Aa
6 Blockages 3 in arteries to small to stent what will happen to these?
I had a MI on Feb 14th 2011 after having symptoms for years of shortness of breath.. Pain in arms and indigestion and being told it was Anxiety I guess I finally found the real problem in a BIG way.. I had two stents to my RCA.. I have 6 other blockages 3 in LAD 2 at 30% one at 40% and three diagonals 2 off of LAD that is 80% and 70% Occluded and one off the circumflex at 50% Occlusion.. I have a lot of Angina and the doctor told me not to go to the E.R. anymore with it but to treat it at home but it remains constant and not sure how to tell if I am having another Heart attack she says 3 of the blockages are too small to stent.. Should I seek another opinion.. I also have 100's of P.V.C'S a day and have symptoms with these.. I am a 47 year old female otherwise in good health.
My husband is from europe this may be something for me to look into his national insurance would cover it
thanks :)
thanks :)
Well there has been a new technique in Europe for a few years for tiny vessels, but I think the FDA were waiting to see success rates before taking it on. I assume you have seen a stent? a tiny scaffolding tube. The drug eluting stents have a coating which is to prevent scar tissue forming in the artery, causing it to re-block. However, as I'm sure you are aware, there is a lot of space between the scaffolding meaning only 10-20% of the artery is touching the coating. So, to get around this problem, Europe has been using drug eluting balloons which are covered with the coating and when the balloon is expanded, it delivers the chemical to 100% of the artery, giving good results. It is very often used in cases where the artery is too small for a stent. I would inquire about this procedure.
Look into the vegan diet. My hubby had 2 stents place 13 months ago and was told he'd need a 3rd one eventually. We went on Dr McDougall's vegan diet and within 3 months hubby got off his meds and lost 22 pounds. No 3rd stent required. He feels great and so do I.
Definately seek another doctor. Was this a cardiologist who made these statements.
It just seems like they have this wait and see attitude she said that collate rials should take over the rest.. I am on a vegan diet trying to reverse it to perhaps ease the angina!
They are saying the vessels are two small to stent.. I have a 50% 70% and 80% in small vessels and them in lad two 30's and a 40% one I think they pretty much just have a wait and see attitude!
Great points, ed. I had a 50% blockage in 2000 but turbulence was noted and the decision was made not to stent. I think insurance companies in the USA generally dictate that stents won't be covered unless the blockage is at least 70%. I had just had my first heart attack. Shortly thereafter I had my second heart attack and three stents inserted.
My earlier post was based on the supposition that the vessels were too small to navigate, and perhaps the vessels are twisted.
Shariesue, this is an interesting but worrisome post, keep us informed.
My earlier post was based on the supposition that the vessels were too small to navigate, and perhaps the vessels are twisted.
Shariesue, this is an interesting but worrisome post, keep us informed.
Just to clarify, I assume they are saying that the blockages are too small to stent and not that the VESSELS are too small to stent?
No blockage is too small to stent, that is just nonsense. If there is a blockage which is causing you symptoms, then they need to find out which one it is. I had a 3cm long blockage a couple of weeks ago, and 2 stents were used. The blockage was less than 1%.
Here's what you do. You go to your Doctor and say that studies have shown that the size of the blockage maybe relevant to risk, but certainly not to symptoms. A small blockage can cause enough turbulence to cause the blood flow to reduce. If you want to really make them take notice, ask them for the proof. Ask them what the baseline of flow was at the top of each vessel, and what it was at the bottom. In case they ask what you mean, I will explain.....
They have a tiny sensor on the end of a catheter which measures the flow of blood going past the sensor. ALL cath labs have these but are very rarely used. They guide the tiny sensor to the top of a vessel, say your LAD and take a reading. This is the baseline. If it drops 2 points below that, then you have a problem. So, for example let's say your baseline is 0.9, if it drops to 0.7 as they push the sensor right the way down your LAD, then there is a blood flow problem and ballooning is required. I've read lots of papers where patients have been found with problems caused by a 30% blockage or less, whereas the 70% has caused no flow problems. Size is not the key.
