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Current Postings on This Page (35):
Amini from Iran -- Your clinical situation is
a complex one and the decision as to whether to do stents (PCI) or CABG
will probably depend on the cardiologist or surgeon you ask. One question
might be answered by whether or not the blockages in your LCX and RCA are
causing functional problems. Yes, one can SEE the blockage on an angiogram,
but is your heart getting reduced blood flow/oxygen or not? This can partially
be answered via a nuclear
stress test, or during the cath itself, using
FFR (Fractional Flow
Reserve) to measure directly the flow. As for costs, you can
look over our topic on "Costs
of Stent and Angioplasty", although these
vary widely.
Forum Editor, Angioplasty.Org, July 17, 2010
I am 49 yr old male, in excellent health (no
diabetic, no high cholesterol, no hypertension, etc) had a heart attack
10 years back, LAD TOTAL OCCLUSION AT OSTIUM, LCX stenosis 60-70 percent
at three location a small area of dyskinetic at apex, failed to reopen
LAD put three stent in Lcx at same time ( medication ASPIRIN, LIPITOR
10 mg/day). 10 years after 1st MI did angiography week back because of
chest
pain ,all three stents were patent with an excellent retrograde filling
from RCA and antegrade filling to LAD, in new angio More than 70percent
blockage of LCX at trifurcation ares 60 percent block in distal segment
of RCA were reported. RCA is dominant no symptom.my father had MI at
age 50 with same trend of blockage and did BY PASS AT 64 and now he is
80 healthy
and active without any symptoms .my cardiologist Cannot decide confidentially
because of location of LCX stenosis and says chances of restenosis is
about 20 to 30 percent so prefer CABG but my preference is PTCA. After
1st attack
MY EF was 45 and remained same till today . at present no cardiac medication
.considering my problem could anybody give the second opinion and how
much is the average cost for Two stent angioplasty
in usa.
Amini, Iran, July 15, 2010
I was told that I had a slight heart attack because
of 90% blockage in Rt. Coronary artery. A stent was put two months
ago. I am having moderate to severe burning sensation in both legs below
knee
and feet. I am only getting 4-5 hours of sleep per night. help!! I
told the Heart DR., but he showed little interest.
EKC, Central Louisiana, USA, July 9, 2010
Stenting increases blood flow. However, heart
muscle that has been damaged from an infarction (heart attack) may or
may not be able to function correctly, no matter how much blood flow it
gets.
Ask your cardiologist about this and what your ejection fraction (EF) is. Also
note that some posters in our topic "Not
Feeling Well After Stenting" report a period of discomfort
for a month or more that in time does go away as the body adjusts.
Forum Editor, Angioplasty.Org, July 8, 2010
how long does it take for ischemia weakened heart
muscles to revive after stenting? I have a stent in for six weeks and
feel intermittent 20 to 30 minute discomfort in heart area, no pain, ea
with
light headedness and need for deep breaths. I thought the increased blood
flow after a stent would stop this.
oldie, Villa Nueva, Guatemala, July 2, 2010
Stephen79 -- your cardiologist, the physician
who best would know you and your clinical condition, is really the person
to ask this question of. There are many variables at play here. Obviously
you need to do whatever you can to reduce risk factors (via smoking cessation,
diet, compliance with medical therapy, etc.) for the advance of the coronary
artery disease that keeps blocking your arteries
and causing
these MIs, but this is challenging, especially in diabetic populations.
Let us know how you are doing and good luck to you.
Forum Editor, Angioplasty.Org, July 2, 2010
I'm 31 year old male. Type 1 diabetic since age
4. First MI in 2005 with stent placement in LAD. 6 months later 2nd MI
with 100% blockage at stent. 2007
3rd MI major with 3 stent placement. At that time I was dismissed as a candidate
for bypass surgery due to a minimally viable myocardium. Since then my EF has
been 20-25%. I had another minor MI in 2008. How long can a person live with
CHF?
Stephen79, Raleigh, North Carolina, USA, June 11, 2010
Forum Editor - Thanks again for your prompt reply.
As per your question about inability to do certain things; I am very
active and can do most everything except when it comes to weights and sprinting.
Being in track all my younger days and an active athlete it is frustrating.
