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HAD ANGIOGRAM WED...90% BLOCKAGE Treating with MEDS ONLY..
Hi I am 60 yr old femaLE...
So scared... He said it (90% blocakage)was in a lad branch off the main artery... this blocked artery was with soft plaque?.. Said he COULD have done a stent , but risk was that it could cause more damage to main artery, perhaps requiring open heart surgery if the stent was not perfect..... also said 40% in 2 r 3 other areas?? They put me on Plavix, Isosorbide, Asprin, Toprol XL, Cholestorol med... I am at home now and in SHOCK over this news.. There was no damage to the heart, ejection fraction good etc.. had a VERY mild attack he said...Now my BP is low at times... and heart rate low/// in the mid 40s when sitting.. I feel very tired... He took me off the isosorbide bcuz my BP was very low (as low as 80s over 40s)...The BP is better now... but the heart rate is low... .. I feel weak and tired... Im wondering if THAT could be the toprol? I am having a VERY difficult time handling THIS?? Several days ago, I was ENJOYING life... now I am afraid to MOVE... HELP please!
So scared... He said it (90% blocakage)was in a lad branch off the main artery... this blocked artery was with soft plaque?.. Said he COULD have done a stent , but risk was that it could cause more damage to main artery, perhaps requiring open heart surgery if the stent was not perfect..... also said 40% in 2 r 3 other areas?? They put me on Plavix, Isosorbide, Asprin, Toprol XL, Cholestorol med... I am at home now and in SHOCK over this news.. There was no damage to the heart, ejection fraction good etc.. had a VERY mild attack he said...Now my BP is low at times... and heart rate low/// in the mid 40s when sitting.. I feel very tired... He took me off the isosorbide bcuz my BP was very low (as low as 80s over 40s)...The BP is better now... but the heart rate is low... .. I feel weak and tired... Im wondering if THAT could be the toprol? I am having a VERY difficult time handling THIS?? Several days ago, I was ENJOYING life... now I am afraid to MOVE... HELP please!
Just make sure you are sitting down or laying down if you decide to take a nitro pill. I'm not a health professional so I'm hesitant to to say this, but I think the troponol is what is causing your low BP and heart rate. I'd check and see if the dose could be reduced. Beta Blockers are important, but they take some time to get used to and it's best to start with low doses and increase gradually.
The advice to leave the blockage alone and not try to stent it is very good advice. Where the blockage is located is considered a dangerous place to treat, as treatment will almost certainly cause a larger problem than if the diagonal artery were to plug completely.
Do take a nitro pill if you get a crushing, or gripping pain.
The advice to leave the blockage alone and not try to stent it is very good advice. Where the blockage is located is considered a dangerous place to treat, as treatment will almost certainly cause a larger problem than if the diagonal artery were to plug completely.
Do take a nitro pill if you get a crushing, or gripping pain.
Strange though how my cholesterol is well below the national average and my HDL is good, but I still managed to form two new blockages in a short period of time. I just can't get my head around why so much emphasis is on cholesterol lipids. In fact, I've come across a fair number of patients who like me, have low cholesterol, but still form blockages.
Perhaps someone can point to me where I'm thinking wrong? Here's what I understand...
Damage in the artery lining causes HDL to signal for white blood cells to attend the damaged area. LDL injects the white cells with fat, turning them into macrophages. When the macrophages have finished their job, they are supposed to signal HDL to come and remove the fat, but free radicals have damaged that ability in the macrophages. These very large white cells die and leave pure fat lying inside the vessel wall. Nothing in the body can remove the pure fat, because nothing will signal anything to do so. We need cholesterol to live, and so we cannot have zero cholesterol. With all that in mind, how does lowering cholesterol do anything at all? It will not reduce the number of white cells attending the damage, because HDL triggers this and we are encouraged to raise HDL. There are always LDL passing the area so it doesn't matter how many, because some will fill the white cells with fat. In the past, it was believed that LDL simply became trapped in the damaged areas, but we know now that this isn't the case. Rather than reducing cholesterol, wouldn't a better therapy be to lower the free radical levels in the body, or at least understand more on this?
