Absent Left Main

[halfheart]

I was diagnosed in 1999,absent left main coronary artery,age 48.I am 56 now.Sept 2006 I had some bad chest pains.My cardiologist sent me for a Nuclear stress test.The results were:
There is an apical infarct with moderate peri-infarct ischemia.
There is apical hypokinesia.
Ejection fraction calculates to 45%.
Afterwards I was given another heart cath( 3rd) which showed absent left maim.Then I was given a Cardiac CT Scan on a 64 dector scanner.The results were:
Coronary Calcium Scoring: The score in the RCA is 46.There is no other coronary calcium.The total score is 46.
Everything showed normal for cardiac morphology.
Left coronary artery:Congenitally absent
Right Coronary artery:The RCA is widely patent.It reveals two focal mostly calcified plaques proximally which are of no hemodynamic significance.
Will you please explain all this to me in layman terms.
I am trying to find some information that I may be able to use to help me with my VA claim on heart disease and Agent Orange and Post Tramatic Stress Disorder,relateing to heart disease when I was Vietnam.I had sarcoma from Agent Orange in 1994.I appreciate any information you can give.
                                     Thank You
                                     halfheart

[halfheart]

I was told that my heart was like Pistol Pete.I don't have a left main completely.No LAD at all.The RCA grew about four times larger than most and hundreds of arterys come off of it encircling my heart.This is how the blood gets to the left side and back of the heart.No bypass surgery can be done because the arterys taper in size.The surgeon said he would not have enough to attach back to.If one blocks off another takes its place.This is how and why I have live for 56 years.Pistol Pete passed away at 40.I have had 3 heart caths at 3 different hospitals and all 3 said the same thing.God Love Me.Now if stress can cause heart disease and the year I served in the Vietnam War was the most sressful situation I have ever been through, having PTSD,then I believe that one year had a great bearing on my heart and my health whether you doctors think so are not.I join the Army to fight for my Country,I wasn't drafted.I was willing to die for the sake of Freedom for you,now, what are you willing to do for me?Is it as likely as not that PTSD could have a direct bearing om my heart disease?Thats all I want to know?Is there a doctor that will give me an answer to this question?If you will, I will appreciate it
                                            Thank You.....halfheart

[Forum-M.D.-MJM]

Hello,
Sorry to hear about your post vietnam health problems and wish you a speedy recovery.

Rergarding the absent left main coronary artery (LM), it depends one what they mean. The LM is a common trunk before splitting into a left circumflex and left anterior descending coronary atery.  Some peole are missing the left main portion but still have normal left circumflex and left anterior descending.  While this is different than normal, it should not cause any medical problems by itself.  I am guessing this is the issue they are referring to.  The other option is that you are missing the left heart circulation -- I doubt this is the case because you would not have been able to servce in an strenuous activity.  Clarify with your current cardiologist, but this shouldn't cause you any problems and simply represents what we call a normal variant.

I hope this helps.

Good luck and thanks for posting.