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100% Occluded RCA post-Hodgkins - angioplasty or not?
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100% Occluded RCA post-Hodgkins - angioplasty or not?

I hope you can help.  I am scheduled for angioplasty this Wed (July 11) and I don't know whether to proceed or not.

BACKGROUND:
I am a 44yo female survivor of Hodgkin's lymphoma & received ABVD chemo and mantle radiation treatment back in the 1990s.

DETAILS:
After an episode of flash pulmonary edema and mild heart failure in Feb 2012, testing showed that my RCA is 100% blocked (near the top) and that the blockage has been occuring for 10 years or so.  My resting ejection fraction is 50-55 at rest and reached near-normal during my stress test.  I have decent collaterals.

I also have mitral valve regurg & prolapse. Recently I've been having increasing, significant fatigue and stable angina during many (but not all) of my 30-min. walks - pain radiates to my R shoulder and arm and ceases when I stop exercising.  My BP is low (80/60) and I have not been able to tolerate Coreg or Lisinopril.  Other than my heart disease, low thyroid and new asthma diagnosis, I am very healthy. I meditate, eat well & exercise (medium walking) 30 min. 5 or so times per week.

MY QUESTION:
I've been told that we are going to "try" to open the vessel and I am scheduled for angioplasty this Wednesday.  

I am petite and I've been told that my blockage is in a very difficult area to get to.  The blockage is also calcified.  My interventional cardiologist has an excellent reputation in my region and the procedure will be done at a major metropolitan medical center.

But I don't feel I fully understand the risks OR the necessity of trying to open up the RCA in my case.

What's are the risk/potential benefits if I proceed with angioplasty?    What happens to my heart function if we leave the RCA alone?

thank you.
-M
Avatar_dr_f_tn
Hello and hope you are doing well.

The ejection fraction is good and though the blockage is 100%, collaterals have developed. Since you have symptoms of unstable angina, it could mean the collaterals are inadequate. If left alone the blockage could lead to an infarction. But please discuss the various options with your doctor, before you consent for the surgery.

Hope this helped and do keep us posted.
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