Perhaps someone can point to me where I'm thinking wrong? Here's what I understand...
Damage in the artery lining causes HDL to signal for white blood cells to attend the damaged area. LDL injects the white cells with fat, turning them into macrophages. When the macrophages have finished their job, they are supposed to signal HDL to come and remove the fat, but free radicals have damaged that ability in the macrophages. These very large white cells die and leave pure fat lying inside the vessel wall. Nothing in the body can remove the pure fat, because nothing will signal anything to do so. We need cholesterol to live, and so we cannot have zero cholesterol. With all that in mind, how does lowering cholesterol do anything at all? It will not reduce the number of white cells attending the damage, because HDL triggers this and we are encouraged to raise HDL. There are always LDL passing the area so it doesn't matter how many, because some will fill the white cells with fat. In the past, it was believed that LDL simply became trapped in the damaged areas, but we know now that this isn't the case. Rather than reducing cholesterol, wouldn't a better therapy be to lower the free radical levels in the body, or at least understand more on this?
COMMUNITY LEADER
Flycaster is correct about the Lovaza. The important thing about increasing your HDL is that the HDL is what binds with the LDL or bad cholesterol and takes it back to the liver to be eliminated or more importantly get recycled. If your liver does not get enough LDL back to recycle, it manufactures more which leads to increased LDL. It is also very important to continue monitoring your lipids, even on a vegan diet as there are so many other factors at work that contribute to high cholesterol than just diet.
If there's any drug you can tolerate, Loaza would be a good start. Good luck to you and Flycaster as well.
Jon
If there's any drug you can tolerate, Loaza would be a good start. Good luck to you and Flycaster as well.
Jon
Paula, thanks for the info....Never heard of a CT angiogram... they certainltly didnt mention that to me as an option... Sounds wonderful.. it shows as much as cath angiogram. but not invasive?? So glad you caught yours early!
Flycaster, yes they gave me nitro pills... I have been hesitate to take one because my BP so low ( better now since going off the isosorbide) & now the low heart rate.. in your opinion would it be ok to take it if heart rate is in the 40s or 50s??..
I am so grateful to have found this site.. I dont feel so alone.
Flycaster, yes they gave me nitro pills... I have been hesitate to take one because my BP so low ( better now since going off the isosorbide) & now the low heart rate.. in your opinion would it be ok to take it if heart rate is in the 40s or 50s??..
I am so grateful to have found this site.. I dont feel so alone.
Woogie, did they prescribe a nitro pill or spray? If not, I'd ask for it, especially since they took you off Isosorbide. If you get a chest pain, you can pop one, and if the chest pain goes away, it probably was your blockage. Be prepared for the mother of all headaches, however.
Paula, you make a great deal of sense to me. I tried exactly what you are trying, and it helped, I'm sure. I've lost 50 pounds in the last ten years on a similiar way of eating. However, my cholesterol didn't change much. All of us make cholesterol in our own livers, and sometimes that gets out of whack, like diabetes, and our livers make too much. This kind of cholesterol can only be controlled by medications. I found out the hard way, and have had to have a lot of heart problems and work as a result. I'd continue to be tested for lipids even if you are on a vegan diet. Also, I'm very surprised you can't take Lovaza. That's just fish oil, highly refined, and extremely effective at raising the HDL's, or good cholesterol. I'd reconsider that decision to drop it.
Paula, you make a great deal of sense to me. I tried exactly what you are trying, and it helped, I'm sure. I've lost 50 pounds in the last ten years on a similiar way of eating. However, my cholesterol didn't change much. All of us make cholesterol in our own livers, and sometimes that gets out of whack, like diabetes, and our livers make too much. This kind of cholesterol can only be controlled by medications. I found out the hard way, and have had to have a lot of heart problems and work as a result. I'd continue to be tested for lipids even if you are on a vegan diet. Also, I'm very surprised you can't take Lovaza. That's just fish oil, highly refined, and extremely effective at raising the HDL's, or good cholesterol. I'd reconsider that decision to drop it.
