 3 days after surgery I was told I had a mild heart attack
in which
they did a heart cath and said I had 50% blockage and it wasn't enough
to repair. I was told my EKG and everything was back to what it was before
the attack. I was told it was as minimum of damage posssible.Four and
a half months later while mowing the yard my chest started hurting so upon
seeing my cardio doctor he said I needed another heart cath done. My
BP
was up to 190/100. They discovered the same artery was 90% and 75% blocked
in 2 different places. I ended up with 2 stents put in place. I was put
on lipitor and BP meds after the first ordeal. My question is how did
this all happen after less then 5 months. Believe me my wife is a RN and
since
we've been together
for 15 years, I watch what I eat. • Ken29410 -- Not sure what your doctors meant by
"too narrow for open heart surgery". Open heart bypass surgery,
also known as CABG (Coronary Artery Bypass Graft) is meant to provide blood
flow to
the heart when the artery is too narrow. If there are specific areas of
narrowing, they can be opened with a stent, but when the narrowing is diffuse
in several vessels, CABG is the recommended procedure. Perhaps they meant
that your artery is not suitable for bypass grafting for some other anatomical
reason. Our only suggestion is to get them to explain your situation to
you more
clearly, so you understand, or possibly you could get a second opinion,
if your coverage allows it. • I was told that my LAD was too narrow for open
heart surgery and there were two stents placed. This was done by the
Dept of Veterans Affairs Hospital. I don't trust these people but have
no choice.
What is the outlook for someone like me? Is that accurate or can it be
done? I'm 46 yrs old and really don't
want to croak yet. • Posters to this topic in particular should read today's article about
findings from the FAME study. And "Heartbreak" -- you should
ask your cardiologist this question, especially in light of these recent
findings about FFR. • had a ct angiogram a few weeks before i'm scheduled for avr surgery. my
surgery is one week from today. cardiologist just called me today saying that
an artery in front of my heart is 50% blocked. Wants me to go in wednesday to
have a cardiac cath. he said if artery is 50% blocked, they will do nothing,
but if more than that, they will do this bypass surgery when i have my avr on
friday. do you know why they even have to do the cardiac cath since they already
know from the ct angio that it's 50% blocked? what's going on now? • Susan -- one of the downsides of stents is the
occurance of blood clots (thrombosis) inside the stent. Your husband's
genetic condition (FVL) puts him at higher-than-normal risk for this, so
the need for a stent would have to outweigh the risk of having a clot form. • My husband has had ALL the coronary tests. His
RCA is 100% blocked with collaterals, left anterior descending is 75%
blocked, left circumflex 60-65%. Cardiologist performed cath and did not
do anything.
Case is complicated because of Factor V Leiden (he has had 2 blood clots
in knees). Do you know of any studies involving FVL and stenting? They
are using a medicine-approach (isosorbide) to try and help his shortness
of breath. Thanks! • Faye -- Sounds like you had an angioGRAM, not
an angioPLASTY...an angiogram is a diagnostic test; an angioplasty is where
a blockage is actually opened up with a balloon and stent. Most cardiologists
would agree with yours -- a 40% blockage should not be treated, unless
it can be shown to be in some way a problem. While most use percentage
as a guide, this can be misleading, according to some recent studies using
Fractional Flow Reserve (FFR) which measures the actual effect of the blockage
on blood flow, rather than the percentage. • I had an angioplasty on Thurs, June 9th. Doc
said there was only 40% blockage in one artery. They would just monitor
over time; that they only put a balloon or stent in, for 60% blockage
or more. Does that soumd right? • See previous responses. A blockage is a sign that
coronary artery disease exists, but it may not be severe enough to warrant
a mechanical intervention, such as a stent. Optimal medical therapy and
lifestyle changes can go a long way to minimizing your risk factors for
heart disease. You should discuss a program with your doctor. • I have 50% blockage and would like to know what
the effects of drinking alcohol are on my condition. I do drink and have
all my life drank anywhere from
10-25 drinks on average per week. • Hi, I am 44 years old and during my regular check
up the ekg was abnormal. They sent me to ER and their EKG showed normal.
The doctor recommended an angiogram and found 30 percent blockage in
all arteries. I am taking crestor for high cholesterol. how can i prevent
heart
attack and live a healthy life? thanks. • Pat -- See response below to Brian. Lower your
risk factors as much as possible and comply with the prescribed medications.
A 60% blockage may or may not be causing reduced blood flow. How was this
figure arrived at? Did you have an angiogram? One tool that
can be used during an angiogram is an FFR (Fractional Flow Reserve) catheter,
which can determine if the blockage has "functional significance" and
stenting may help. But treating a blockage that is not causing a problem
is actually
not recommended -- see
FAME study. • I had a heart attack approx 10yrs ago. I have
had an angioplasty, now the doc tells me there is a 60% blockage in the
same artery, which he will treat
by medication. Is there a cause for concern. • Brian -- 30-35% blockage is low. That combined
with the negative results on the battery of other tests should rule out
problems from coronary artery disease. Do you have risk factors that
would make you concerned, such as smoking, weight, cholesterol, and family
history? Managing stress better is very good thing for anyone. See if
relaxing and not worrying that something is wrong with you helps. Dean
Ornish prominently features meditation and relaxation in his therapeutic
program for patients who have significant coronary artery disease, so
there
are definite benefits. • For the past month or so have had shortness of
breath, dizziness, anxiety (i have a history of anxiety/panic), and chest
heaviness. A few years back had very similar symptoms and had ekg, echo,
tilt, nuc. stress, reg. stress and everything came back fine. This time
they felt we should do an angiogram and found a 30-35% blockage in the
front artery and another area of a heart vessel that was slightly dilated.
