Jaw pain and chest pressure 6 mos after CABG

[Auntino]

41 yr old female, insulin dependent diabetic 30+ yrs, P.a.d., 20 lbs overweight. I used to smoke but quit 6 mos ago.  After disasterous results with stents (12 in RCA) within an 18 mos period, quadruple CABG was done 6 mos ago after a new blockage to the LAD showed up and it was not there 3 mos before.  6 mos later I notice jaw pain w/ and w/o exertion as well as chest pressure w/ and w/o exertion and especially after a heavy meal or upset.  I am on Lipitor, Zetia, Topral, Plavix and aspirin and the chest pressure - when persistant (comes and goes throughout some days but not here everyday) does respond to Nitro.  The Dr. recommends an angiogram but I am reluctant after so many.  Do you think it is necessary and what are the odds of the native arteries being blocked?  My last cholerterol check was in April and overall was 207, HDL 33, LDL 1450, Triglycerides  130.  

[Forum-M.D.-MJM]

Hello,
Sorry to hear about yor struggles with coronary disease.  Your symptoms do sound like cardiac chest pain or angina.  With your history, I would not take the chance.  An angiogram sounds like a reasonable strategy to assess for blockages.  The odds have you having a significant blockage with the symptoms you describe and the history is high enough to justify taking a look with an angiogram.
I hope this helps,
thanks for posting.

[save]

It sounds like you have really been through a lot.  I am facing another cath and had open heart surgery about 6 months ago.  A cath is  not something one wants to keep doing.  Did they ever give you any form of nitro?  It really does help me.  I wear the patch, and I can tell the difference.  It sounds like you have blockage that returns.  I wish that I could tell you what to do, but everyone (medical) is telling me that I need to do the cath and not take a chance of a heart attack.   The cardo told me that when I have symptoms, my heart is in distress.  He said in time it damages ones heart or they can die.   I was in rehab and put out.  I have put it off for 2 months now, but I am just about ready to give in.  Let me know what you decide.

[Auntino]

It's been a bit tough but I'm doing what I'm supposed to and thats all I can do.  I am going to say yes now to the angiogram.  I just can't imagine it being anything because it's only been 6 mos since the surgery.   Good luck to you too.  Why were you put out from rehab and why do you need another angiogram so soon since your surgery?

[Auntino]

Thank you for your advice.  1 mistake. My LDL was 145 - not 1450 but I'm sure you realized it was a typo!  I just can't imagine there being anything new because it's only 6 mos since the CABG but you are right that the odds are strong that there will be.  If my own dr had just said that, I would not have been so undecided.  He just says "you know where this is heading" and schedule it when you're ready.  Your advice was cut and dry.  Thanks - I'm going  to go for it.

[anacyde]

I would do the angiogram if it were me.  My father had some pain after his CABG surgery and it turned out he needed a few more stents.  It was 6 years later, not six months, but everyone is different.  He's doing well.  Definitely keep on top of your health.  I hope all goes well for you.