I just had a CT angiogram yesterday. I am 58 year old woman and have high cholesterol, fatique, some angina off and on due to stress and had a stroke in my left eye. Before the stroke in my eye two months ago I felt fine and thought I was very physically fit--I was not on blood pressure medication and didn't know my cholesterol level was so high.
My cardiologist did an EKG, Echo, Stress Test, 21 Day Event Monitor and now wanted to do an invasive cath angiogram, However, I wanted a second opinion and the second cardiologist recommended a CT angiogram. I was much relieved by this option because I think it would be far too easy for my cardiologist while doing the cath angiogram to start throwing stents in even if they weren't completed needed. In otherwords, you might have a blockage of less than 70%, but hey, the cardiologist might think, as long as I'm in here I want to feel like I've gotten something accomplished so why not put in a few stents (which have been called tiny ticking time bombs by some researchers). In anycase, the CT angiogram gives such a completely detailed picture of the heart from every angle and the cardiologist can even go inside of the arteries to see the plaque build up and see EXACTLY how blocked blocked the artery is. I was able to see everything on a computer screen, even my heart as it was beating. And the cardiologist was able to rule out other concerns my first cardiologist had suggested, i.e., that I might have previously had a silent heart attack which damaged my heart or that I might have a left bundle branch block, or that I might need a stent for that, etc. As it very lucky turns out we caught things in time. I do have heart disease, and more than I should have for my age, but no more than 30% blockage in the areas where plaque has built up or calcified (which can be plainly seen as white spots/blobs in the arteries.
I have a very sensitive system can't tolerate any cholesterol lowering drugs I've tried or niaspan or lovaza, but what I am doing is following the Dr. Dean Ornish Vegan diet. I've been on it for six weeks thus far and love the change in foods. I'd much rather give up meats and dairy than have a heart attack or have another stroke and go blind in my other eye. A vegan diet has been proven to actually reverse heart disease over time and dramatic lower cholesterol to safe levels without be toxic to one's liver. So if one has the time, which the CT angiogram showed that I do, it is really smart to make a life style and diet change. Less stress, more serene exercise, meditation and eating all the Vegan food you want and getting healthier by the day.
My cardiologist did an EKG, Echo, Stress Test, 21 Day Event Monitor and now wanted to do an invasive cath angiogram, However, I wanted a second opinion and the second cardiologist recommended a CT angiogram. I was much relieved by this option because I think it would be far too easy for my cardiologist while doing the cath angiogram to start throwing stents in even if they weren't completed needed. In otherwords, you might have a blockage of less than 70%, but hey, the cardiologist might think, as long as I'm in here I want to feel like I've gotten something accomplished so why not put in a few stents (which have been called tiny ticking time bombs by some researchers). In anycase, the CT angiogram gives such a completely detailed picture of the heart from every angle and the cardiologist can even go inside of the arteries to see the plaque build up and see EXACTLY how blocked blocked the artery is. I was able to see everything on a computer screen, even my heart as it was beating. And the cardiologist was able to rule out other concerns my first cardiologist had suggested, i.e., that I might have previously had a silent heart attack which damaged my heart or that I might have a left bundle branch block, or that I might need a stent for that, etc. As it very lucky turns out we caught things in time. I do have heart disease, and more than I should have for my age, but no more than 30% blockage in the areas where plaque has built up or calcified (which can be plainly seen as white spots/blobs in the arteries.
I have a very sensitive system can't tolerate any cholesterol lowering drugs I've tried or niaspan or lovaza, but what I am doing is following the Dr. Dean Ornish Vegan diet. I've been on it for six weeks thus far and love the change in foods. I'd much rather give up meats and dairy than have a heart attack or have another stroke and go blind in my other eye. A vegan diet has been proven to actually reverse heart disease over time and dramatic lower cholesterol to safe levels without be toxic to one's liver. So if one has the time, which the CT angiogram showed that I do, it is really smart to make a life style and diet change. Less stress, more serene exercise, meditation and eating all the Vegan food you want and getting healthier by the day.
