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Heart Disease (Expert Forum)
Bypass needed at 28
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Bypass needed at 28
by igixxn2, Feb 10, 2003 12:00AM
To make a long story short, I've been going through the typical CAD tests as a precautionary measure since my brother who is 30 just had a heart attack. (I'm 28) Well, after my cholesterol was found to be 505, I scheduled a Cardiolite Stress Test and made it through the exercise portion okay with no chest pain, even though my EKG showed some signs that I might have blockage. The images taken after the stress test showed even more evidence of blockage. My at rest images were normal and the after stress images were abnormal. I was thin reluctantly scheduled for a left heart catheterization, which was done last week.
The results were not good. Three blockages were found, 100%, 75%, and another 95%. The only reason I'm alive (and with no pain) is I've grown collateral arteries to supply blood to the blocked areas of my heart. The cardiologists was not interested in attempting to treat these with angioplasty and has recommended that I have a quadruple bypass.
You can imagine the shock to find this out at the age of 28.
Is bypass my best option? This whole thing would be easier to swallow if I at least had some sort of symptom. I'm in better shape now than I've been in a long time and I feel great.... are there any decent alternatives?
The results were not good. Three blockages were found, 100%, 75%, and another 95%. The only reason I'm alive (and with no pain) is I've grown collateral arteries to supply blood to the blocked areas of my heart. The cardiologists was not interested in attempting to treat these with angioplasty and has recommended that I have a quadruple bypass.
You can imagine the shock to find this out at the age of 28.
Is bypass my best option? This whole thing would be easier to swallow if I at least had some sort of symptom. I'm in better shape now than I've been in a long time and I feel great.... are there any decent alternatives?
Doctor's Answer
by CCF-M.D.-KE, Feb 10, 2003 12:00AM
Dear Igixxn2,
I am sorry to hear that you have severe coronary artery disease at such an early age. This is likely in part due to an undiscovered genetic abnormality. Without knowing the location of the blockages and reviewing the catheterization films, I can not make a definitive recommendation. However, the blockages are significant and may be best treated with coronary artery bypass grafting. If you are concerned about your best option you should seek a second opinion. I would soon schedule an appointment with a cardiologist at a nearby university based medical center. Take all of your medical records to this appointment, including a digital copy of your heart catheterization. Also consider making an appointment here at the Cleveland Clinic if possible. The appointment desk can be reached at 1-800-CCF-CARE and our website is www.ccf.org.
I hope everything works out well for you.
Thanks for your question,
CCF-MD-KE
I am sorry to hear that you have severe coronary artery disease at such an early age. This is likely in part due to an undiscovered genetic abnormality. Without knowing the location of the blockages and reviewing the catheterization films, I can not make a definitive recommendation. However, the blockages are significant and may be best treated with coronary artery bypass grafting. If you are concerned about your best option you should seek a second opinion. I would soon schedule an appointment with a cardiologist at a nearby university based medical center. Take all of your medical records to this appointment, including a digital copy of your heart catheterization. Also consider making an appointment here at the Cleveland Clinic if possible. The appointment desk can be reached at 1-800-CCF-CARE and our website is www.ccf.org.
I hope everything works out well for you.
Thanks for your question,
CCF-MD-KE
I am wondering why, if they said you had 3 blockages, that they are recommending a quadruple (4) bypass, which would be used if there were 4 blockages. Sounds like a miscommunication.
Make sure you get everything in writing when dealing with doctors about such a serious matter.
Sorry to hear of your problems. In my case I identified problems at 42 via a UBCT scan which showed extensive calcification in my arteries - although as in your case no symtoms.
I was lucky enough to be referred to a fairly prominent (and perhaps a little controversial) Preventative Cardiologist who is a firm believer in using the best of traditional and alternatve medicine to treat our type of problem. He is a believer in surgery only as a last resort - and I think only rarely in people who have no symptoms. I think if you do some research you'll find that surgery is a pretty effective medium term (average 7 years)treatment for folk with symptoms but fairly unproven in it's ability to head of a critical event such as a heart attack.
I think my Cardiologist would be fairly horrified that a young guy of 28 (with no symptoms) should be recommended major by-pass surgery without first attempting to control his condition via lifestyle/medication. After all your real problem is less "blocked arteries" and more an underlying problem with your lipid/sugar/chol etc profile which causes the clogging to occour - this needs to be treated regardless of any by-pass otherwise the clogging will just continue.
I know that my Cardiologist would run a major blood profile so as to be certain as to what is causing your problem. With your Chol level so high that probably is the reason but he would also check for things such as CRP, lp(a), homocystiene, insullin/sugar levels and then devise a lifestyle program to address your underlying problem.
The lifestyle program would most likly include - excersice @ 30 mins 3 or 4 times per week: diet low in saturated fat, red meat and reffined carbs and high in fruit and veg/fish/olive oil/red wine/garlic/almond and walnuts. He would want to address your Chol with statin drugs and niacin and have you on vitimim C and E supplemets and possibly Ginko Biloba.
PLEASE try to seek a second opinion from a good preventative Cardiologist before undergoing any surgery. You may find that a good lifestyle program can stop your disease in it's tracks without surgery - it has to be worth exploring and if you body is already growing collateral viens then that should be a pretty good start.
It's your body and your future - your really should question these doctors hard.
Very best wishes to you - Paulus
You have to live a long life and the average lifespan of venous grafts is 7 years. What are you going to do when your in a worse boat at age 35?
You need to get on a very aggressive cholesterol reduction, exercise, and weight control program. You can get your total cholesterol below 150 with a combination of multiple drugs. That will take the risk our of your situation. It's not the blockages that kill you, it's the rupture of lipid rich plaques. Dry out the lipids and you dramatically reduce the risk.
Sure you have a genetic predisposition to the early onset of CAD, but you can override that with drugs, exercise, and lifestyle changes. In 5 years you could have normal health, if you are serious about it.
Best of luck to you and don't fall for the cardiac surgeons sales pitch. Seven years from now, when you are hosed up again they will have your fee and will not remember your name. It's up to you to turn this situation around.