I can walk for 1 hour a day without any difficulty, but when I try running
or jogging I can't run more than a few minutes (not sure if it is heart
related). Also lifting heavy objects anything over 40 - 50 lbs does get
me tired. For reference I am 5-8 and 160 lbs. One thing I would like
to
add is that I get less tired now than before. In the first year after
the MI I got tired very quickly and needed a lot more sleep than I do now.
RD, Dallas, Texas, USA, April 26, 2010
An ejection fraction of 45% is below normal (normal
value is 55-70%) but it's not bad. Do you find yourself unable to do
certain things? But having gotten the stent during an active MI probably
saved
a lot of your heart muscle. (See our recent article on this subject, "Heart
Attack and Angioplasty: A Public Education Challenge".)
As for your family decision, there's no advice but just to say if everyone
suffering
from
coronary artery
disease
decided
not to
have
children, we'd be a much smaller nation than we are -- it is still a
very
widespread disease. It is in fact very important to be aware of the family
history, so that you can be extra-vigilent in controlling all your risk
factors. Genetic tendency is just that -- a tendency. Environment and
lifestyle can go a long way toward negating those tendencies -- or amplifying
them.
Forum Editor, Angioplasty.Org, April 26, 2010
Forum Editor - Thanks for your reply. The original
stent put in while i was in active MI. My EJ fraction is 45%, which i
am told is not good. As per the cardio there was some damage to the walls
and the heart muscle itself. I know if my wife and I plan to have kids,
there are greater chances for the kids to have heart disease due to my
condition. I would like to know if others have had kids after such an
incident?
And if my wife and I do plan to have kids will it be the right thing
to do since they may be at a greater chance of having heart disease.On
a side
note, after i changed cardios (cause the first one did not have technology
to conduct CTA scans) they found lumps in my chest and luckily I did
not have lymphoma cancer, but have granulomatous lymphadenitis, which does
give me chest pain, but is unrelated to the heart. Thank you for your
reply
and
looking forward to your advice.
RD, Dallas, Texas, USA, April 26, 2010
Raja -- these questions should be answered by
your father's cardiologist, including the correct medicines. For your
information, stents have been used very successfully in all ages, including
very elderly
80 and 90-year-olds. And RD -- was there damage to your heart
from the heart attack -- or was the original stent put in during the
heart attack, and kept the heart muscle from dying?
Forum Editor, Angioplasty.Org, April 9, 2010
Should I have kids after a MI? I am 32 now and
at age 30 had a MI with 100% blockage in my LAD. I have had to go back
at age 31 (within 6 months of my first stent) to get a drug-stent put in.
Have had history of high BP. I am healthy, with normal body-weight and
exercise regularly. Wife and I are thinking about starting a family. Want
to know if anyone has had children after an MI. Any doctor's advice you've
consulted with would be great as well.
RD, Dallas, Texas, USA, April 7, 2010
Just few days back my father got a heart attack.
doctor suggested two stents needed for his heart. now he is 65years
old is it correct age and one more thing is his heart is supports with
that
stent can any one suggest the right medicine and his heart is supports
or not
Raja S., kbg, India, April 7, 2010
Rosammajohn -- sounds like your brother didn't
have a heart attack (the topic here) but is suffering from congestive heart
failure (CHF) -- what happens when a damaged heart is not functioning --
as you report, it is working only 15-20% normal on a ventilator, which
is pretty low. This is a complex situation and you should ask your doctors
about your brother's
prognosis
Forum Editor, Angioplasty.Org, January 22, 2010
My brother had a heart failure. he is in ICU and in ventilator. The time
he was admitted his blood pressure is 100/60. his heart beat is 120.There is
fluids in his lungs and was very difficult to breathe. Pumping of the heart is
only 25%. After 2 days in ventilator, his pressure is normal, heart beat is normal,
but pumping of the heart is only 15 to 20% with ventilator. doctor says it is
critical. what is the risk?