Ooo sorry to hear that Flycaster (luv ur nic) It does sound like the same thing... Do u still cast?? Wishing you well w the surgery.. keep me posted K?
Thank you ed.. I will look this up... and mayb there is a better one.. I dont know. I have lived here all my life.. and people come here all over to see the heart doctors here.. they have a good rep. but I just had a gut feeling i did not like about the appointment... possibly because he was off his game due to sickness.
Ally, you are a good encourager :)... thanks!... I am sure gonna try to get myself FIT. & Good for you !!
SOme chest pain woke me in the night... I had gas cuz I could feel it bubbling around.. so hoped it was the gas?? No telling how long I haVE BEEN WALKING AROUND W THIS BLOCKAGE... , BUT NOW THE SLIGHTEST CHEST PAIN OR INDIGESTION GETS WAY MORE OF MY ATTENTION THAN B4... sorry caps... THAT is the part that is hard to live with... I was thinking mayb I should get up and go to the ER... but then, just didnt know what I should do... I finally just went back to sleep,, hopinng I would wwake uP... Its sure not an ez thing to adjust to is it// When do u know to go get help?
Thank you ed.. I will look this up... and mayb there is a better one.. I dont know. I have lived here all my life.. and people come here all over to see the heart doctors here.. they have a good rep. but I just had a gut feeling i did not like about the appointment... possibly because he was off his game due to sickness.
Ally, you are a good encourager :)... thanks!... I am sure gonna try to get myself FIT. & Good for you !!
SOme chest pain woke me in the night... I had gas cuz I could feel it bubbling around.. so hoped it was the gas?? No telling how long I haVE BEEN WALKING AROUND W THIS BLOCKAGE... , BUT NOW THE SLIGHTEST CHEST PAIN OR INDIGESTION GETS WAY MORE OF MY ATTENTION THAN B4... sorry caps... THAT is the part that is hard to live with... I was thinking mayb I should get up and go to the ER... but then, just didnt know what I should do... I finally just went back to sleep,, hopinng I would wwake uP... Its sure not an ez thing to adjust to is it// When do u know to go get help?
You and I have exactly the same problem, I think. I'm blocked 90% in the first branch of the LAD in the ostial position (where the artery branches off) as well, and 90% off a branch of the Right Coronary Artery. Trying to fix the LAD block is considered too dangerous in my case. There are a lot of factors, I've learned, why this blockage is sometimes not fixed. The curvature of the LAD, the angle of the branch are important considerations. Balloon therapy, which pushes the plaque away from the blockage, is sometimes very dangerous if the plaque could be pushed away from the blockage and into the main artery.
In my case, I'm meeting with a surgeon to plan bypass surgery, as I can't afford another heart attack, I've got too much heart damage. I'd listen to your doctors, and quite frankly, mixing in a heart healthy diet is essential. Best wishes, keep us informed.
In my case, I'm meeting with a surgeon to plan bypass surgery, as I can't afford another heart attack, I've got too much heart damage. I'd listen to your doctors, and quite frankly, mixing in a heart healthy diet is essential. Best wishes, keep us informed.
It could be that you don't feel any pain because of your meds, especially beta blockers. Two years ago I was on those and I tried coming off them because I felt fine. Sheesh, I can tell you that within 36 hours I was back on them again. Everytime any anxiety entered my body, it was like being kicked in the chest and having the wind removed from my lungs.
