should I wait ?

[mikeytambo]

Dear Dr.
     A little background...I am 40 year old female, with no risk factors except a little family history. suffered for about a month with exertional angina, normal ekg, normal nuclear stress
test.March 15 had unstabile angina and vomiting. Went to ER, abnormal ekg, troponin of 4. Had emergency angioplasty 100% well collat. RCA. the LAD is also blocked 70-80%. They didn't fix it then because they paddled me for irregular heartbeat.
My cardio said to wait and see if we should angio the LAD, I went to another cardio and he said a 70-80% block of LAD is not borderline, and needs to be fixed . He said with no angina it can wait till June to see if at that time the RCA is restenosing.
They got an optimal result with RCA. My current meds are zocor, foltx, atenolol 50 mg , plavix, and cozaar, instead of zestril which made me cough. Should I wait, or is this a ticking time bomb.Thanks , Debbie

[AGS]

LAD = Left Anterior Diagonal.  (Left front running diagonally) It supplies a large amount of the heart muscle (myocardium)making up the left ventrical - nick named the "widow maker" because it feeds such a large amount of myocardium.  RCA is Right Coronary Artery.  If you are trying to learn some terminology and understand the anatomy of the cardio-vascular system, check our a local medical book store, and start doing searches on the web using words / phrases like LAD, RCA, angina, etc.

[Addie]

What is LAD and RCA?  I am trying to get educated on these terms for my 35 year old son in law who was recently stented for a supposedly blockage and will have another angio on Friday.

Thanks

[CCF-M.D.-CRC]

Dear Debbie,

To use an oft quoted phrase here "it depends...".  The first thing I would review would be the cath films.  A picture is worth a 1000 words and 70-80% could mean a lot of different things depending on where in the vessel it is located and the overall appearance of the stenosis.  Second, if you are still having angina it should be fixed sooner rather than later.  Third, it depends on how aggressive your doctor is about treating stenosis.  

I think your doctors did the right thing by treating the vessel causing the heart attack first.  Depending on the factors discussed above it may be reasonable to wait until June to make a decision on fixing the other stenosis.