Rosammajohn, Kerala, India, January 21, 2010
My 77 yr. old mom has always been very active
and healthy with her only daily medication being a multi-vitamin. On
Tues. of last week, she had a massive heart attack with 99% blockage of
right
coronary artery. She had three stents placed in the artery. Had bleeding
from blood thinners, 4 units of whole blood, 3 of plasma, has developed
pneumonia. Her vitals have been good, but she is experiencing a lot of
anxiety. Was moved into room today from ICU but is so weak and still
complains she can't breathe. She has sat in chair a few times but it is
almost a
week later and I'm concerned she can't walk yet. Will this get better
and when. They are talking about dismissing later this week from the hospital
and I don't feel she is in anyway ready. Has anyone experienced a parent
that panics and
has trouble breathing from this? Is this normal?
Deb, Healdton, Oklahoma, USA, January 4, 2010
Aileen -- much depends on the clinical status
of your father's heart -- was there damage done during the heart attack.
Angioplasty and stenting is best done as soon as possible once symptoms
of an infarction occur. There is debate about the value of stenting
that long afterwards -- but much depends on whether those blockages are
blood flow-limiting and whether they pose a risk to another heart attack.
Forum Editor, Angioplasty.Org, November 28, 2009
Hi, My Father has a heart attack 5 days ago.
He had an angiogram 4 days ago and two blockages were identified. They
think one of the blockages can be treated by putting in a stent but the
other is too close to the heart so may
need to be treated with drugs. From any reading I have done it does not seem
advisable to treat a blocked artery using a stent this long after the attack?
Is it normal to do one anyway and is it not better to try and treat both blockages
with drugs or a bypass? Any advice much appreciated.
Aileen M., Budapest, Hungary, November 23, 2009
On May 18 I had a serious heart attack at that
time I had two stents placed in my right coronary artery. Prior to leaving
the hospital the operating physician,
not my normal cardiologist, scheduled me to have a nuclear stress test in
order to determine the amount of damage if any done to the heart muscle.
That was
to have been done on the 24th of June, on the 18th of June my cardiologist's
office
called to notify me that the nuclear stress test was not necessary. They
wanted to do a regular stress test and get me into cardiac rehabilitation.
I was wondering
if someone would be able to share with me the tests that they had after having
a heart attack. Your insight and information is greatly appreciated.
Fay, New York, USA, June 20, 2009
My age is 38, male. . I was admitted in the hospital
on 1st january last year.Medication started from 1st jan to 18th jan.I
have been underwent angiogram on 14th jan and two stents were plased on
18th January. My present condition is moderate lv dysfunction with BP 90/60
and 40% ejection fraction. I fere some damage took place to the heart.
Now I am walking, doing all works without any difficulty, with occational
mild burning pain for little time. Is there any medication/procedure to
get back good BP and good ejection fraction.
Narendar, Osmania University, Hyderabad, India, March 16, 2009
Mr. Singh -- very sorry for your loss. Your father's
case sounds very complex and there's not much anyone without specific knowledge
can say, except for some general facts about heart attack treatment with
angioplasty. It is the "gold standard" -- emergency angioplasty, opening
up the culprit artery during the heart attack, can actually stop the attack
and save the heart muscle. Your father had angioplasty after the attack
(MI) was completed. The internal bleeding can be caused by a number of
things, but it is a complication of interventional and surgical procedures
and definitely is associated with increased mortality. There has been much
debate about whether opening an occluded artery well after the actual heart
attack is beneficial -- the OAT trial in the States showed it was not.
Forum Editor, Angioplasty.Org, February 5, 2009
My father,67,one night ,with no history of any
heart ailment or complaint till that time, had an attack was revived
with an electrical shock and after 2 hrs. again had same attack and was
revived.
In the morning angiography was done and angioplasty procedure was performed
the next day morning and one stent was put. after 3 hrs. of the procedure
he had another attack and was revived with the shock again. After 3-4
hrs ,he was put on ventilator and the doctors said he is bleeding internally
and started the blood transfusions and gave him about 21 units . then
they
started giving blood plasma transfusions and in total they gave about
32 units of blood plasma over the next two three days. The we were told
after
another day that he has developed ARDS and the next two days we were
told he is having septicemia ( very bad lungs ) the fight ended after 19
days
with Multiple organ failure and ultimately he passed away.We wonder still
! Was angioplasty really required ? Was there anything wrong done during
angioplasty procedure ? Shouldn't the stent be put at the time of angiography
only ? shouldn't he be kept under observation for some time after the
attacks before the angiography ? Could he have some how survived ? Please
help
in understanding
this,please...!