Ahhh, yes the skipped beats! I used to run around having everyone feel my pulse because it would literally stop and start up again. I had SVTs and was put on Amiodarone. After taking that drug for 9 months I stopped. I had to be monitored while on that drug and all the awful side effects! I decided to quit. That was 4 years ago and the SVTs have not returned. Getting started on the exercise was such a BIG effort. But once I got into a "groove" with it I can't seem to get enough! Strange things is, I never have a spasm while exercising, but they will wake me from a dead sleep, sometimes 4 or 5 times a day. Those are getting better though. Before the Norvasc I was having them 10 or 12 times a day. Now I can have a long stretch without any (maybe a couple of weeks). The exercises make me feel so much better, also. We live and learn in here. But the best part is we are LIVING! Take care, neighbor. Ally
Good morning good people!
Thank you so much for replying! This WAS a second opinion in a round about way..... Mayb I should give a little more background info....Since I was about 18 I have had an irregular heart beat that I FELT every time it misbehaved.. THIS turned me into a pulse feeling, nervous wreck for YEARS... I saw doc after doc ... had EKGs Ultra sounds Echos, holters thaliums & angiograms (like 4angiograms between ages 30- 50) NOTHING was serious.. just the skippings & sometimes racing heart beat. But THAT drove me crazy... FINALLY, THIS doctor (the one I am going to now) put me on a drug called Rythmol, and the agonizing pvcs STOPPED. THis was about 5 yrs ago.... I quit worrying and being obsessed with my heart...I LIVED LIFE..... I also lost my ins not long after this, so quit going to doctors.... until this... I went to the ER because I had high BP.. 200's/110.... The EKG was not normal and the blood work was elevated... My cardilologist was out of town, so one of his partners did the angiogram... He is the one that said medication would b the best treatment for me saying stent would b too risky.... When the BP got so low, I called my regular doctor and he wanted to see me. At first he said he thot he needed to try a stent ( however explaining to me how RISKY it would be) He then said to me..." you are VERY unlikely to have a heart attack".... I said, 'then why do I need a stent?" He said for the PAIN... I said I dont have Pain... He then scratched his head, studied the chart and said he didnt feel well and would need to look at the VIDEO of the angiogram bfore deciding(he was only looking at the still shot) He shook my hand & left the room... They made me an appointment for 2 mos later ! Im thinking mayb he saw I didnt have insurance any more and thot twice about wasting his time??? I know that sounds bad to think such a thing, but it DID cross my mind. I Do KNOW he was sick that day, so hopefully that is why it was such an odd appointment.
Ally I am also a southern cook.. chicken fried steak & gravy in these parts have made cardiologists in the area the richest in the country! I had already started a healthty eating plan (The Makers Diet) before all this happened... NOW, I KNOW i must stick with it!
I guess I always thot IF they find anything, they will stent it or balloon it, I never dreamed they would do NOTHING... (well except for medication) I have felt like a walking time bomb since. Very anxious, weak, dizzy spells, tired...like I said, afraid to move! Also they took me off the Rythmol, and the pvcs are showing up again... ugh!
Thank you so much for replying! This WAS a second opinion in a round about way..... Mayb I should give a little more background info....Since I was about 18 I have had an irregular heart beat that I FELT every time it misbehaved.. THIS turned me into a pulse feeling, nervous wreck for YEARS... I saw doc after doc ... had EKGs Ultra sounds Echos, holters thaliums & angiograms (like 4angiograms between ages 30- 50) NOTHING was serious.. just the skippings & sometimes racing heart beat. But THAT drove me crazy... FINALLY, THIS doctor (the one I am going to now) put me on a drug called Rythmol, and the agonizing pvcs STOPPED. THis was about 5 yrs ago.... I quit worrying and being obsessed with my heart...I LIVED LIFE..... I also lost my ins not long after this, so quit going to doctors.... until this... I went to the ER because I had high BP.. 200's/110.... The EKG was not normal and the blood work was elevated... My cardilologist was out of town, so one of his partners did the angiogram... He is the one that said medication would b the best treatment for me saying stent would b too risky.... When the BP got so low, I called my regular doctor and he wanted to see me. At first he said he thot he needed to try a stent ( however explaining to me how RISKY it would be) He then said to me..." you are VERY unlikely to have a heart attack".... I said, 'then why do I need a stent?" He said for the PAIN... I said I dont have Pain... He then scratched his head, studied the chart and said he didnt feel well and would need to look at the VIDEO of the angiogram bfore deciding(he was only looking at the still shot) He shook my hand & left the room... They made me an appointment for 2 mos later ! Im thinking mayb he saw I didnt have insurance any more and thot twice about wasting his time??? I know that sounds bad to think such a thing, but it DID cross my mind. I Do KNOW he was sick that day, so hopefully that is why it was such an odd appointment.
