My mom who is in her early 70's, recently complained pain in various places in the body. As the pain was predominantly on the right hand and right wrist, she was taking treatment from an Orthopedic who didn't doubt the symptoms she had is really cardiac related. However, when the pain manifested to chest and back, with emergency care, she was directed to Cardiology.
There is no family history of BP or Sugar in her family, and all her siblings living for 88 years or more, and parents as well lived beyond 88 years.
When tests taken,
- CKMB was showing > 80.0 ng/dl,
- Troponin-I showing 14.1 ng/ml.
- ECG was abnormal
- Echocardiogram showed LVEF as 40% with impaired LV Systolic function.
With these reports, the cardiologists confirmed that she might have underwent the attack already hours before she was taken to the hospital.
When Angiogram was taken, the doctors could find only one blockage at 99%, and all the other arteries absolutely fine. Immediately, we have done the Stent and Balloon angioplasty to remove the single block as well. Now she doesn't have any blockage. She was discharged within 2 days, and she appears little weak, and becoming normal gradually.
Though she is stable now, as we don't know when exactly the heart attack happened, and how much we have delayed, we are very much worried.
Can someone help me answering the following questions?
1. Can a single artery blockage cause such a heart attack? Won't the heart still get the blood from the other unblocked arteries?
2. What will happen to the damaged muscles in the heart?
3. Are there any tests to ascertain the damage it had caused?
4. Won't the damaged muscles doesn't revive at all?
5. What are the ways in which the LVEF can improve from 40%?
If the blockage is in one of the major arteries, the anastomotic blood supply may not be adequate. As the blockage has been relieved, the blood supply will be restored and the viable myocardium will survive and this will help improve the ejection fraction. Imaging studies such as stress testing will help ascertain the damage and the present ejection fraction.
Thank you. Unfortunately the only blockage she had was in the main artery that supplied blood on the left ventricle. What we don't know on exactly how much time had actually passed after the heart attack, unable to understand the extent of the muscle damage.
As the blockage was 99% of a major artery, it needs to be immediately relieved. Ways to detect muscle damage are by detecting a diminished movement of the heart walls, referred to as hypokinesis on ECHO. It could also be seen in nuclear scans as defects. But over all the cardiac muscle helps to pump blood, which is reflected in the ejection fraction. If this is good it indicates that the muscle is functioning adequately well. So, keep monitoring this.
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