coronary blockage

[ignatius373]

I have 90% blockage in a small coronary artery no the the main arteries. How can I check to see if the collaterals are forming around that blockage?

[ed34]

Just to add something important here. Even though a nuclear perfusion scan is the best option, it can still be misleading in diagnosis. However, it is known that you have a blockage and no misleading will take place. I've had several nuclear scans that revealed great circulation in the coronary arteries, yet my arteries were known to be a mess, full of blockages. This is because there were lots of collaterals. It's misleading because I had lots of angina symptoms on exertion, which means the collaterals were not adequate in number or width. If I had a nuclear scan before an Angiogram, I would have been sent home diagnosed with a healthy heart. My Cardiologist said that my case changed his views on tests and in future he would not use a nuclear scan as conclusive evidence.

[ed34]

I agree with Erijon, the only accurate test is a nuclear perfusion scan. Angiograms can only see vessels down to a certain size, so if you have lots of tiny collateral vessels, they will be invisible. With a blockage of around 90%, symptoms are only likely to appear when the heart is working harder, so ECG and Echo will look normal. I had a stress echo a few years back and no problem was noticed until they got my heart rate up to around 160bpm and then the ECG also started to show a dipped ST wave.

[Bhupinder Kaur, MD]

Hello,
Collateral vessels are extra blood vessels that connect portions of the same artery or link two different arteries. Collateral circulation can be diagnosed with the aid of medical tests such as an echocardiogram, electrocardiogram, percutaneous transluminal coronary angioplasty (PTCA) or color dippler.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[erijon]

A nuclear or Thallium stress test will show the distribution of blood to the heat muscle. If there is uptake with stress, you most likely have collaterals forming.