80%blockage lad 60% blockage rca

[beksmom]

I had a heart cath done 2 months ago due to angina.  I have cad and a stent in my rca.  Cath showed an 80% blockage in the lad and a 60% blockage in the rca above the stent.  One doctor wanted to do a cabg, but his partner disagreed and told me to quit smoking and discharged me.  Now I still have angina ( I have not smoked since I left the hospital).  Should I be concerned with these numbers??

[ed34]

I think you are very wise and I believe you will receive a quick reply from the cardiologist.
I had a case in July 2008 where a surgeon said he could put me into theatre, perform an arterectomy on my left coronary artery, and this would remove all the disease giving me a normal life again. He actually offered to do the procedure a week later. I researched this procedure and told him that I would let him know in due course because I was looking into alternatives. A year later it looked like this was my only remaining option, and although risky, i was sick of my symptoms. So in July 2009 I wrote to him, saying I would like the procedure done. He called me in for a chat and said "I have looked at your angiogram again and I have concluded that an arterectomy will not really gain anything. If I perform the procedure you may get some benefit, but for only a short period of time".
Boy oh boy was I angry. I wrote him a letter and copied it to my GP. I asked why he had changed his mind after a year when using the same angiogram images. If I had laid on his table a year ago, I would have gone through all that discomfort for nothing. I said many other things also but it's best not to repeat those things on here. The letter reached him, but somehow it seemed to leak to other cardiologists in the same hospital. It also seemed to leak to other hospitals, everyone seemed to know about it. I thought all cardiologists would dislike me and refuse to treat me, but on the contrary, they all seemed to think I was correct in my actions and agreed. The cardiologist who recently opened my left artery and stented it said "we've never met, but I like you. You stick up for yourself and that's good". I don't know how that letter leaked out, but that isn't my concern. I have heard that the surgeon concerned is no longer at that hospital.
So I say to anyone, stick up for yourself, we are all human and we all have the same rights to life.

[beksmom]

Thank you very much for your suggestion to get a new cardiologist.  I see your point and I plan to try and make an appointment as soon as possible.  I have also decided to write a letter to the attending cardiologist who discharged me as per your suggestion.

Best regards,
Beksmom

[ed34]

Personally I would go to a different cardiologist. A blockage that is 70% and above is seen as serious and requiring intervention if possible. In your case it is possible. You can 'pray' that you develop collaterals, but of course you may not. The problem is that nobody knows how long that 80% blockage took for form and how long it will take before it reaches the dreaded 90-100%. Puting it bluntly, there is a reason why they call the LAD the "widow maker".
If I was in your shoes, I would write a letter to the Cardiologist you saw, copying it to your GP. I would ask where he obtained information regarding an 80% blockage improving by quitting smoking, because this wouldn't happen. I would also state you have given up smoking but symptoms have not changed, what does he now suggest.
Cardiologists like that shouldn't be allowed to get away with such stupid attitudes. This is your life and I would take it by the horns and sustain it.

[kenkeith]

Unfortunately, some individuals do not tolerate medication very well and that limits options.  Hope it works out for you. Take care.

[beksmom]

Thank you for you suggestions.  Unfortunately I do not tolerate the statins too well due to hypotension.  I am much more positive now that you told me about your angina being controlled with medication rather than intervention.

[kenkeith]

If medication does not reliefve your angina, you may require an interventional procedure, and stent would be first option to consider.  A 60% blockage may not be a problem...but that blockage inaddition to distal stent may be a problem!?  Assumption, less blood flow to the stented area causing reduced flow out of the stent.  There may be some stenosis at that site of the stent.

An 80% LAD blockage may have developed collateral vessels that provide a natural bypass to provide blood/oxygen to the deficit area.  I have a completely blocked LAD and blood flow for the last 6 years provides enough blood to prevent angina with medication.  Statin medication seems to be increasing my tolerance for exercise, and that may or may not be an indication of chol reversal.