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70% Blockage
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70% Blockage

I hope somebody can help me.  I recently had Coronary CT & my cardiologist says I have a 70% blockage of the LAD which is mild to moderate.  He put me on Crestor & Plavix and I absolutely cannot tolerate statin drugs, but I tried the Crestor anyway, have been on 9 different ones and they all affect me the same way.  By the second day I'm not able to even function, can't even walk from one room to the next.  I  Gave the Crestor a week & couldn't even get out of bed, have been off of it for 3 days and am almost back to normal.  He told me to start taking Omega3, CO CQ10 & Vitamin B Complex.  My only symptom with the blocakage is shortness of breath after activity.  He said I could get a stent, but would still have to take meds after, so he advised I try to take care of it with meds & lifestyle.  I already exercise, am not overweight, eat right, don't smoke, don't drink.  Guess I'm just scared that I'm going to have a heart attack, since I can't take the meds.  Some people say I should have by pass surgery, but he didn't suggest it, and I've always heard that insurance won't pay unless it's 80% blocked or more. How serious is a 70% blockage?  He didn't act very concerned.
I would appreciate any input anyone has.

Thank you!
Patsy223
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367994_tn?1304957193
Your doctor is following the guidelines of the AHA and AAC....stents less than 70% treat with medication.  I have 73% blockage of the circumflex and have been treated successfully with medication.  Successful treatment means there are no symptoms (angina chest pain)...that is usually caused by vessel blockage greater than 70%.  Shortness of breath is not an indication of the blockage...if it were related to the heart, it would indicate low volume of blood pumped with each heartbeat a more serious condition and also SOB could relate to your respiratory system, etc...  

Your doctor isn't providing any medication for ischemia (lack of blood flow due to vessel blockage...your 70% LAD block).  You are being treated to lower the probability to further block your vessels with plaque.  Unless you can have acceptable cholesterol level, etc. with diet and exercise, the doctor believes it is in your best interest to be medicated.

You don't requrie a bypass nor a stent.  Reduce your lipid level is the treatment advised. You may have to work out something out with your doctor regarding the medication...


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976897_tn?1379171202
"How serious is a 70% blockage?"
"My only symptom with the blocakage is shortness of breath after activity"

You have basically answered your own question, but in reality 70% is not classed as life threatening. Your coronary arteries are actually larger than they need to be, which is a great thing. If the vessels are only able to carry enough blood for your hearts needs, then you would be on your knees by now. However, I would monitor your shortness of breath and if it gets worse, make sure you notify your cardiologist. Statins are a very good way to help stabilise the problem because they have a two fold effect. First they prevent the liver from producing so much cholesterol, then the liver has a deficit of cholesterol to produce bile, so it recalls a fair amount of LDL back from your circulation to recycle it. Many side effects from statins disappear after a few days, but if not then you are obviously intolerant to them.
Around 70-80% of the cholesterol in your body is made in the Liver, so 20-30% is collected from foods you eat. I have hypercholesterolemia and have both sides inhibited by drugs. I take statins for the liver, and ezetimibe(ezetrol) to inhibit fat absorption through the gut. Maybe your Doctor could consider this as an option, a drop in 20% is a quite a high number to play with.
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367994_tn?1304957193
What is the etiology of shortness of breath and ischemia?  If the cardiac output is sufficient there well be no shortness of breath.  I may be incorrect but schemia (vessel occlusions) does not reduce CO. What is your basis for SOB and ischemia?

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1294473_tn?1272388180
Thank you all so much...I feel much better!  I also had a CT scan of my lungs and they and all pleural areas were clear.  I think my shortness of breath is from my BP meds.  When I was off of them for awile the SOB went away, but Dr.'s never believe you when you tell them you think it's the meds!
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367994_tn?1304957193
Thank you for your response.  Unfortunately some blood pressure medications may cause  shortness of breath. It is good to have a pulmonary issue ruled out.  Take care.
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976897_tn?1379171202
"If the cardiac output is sufficient there well be no shortness of breath"

I really don't understand why I always seem to be the exception to the rule. I suffer from shortness of breath, gasping from one flight of stairs, and my EF is 70%. No pulmonary issues and heart anatomy is in great shape.
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712042_tn?1254572809
If you are going the medication route, and you really have to, then speak to your doctor about prescription fish oil, called Lavaza. It is pure and each dose consistent. It is a great anti-inflammatory, works on lipids, beneficial for joints and other things.
Yes, there are known exceptions involving the heart microvessels, cardiac output and shortness of breath. Watch your exertion and keep track of your SOB triggers.  Best of Luck. Joan.
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367994_tn?1304957193
"I really don't understand why I always seem to be the exception to the rule. I suffer from shortness of breath, gasping from one flight of stairs, and my EF is 70%. No pulmonary issues and heart anatomy is in great shape".

Do you have shortness of breath when running?
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976897_tn?1379171202
"Do you have shortness of breath when running? "

Strangely enough I tried it the other day when the dog escaped. I ran about 30 paces and was bending over gasping for air. Throat discomfort was immense and chest pains mild. All vanished after 20 seconds of rest. I thought I would maybe reach further on the second attempt so set off again. Same distance, same problems, so I gave up got my son to get the dog. On a flat surface I'm great at walking, I can go on and on for what I believe would be miles. Even a 1 degree incline seems to have a huge impact. I often say to my son "we are going up hill" but he laughs saying it's flat. I know it isn't because of the effect and when we walk back the other way its very easy. Last weekend I tried a bike again. I managed to get the peddles round about 10 times and I actually fell off where I was so weak. With an EF of 70% you would assume there's plenty of oxygen getting around. My legs/arms etc all feel fine, they dont ache. I just get very short of breath. So I have to assume the coronary arteries have some kind of control over breathing rate OR the heart muscle injects something into the blood which is picked up by respiration control?
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