N P Singh, New Delhi, India, January 25, 2009
In 2007 my husband (64 years old) had one coronary
artery drug-eluting stent placed. The procedure went fine. He was 70 %
blocked before stent, completely clear after stent. He spent the night
in the hospital, came home at 7:00 a.m. and at 2:30 in the afternoon developed
massive chest pain, nausea, tightness,fullness, etc. We took him to the
emergency room of the hospital where the procedure had been performed (It
was only 4 miles away). He was at the triage window within 10 minutes of
the beginning of the chest pain. They triaged him within 3-4 minutes, gave
him a level "2" rating and put him in a patient room. There he stayed for
a little over 3 hours with no pain medicine for the first hour and a half.
BP 224/109; sweating profusely; horrible pain, in chest, up neck, and down
left arm. The ER physician refused to call a cardiologist when I requested
one. I reminded him of the time window for various treatments to reduce
heart damage. He told me that it might not be a heart patient. He said
only time and tests would tell. The 3rd EKG came back ACUTE MYOCARDIAL
INFARCTION. Still he did not send him to the cath lab. I had left a message
on my husband's cardiologist's phone (it was his day off)and when he happened
to check it, he came right to the hospital - 3 hours after Bob's admission.
In 3 minutes Bob was headed for the cath lab. I feel the ER physician made
a terrible mistake and my husband has to pay for it with a severely damaged
heart which will greatly decrease his quality of life and decrease his
remaining years of life. I am in Florida and there's not much you can do
if your ER physician makes a mistake.
Kathleen, Florida, USA, October 5, 2008
LB Ohio, your husband may have pain in the scar
area for months. As long as the Drs rule out infection, it takes up to
a good year to feel 99% better.
If he's lucky, sooner. I had same surgery and the scar area and my entire chest
hurt for many months after. I don't know if it has to do with diabetes (as
I am diabetic also) or if this is the norm but hang in there.
Kathy F., New Jersey, USA, January 30, 2008
my husband david 43, had a quadruple bypass on
jan.4th of this year. on jan.2nd was his heart attack. he was on the
vent for 2wks. a diabetic since and now a non-smoker. its the 28th and
for the past couple of days david has been suffering spasms in his chest
around the scar. at times bad ones! his drs. dont know why. everything
else ok. has anyone else know of this?
LB., Ohio, USA, January 28, 2008
Steve -- Tenormin (a beta-blocker) and Lisinopril
(an ACE inhibitor) can possibly cause light-headedness and it's possible
that an adjustment to dose may be indicated. While dosage is usually
done by clinical assessment and body weight, some individuals are more
sensitive
to meds than others. If these symptoms persist and are potentially limiting
your functioning (you don't want to get an attack of light-headedness
on the highway) definitely put in a call to your cardiologist and describe
your symptoms. Couldn't hurt. But don't stop or reduce your meds without
talking to him/her first.
Forum Editor, Angioplasty.Org, November 23, 2007
Thank you for your reply. it's been 3 days since
the procedure and sometimes I feel little light headed. I noticed on
the medication plavix, tenormin could cause this as well as I am taking
lisinopril
for bp, and addition of tenormin could be lower my bp too much? my follow
visit is still 10 days away, should I be concerned or is my body getting
used to the medication?
Steve, Woodside, California, USA, November 23, 2007
Steve -- you're correct. The LAD (Left Anterior
Descending) artery IS one of the main vessels. As for your fears about
correct placement of the stent -- you must have been reading some of
our articles about intravascular ultrasound (IVUS)
-- and why some cardiologists urge its more widespread use. The good
news is that these concerns and this message has been getting out to the
cardiology
community and physicians have been more aware of this. There's no reason
to think that your stent was NOT placed correctly -- especially dramatically
opening up a 99% blockage. Also, the message is less that the stent has
not been placed correctly, but that it needs to be fully expanded.
If you
have concerns, certainly ask your interventional cardiologist. You are
in an
area where
there are
many
excellent
facilities
and cardiologists. (In fact, IVUS was developed not very far from Woodside.)