Doc's says symptoms I am having most likely are not coming from what
they found. He recommended to just lower cholesterol and take aspirin and
to
recheck in one year with stress test. I am very worried about what they
found and feel like a ticking time bomb. Am I blowing this out of proportion.
I have already changed my diet, exercise and am trying to manage stress
better. Doc says that most people have plaque buildup by their 40's and
do not be overly concerned. I am still extremely worried, would a second
opinion be helpful? • Mike -- maybe it's stress from life. There are
two non-invasive tests that could reveal more: a nuclear stress test
and a CT Angiogram. You can read about them in our "Patient
Guide to Heart Tests". Sometimes stress is caused by
not knowing if you should be stressed! More and more, cardiologists are
beginning to think that a CT Angiogram may be the better test in cases
of intermediate or indeterminate causes of chest pain. Talk to your cardiologist
about these. A CT Angiogram is very accurate in terms of ruling out coronary
artery disease. If you do decide to get one, make sure the technicians
use dose-reduction protocols. If they don't know what you mean, go somewhere
else. • Hello, I am a 40 year old male. I have been having
chest pressure(not pain) that comes and goes on the left side, and also
pressure in the upper left arm area for over a week now. I had the same
problem about 10 months ago, and at the time my cardiologist performed
a number of tests including a stress test, eco cardiogram, ekg, and everything
was fine. In this more recent episode, I went to my cardiologist three
days ago, and he performed another ekg, chest X-rays, and it was again
negative. I do have a family history of heart disease, and my cholesterol
is 230 (LDL is 140). My problem could very well be stress related, as
I have a lot of stress and anxiety in my daily life, but I want to rule
out
any potential problems associated with my heart. What should I ask my
cardiologist beyond what he has already done to rule out any heart related
problems.
Thanks
in advance. • Judith -- Only your doctors can give you "medical
advice". A 50% blockage is usually considered the minimum for an
intervention like angioplasty -- but it really
depends on whether that blockage is actually causing a reduction in blood
flow to the heart muscle. The visual size of a blockage does not necessarily
mean that this blockage is a problem. Have you had a nuclear stress test,
which
would measure whether the blockage is causing ischemia (reduced blood flow
and oxygen to the heart)? Certainly, reducing your risk factors is number
one, so what your doctors prescribed (meds, diet and exercise) seems reasonable. • I'm a 63 year old female. I have disabling emphysema,
and a 50% blockage of the left coronary artery determined yesterday by
catheterization I had all the symptoms of heart attack 4 weeks ago but
no heart damage as it lasted 15 seconds. They say the plaque is soft,
but the calcium scoring said differently. They suggest exercise, diet and
an
LDL lowering drug, my total cholesterol was 207 and I have very low blood
pressure, and no family history of heart disease. but No guidelines are
given for exercise. Do I just wait for the next heart attack? lol This
seems inappropriate, wrong in fact. Can you advise me? • Jose -- you have small blockages, and taking steps
to reduce your risk factors is precisely the right direction -- as for
whether or not to take a statin like Crestor, that's something you should
discuss with your cardiologist. Some people's physiology just won't go
below a certain level of cholesterol -- and statins have been shown to
have benefits in more than just lowering the numbers, but each individual
is different. Certainly your progress has been very good! • I did a CAT. My LAD is between 25 and 50% blocked
beginning 1/3 medium. Discrete irregularities in the proximal, 25%. Everything
else is fine. I take
medication to control my blood pressure. I was able (by losing weight and right
diet) to reduce my cholesterol LDL from 153 to 120 within 40 days. My doctor
prescribed aspirin and also a cholesterol drug - Crestor 10mg. He wants my LDL
to reach 70. Do you think he is exaggerating a little bit? I believe I can reach
LDL 100
w/o medication. Wouldn'tīt that be enough? I do not like the idea of taking cholesterol
reducing medication. Thanks Joe. I will be 59 in may. • I wish that I had at least hadn't had my heart
attack on Thanksgiving Day. We were one of the lost job, home, and ended
up staying a week with our son and his wife, and our 2 year old grandchild.
You can imagine the stress. I had been having jaw pain, ear pain suddenly
and then it felt like something exploded in my back. I couldn't get warm,
i was vomiting every fifteen minutes. Paramedics took me no matter what
they gave me it did not stop the pain. The stress test lasted about 7
seconds, my heart was beating over180 . They said I had 30 percent blockage.
they
said I needed a pace maker and a stent. How long before and also blood
pools up in the back wall of my heart. When i stand up my blood pressure
goes up and when I sit or lay down it goes too low, I mean up as 240/120.
Then when I lay down it drops to 60/40. • Anne from the UK -- we assume you are on other
meds as well. Certainly an annual visit to the cardiologist would be
wise, although an EKG is not necessarily going to show the extent of any
blockage. For that a stress test or possibly a CT Angiogram might be indicated
--
if symptoms return. • I am a 53 year old woman who had a heart attack
2 years ago. My LAD was destroyed and I had significant muscle damage
so that I am on Warfarin for life. My RCA is 50% blocked but my consultant
has discharged me. I worry that the RCA becomes more blocked but no-one
will know. Other than that - I feel fine with no angina. Should I pursue
for yearly/six-monthly echocardiograms? • I just had an Angiogram and am blocked 20% in
2 main arteries and 30% in 2 spots in the main artery.On beta blockers
the nitro patch and Crestor. They
think I might have Angina. |
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