Ally I am also a southern cook.. chicken fried steak & gravy in these parts have made cardiologists in the area the richest in the country! I had already started a healthty eating plan (The Makers Diet) before all this happened... NOW, I KNOW i must stick with it!
I guess I always thot IF they find anything, they will stent it or balloon it, I never dreamed they would do NOTHING... (well except for medication) I have felt like a walking time bomb since. Very anxious, weak, dizzy spells, tired...like I said, afraid to move! Also they took me off the Rythmol, and the pvcs are showing up again... ugh!
Get a second opinion. But to try and prove to you that you can still live a full life I will give you some of my experience. In 2004 I went to the ER with some symptoms, not a heart attack. They found my RCA was almost totally occluded. It was stented and then I started having angina. The following year I had an actual heart attack. They found some smaller blockages. Another year goes by and I have yet another heart attack. They had to stent the stent to reopen it. After this I decided it was time to make some changes. I changed my diet (what a challenge that was being a southern woman. everything fried and served with gravy) Then I began to exercise, I now walk briskly for an hour every day. Take my meds and supplements. I feel healthier now then when I was 30. I do have another blockage that will require bypass, but as long as it is not a bother I will not have that. Last year I found out that my angina is actually coronary artery spasms. Just knowing this helps me deal with it.
I'm telling you all of this to prove to you there is always a way to better health. The hard part was getting started. I would certainly see another doctor and get some answers. Your beta blocker dosage sounds like it is too high for you. That may need adjusting. I take the same meds basically, and I can't deal without my beta blocker. I feel so bad. I also take the Isosorbide and a calcium channel blocker for the spasms as well as a few others.
Take care, Ally
I'm telling you all of this to prove to you there is always a way to better health. The hard part was getting started. I would certainly see another doctor and get some answers. Your beta blocker dosage sounds like it is too high for you. That may need adjusting. I take the same meds basically, and I can't deal without my beta blocker. I feel so bad. I also take the Isosorbide and a calcium channel blocker for the spasms as well as a few others.
Take care, Ally
Get a second opinion. To shove you on meds and ruin your quality of life is not good heart management. He could have tried to balloon it as the blockage is 'soft' and although 30-40% of these re-block, that still gives a 60-70% chance that it will stay open. Why stenting will damage the main LAD is a bit strange, with the equipment they have today they can be very accurate at positioning stents. During my last procedure I had a cardiologist who was in his final year of learning, which I agreed to, but he was overseen by a very renown expert in my area. A couple of times the expert told him that the stent had slipped by 1mm and he should reposition it BEFORE inflating, and run another test (more dye). It just doesn't sound to me like your cardiologist has much confidence or experience. Do some research on him, I have looked up all mine on the internet to see their qualifications, when they left medical college, their area of expertise and how long they have been practicing stenting.
Tiredness is part of the medication side effects, it should be better in a couple of months.
However, if your BP is very low, this can also cause tiredness.
Since we are speaking about the opinion on how risky is to stent it, my advise is to get a copy of the your angiography, (the video of the procedure in a CD) and try to get a second opinion from a hospital with large experience on that sort of intervention.
Jesus.
However, if your BP is very low, this can also cause tiredness.
Since we are speaking about the opinion on how risky is to stent it, my advise is to get a copy of the your angiography, (the video of the procedure in a CD) and try to get a second opinion from a hospital with large experience on that sort of intervention.
Jesus.
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