The sensor is FFR (fractional flow rate). I can tell you that they are NOT sure if any of your blockages are causing issues, they simply don't see them as a risk because they are less than 70%. Ask them for the proof and watch their faces.
Here's what you do. You go to your Doctor and say that studies have shown that the size of the blockage maybe relevant to risk, but certainly not to symptoms. A small blockage can cause enough turbulence to cause the blood flow to reduce. If you want to really make them take notice, ask them for the proof. Ask them what the baseline of flow was at the top of each vessel, and what it was at the bottom. In case they ask what you mean, I will explain.....
They have a tiny sensor on the end of a catheter which measures the flow of blood going past the sensor. ALL cath labs have these but are very rarely used. They guide the tiny sensor to the top of a vessel, say your LAD and take a reading. This is the baseline. If it drops 2 points below that, then you have a problem. So, for example let's say your baseline is 0.9, if it drops to 0.7 as they push the sensor right the way down your LAD, then there is a blood flow problem and ballooning is required. I've read lots of papers where patients have been found with problems caused by a 30% blockage or less, whereas the 70% has caused no flow problems. Size is not the key.
The sensor is FFR (fractional flow rate). I can tell you that they are NOT sure if any of your blockages are causing issues, they simply don't see them as a risk because they are less than 70%. Ask them for the proof and watch their faces.
I agree with the other posters. I would get a second opinion. I just went through a situation where secondary vessels were blocked in such a position that stents couldn't be inserted. I have had eight stents inserted, and they were starting to occlude, and it eventually required bypass surgery. I wish I had chosen bypass surgery when my Cardiac Artery Disease was very active twelve years ago.
Regardless what you do regarding medical care, I would urge you strongly to eat a very health-healthy diet, try and exercise daily, and hopefully you are taking drugs to control CAD. Also, are you taking drugs to relieve angina? These drugs include Nitro pills that one should take when angina builds up.
At your age, you have, I would think, a very aggressive case of CAD. It can be stopped, but it takes diet, exercise, medications and interventions, and it sounds like your doctors are no longer considering interventions. I'd get a second opinion in a New York Minute.
Regardless what you do regarding medical care, I would urge you strongly to eat a very health-healthy diet, try and exercise daily, and hopefully you are taking drugs to control CAD. Also, are you taking drugs to relieve angina? These drugs include Nitro pills that one should take when angina builds up.
At your age, you have, I would think, a very aggressive case of CAD. It can be stopped, but it takes diet, exercise, medications and interventions, and it sounds like your doctors are no longer considering interventions. I'd get a second opinion in a New York Minute.
First of all no doctor should ever tell you not to go to the ER with chest pain. That's ludacris! I'm sorry. I went to the ER in 2004 with "symptoms" and it was found that my RCA was 90% blocked. It has been stented twice. I had a heart attack twice after the stents. I continued to have angina unitl it was found last year that I am actually suffering with heart spasms. It took so trial and error to find. And I am being treated for it. But they still bother me a lot. If I have chest pain that worries me I will not think twice about going to the ER. Take care and change doctors. Ally
Yes, I would look for another opinion. Sometimes what it is possible or not, it depends on the experience and material that each doctor/hospital has.Try to get the video of your angioplasty (in a cd) and all your medical records.
However there are a couple of things that I do not understand:
1) What solution has your doctor give you for your angina pain?
2) You do not mention to have angina before the heart attack. Do it appears only after the HA?
Jesus
However there are a couple of things that I do not understand:
1) What solution has your doctor give you for your angina pain?
2) You do not mention to have angina before the heart attack. Do it appears only after the HA?
Jesus
Have an Answer?
You are reading content posted in the Heart Disease Community
Is a low-fat diet really that heart healthy after all? James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines.
Can depression and anxiety cause heart disease? Get the facts in this Missouri Medicine report.
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
Learn what happens before, during and after a heart attack occurs.
What are the pros and cons of taking fish oil for heart health? Find out in this article from Missouri Medicine.
How to lower your heart attack risk.
