70% blockage

[JJA610]

had open heart surgery back in 2003 double by pass not they tell me I had a 60 % blockage two years ago but sinse I'm having severe chest pains it probally has increased to 70% and probally will have a stent sisne its 70% What is your opoion on this matter. THANKS J.J.

[ed34]

It is very difficult for Cardiologists with some patients. The reason being, that angiograms do not reveal all vessels. Most collateral vessels are totally invisible on an angiogram because they are so small for example. This can be very misleading with proposed treatments. Let's say you have two blockages, one at 50% and one at 80%. During a stress test it simply reveals ischemia to the left side of the heart. You then have an angiogram which reveals the two blockages, 50 and 80. The Cardiologist will follow guidelines put in place, which state anything 70% or above should be stented. Now, this means that the 80% will be seen as the culprit causing the pain, it will be stented, and the 50% will be left alone. After treatment, you still feel chest pains, but why? because the angiogram didn't reveal that collaterals were bypassing the 80% blockage, and the 50% was causing you the pain. In the higher proportion of patients, these rules seem to work, but for many thousands of others the rules do not fix the problem. Some people have chest pains from 40% blockages, some won't feel a thing until it reaches 90% or more and this is probably because collaterals form differently in all of us.

[JJA610]

Believe this or not my card. has done stress test which shows blockages and has the angiograms done and it shows different in fact she just told me the other day if we did the stress test again it would show the same results along with the same results with the angiogram. It don't make sinse to me totally confused. jja

[kenkeith]

I have had a 70% blocked circumflex vessel for more than 6 years, and I take a nitrate prior to any rigorous activity.  With proper diet, exercise, medication there has been no advancement.  If you are having chest pains (angina) due to the blockage, and there is no relief with mediation, then a stent may be implanted.  

A stress test would be helpful to determine if there are any other blockages as well as the known occlusions status

Thanks for sharing your experience, and if you have any followup questions, you are welcome to respond.  Take care