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Heart Disease (Expert Forum)
4 Heart Caths Later
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
4 Heart Caths Later
by jmike1_, May 06, 2006 12:00AM
I am a 39yr old male, don't smoke, drink very little, and formerly exercised regularly. However, I had high cholesterol, and a strong family history (Dad has had 14 angioplasties and 9 stents). Chest pains started in early Feb, and eventually the doctors at Walter Reed (I'm active duty army) agreed to do a thalium stress test. It showed ischemia and they did a heart cath on 8 Mar 06. They found 80% blockage in my LAD in 3 places, and put in 3 stents. I continued to feel bad and have similar sypmtoms. They did an echo cardiogram which showed nothing, and decided I might have reflux. The symptoms persisted, and I had to call an ambulance in early April 06. They found another 70+% blockage in the LAD between the uppper two stents they put in earlier, and added a 4th stent. My sypmtoms did not go away, and the next weekend I again had to call an ambulance, and got my 3rd heart cath which was negative. Two weeks later, I had to call the ambulance, and was admitted to Walter Reed. The test for reflux was negative. They decided to do another thalium stress test which showed mild septal ischemia, and they did a heart cath that afternoon. The cath showed significant LAD disease which they couldn't treat with angioplasty because they were afraid of disecting the heart (very low in the LAD). They are treating me with meds instead: plavix, baby aspirin, lipitor, niaspan, lisinopril, adalat, isosorbide mononitrate, and toprol. My ?s: I still have pain - what is my longterm prognosis (heart cath every year?), I am scheduled to PCS to Romania in 07, is this safe? Thanks!
Doctor's Answer
by CCF-M.D.-MJM, May 07, 2006 12:00AM
Hi jmike,
I am sorry to hear about your problems--you are too young for this. You are on all the right medications.
Regarding your change of station, it depends on what you do. I would not approve you to go into combat duty or anything that could cause stress or bouts of chest pain. I have heard the army release people on medical disability for much less than this. If you work at a desk job, I doubt this would be a big problem.
Prognosis is always a difficult one to speculate about. You clearly need maximal medical management and risk stratification. You should work aggressively with your doctors to do this. Many times people your age will form new vessels to help perfuse the areas of your heart not getting enough blood but it is difficult to say for sure.
I hope this helps. Good luck and thanks for posting.
I am sorry to hear about your problems--you are too young for this. You are on all the right medications.
Regarding your change of station, it depends on what you do. I would not approve you to go into combat duty or anything that could cause stress or bouts of chest pain. I have heard the army release people on medical disability for much less than this. If you work at a desk job, I doubt this would be a big problem.
Prognosis is always a difficult one to speculate about. You clearly need maximal medical management and risk stratification. You should work aggressively with your doctors to do this. Many times people your age will form new vessels to help perfuse the areas of your heart not getting enough blood but it is difficult to say for sure.
I hope this helps. Good luck and thanks for posting.
I was diagnosed SVT 1981, controlled by Verapamil and Xanax. I do have anxiety issues.
Fast forward to last summer. June-2 stents to correct 2-90% blockages. August-2 more stents to correct 2 new 60% blockages.
September-stent #5.
Experiencing severe pain under the sternum. A cat last month showed all 5 stents open. Full bone scan "unremarkable". CAT scan "unremarkable". Seeing clinical psychologist to work on the anxiety end. Next step is an upper/lower GI series to eliminate esophagus, stomach.
My bottom line appears to be that it is "all in my head", that my anxiety issues are controlling my brain, and I will have to live with the pain. It really sucks because I was very active prior to the stenting, and have gained 15 pounds. I walk a lot, carry a pedometer, get my 10,000 steps in on most days.
I just wanted you to know that when I saw your post, I immediately related to it. Best of luck to both of us.
I feel that I now live in some kind of time warp, and would love to get my old life back. You are not alone.
Thank you very much for relating your story to me. I wish I were alone and that no one else was going through this. Don't necessarily think it's all in your head - there are so many small vessels and spots way down in the arteries that are tough to find. A really low blockage in my LAD is my problem, and it took them 2 caths to find it (I was thinking it was in my head too). Luckily, I have a great outlook and will not allow myself to get depressed. As I said, I go to Walter Reed, and see the young men and women missing body parts from the war, and it makes me realize I just don't have it that bad. Am hoping that the pain/angina will go away and I'll get used to it. Until then, I guess my life will just be a little different. Will say a prayer for you, and wish you the best!
Mike
Mike
Have had 3 caths and 4 stents.
I want and need collaterals in that area. I wish you well.
Hope everything works out for you, God Bless and thank you for serving.
I don't think that doctors properly evaluate the risk when stenting, especially on young people. Unfortunately, the problem with the current stents are that they are forever. They are working on stents which will disolve over time, but they are years away from the market.
Problem is that, if you have an angioplasty, and they see any narrowing, they will stent it, forfeiting the chance for that artery to ever by returned to normal health. And contrary to what cardiologists generally believe, coronary arteries can be returned to reasonably good health with agressive lipid medication, exercise, reasonable diet, and a few other lifestyle modifications.
The old sales pitch is always that you are at high risk of dying any minute, so they have to stent