There's no non-invasive test accurate enough to test the precise expansion.
Forum Editor, Angioplasty.Org, November 23, 2007
I am 42 yr old male, in excellent health, but
was found to have had a heart attack, I just received (Nov 21st) one DES
due to 99% blockage in my "LAD" I believe it is one of my main vessel,
I understand all my other vessels are in great condition. Although, the
before and after image they showed me after inserting DES is dramatic,
I am concerned, after reading the articles on the site about misplacement
of DES, I do have a follow up visit with my cardiologist soon, is there
a test they can do to confirm the correct insertion of the DES?
Steve, Woodside, California, USA, November 22, 2007
Hi, my Dad had 2 stents put in his main Coronary
Artery it was 99% blocked. He had a major heart attack and thanks to
my mother she took him to the ER fast. They told him he is very lucky to
be
alive anyway, he had this done 8 months ago and is doing great! The technology
today is awesome thanks to this I still
have my Dad in my life.
C., Illinois, USA, September 3, 2007
Rick -- family history is certainly a risk factor.
The fact that you have had negative nuclear stress tests is good, showing
low probability for coronary artery disease. What does your cardiologist
say about the near-fainting episodes? Has he
run a test that would show potential valvular problems, for example, a
stress echo (not sure what you mean by a sonogram)?
Forum Editor, Angioplasty.Org, July 8, 2007
My two younger brothers, ages 49 and 51 respectively
have had heart attacks, the younger one just a few days ago. After the
older one had his which he survived with 5 stents to deal with his 95+
blockage, I had a nuclear stress as well as a sonogram, both of which were
negative conducted by my cardiologist. Now the younger one, a former world
record holder in distance events just suffered his heart attack a few days
ago and also survived. He would appear to be in excellent shape with daily
workouts and not a likely candidate compared to me, his oldest and much
heavier brother, age 53 but also a former runner. I have had no chest pain
but a two instances of almost passing out that weren't fully explained
along with several of lightheadedness and just not feeling right that have
lasted from several hours to a day or two during the last year. Should
I seriously be thinking
about a angioplasty?
Rick, Tehahchapi, California, USA, July 3, 2007
MMD - I am very sorry to hear about the way that
your husband was treated. My experience was almost exactly the opposite
as that of your husband. I experienced an MI in February. As soon as
I arrived at the ER, I given an EKG and 15 to 20 minutes later was in the
cath lab where a balloon angioplasty was performed and three drug-eluting
Taxus stents were placed my LAD. As the result of the prompt treatment,
and possibly because I had a system of collaterals as the result of frequent
exercise prior to the MI, damage to my heart muscle was minimal. Six
weeks
after the MI I had an echocardiogram which indicated an ejection fraction
of 65%. I would also add that as the result of both luck and knowledge,
I happened to have selected hospital that has an interventional cardiologist
either physically present at the hospital 24/7 (as was the case when
I arrived) or who is on call and could be at the hospital within 15 minutes.
Larry T., Virginia, USA, May 24, 2007
MMD -- one of the challenges with emergency treatment
of heart attack is for hospitals that can perform angioplasty to have a
system in place to get the patient diagnosed and on the cath lab table
within 90 minutes to two hours. In this way, the infarct can be stopped
and damage to the heart muscle minimized. It is one of the undisputed benefits
of angioplasty. Sounds like the diagnosis took place later in your husband's
case. An important measure would be how well your husband's heart is pumping
-- sometimes called an ejection fraction.
Forum Editor, Angioplasty.Org, May 22, 2007
Recently my husband had his 5th heart attack and
this is the 6th stent. He is only 41 years old, thanks to good old genetics.
The majority of the stents was boston scientific the latest on was Cypher.
He had his MI on Friday 1am, he was not cath till Monday am. His cardiac
enzymes increased on Friday was never diagnosed until Monday. This is totally
out of character of what we are used to. His last cath was done by military
med, within one hour he was being cathed. It appears that that Friday the
cardiologist had a Saturday family commitment and the hospital was going
to release my husband to come home that Saturday. I refused to bring him
home. We have an appt with a new cardiologist...Does anyone else have any
ideas we can look into.
MMD, Ohio, USA, May 22, 2007
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