Problem area in diagonal off Left Anterior Artery

[TJ38]

My doctor is at Albany Medical Center, Heart Institute.  I had the nuclear stress test and EKG showing that blood pressure jumps when i'm on the tredmill and the pictures showed that there is a 'spot' that doctor wants to look into in the area described in titled above.   I have a cardiac cath scheduled for next week.   I'm in my late 30s.  I'm very nervous.  Doctor says they will go in and if they see a problem will put in a stent.

Questions:
1. Is Albany Medical Center a reputable facility ?
2. Should i get a second opinion ?
3. Will i be able to find out what blockage i have in each of my arteries ( percentage ) from having this cardiac cath ?
4. Does the fact that I have a blockage in a diag off the LAD usually indicate that there is additional heart disease ?
5. Am i too young to have a stent in my chest ?  I'm nervous about all this talk on forums about "20% reclosures occur".  Seems like having a stent often ends up in added problems and eventually open heart surgery.
6. Do you know of any patients that have had stents put in in their late 30s and live on without additional problems ?

I am not a smoker but have been eating heavy with stress and no excercise for last 10 years of my life.  I put on 50 lbs in my last 8 years as well.

Look forward to any help/feedback to keep up my spirits.  I have kids and a wife and i'm scared.

[CCF-M.D.-DLB]

1+2. I am not in a position to know these answers.
3.Yes, the cardiac cath will allow your cardiologist to know the extent of coronary artery blockage in all your heart arteries. Also, sometimes the stress tests are wrong.
4. No, not necessarily. You could have blockage in just one artery.
5. No. We put stents in 30 year olds if it is necessary.
6. Most patients with stents do not have problems from the stent per se. However, the fact that someone needs a stent at such a relatively early age is indicative of aggressive coronary artery disease and there is a high likelihood of needing addtional procedures in the future.

[TJ38]

The doctor mentioned a term "aggressive coronary artery disease".  Is this 'disease' something that can really be 'stopped' by habit changing, medication, etc ?  Or is it like a cancer where once the plaque starts forming it starts to multiple cells ?

[christine m. smith]

Hi!

My nuclear scan showed a similar thing, specifically described as "mild ischemia in the area of the left anterior descending artery" and the cardiac cath showed normal coronary arteries. I went into the cardiac cath looking at a "no-win" situation, in my opinion. If the cath was abnormal, that wasn't good and if it was normal, I had no explanation for my symptoms which bothered me enough to seek help in the first place. Like you, I was worried about all the "restenosis" I read about with angioplasties. The cardiologists kept telling me the normal cath was very good news but I'm not 100% convinced.  I understand your anxiety.  Good luck.

Chris S.

[TJ38]

First, the procedure is completely without pain.  You get vallium and benodril first to get you a little more relaxed.  Then they give you a small local shot of novocaine in the area where your right leg ( in my case )meets your hip.  You don't need to urine cath setup (for you guys as nervous as i was ).  Then you go in this cool room with music playing and they drip some of this stuff into your IV and you feel like you have no worries.   You feel very slight pressure when they insert the cath probe into the leg area ( very very little ! ) and from that point on all you feel is a very slight warming in your heart area as they inject some die to watch your heart.   The whole procedure is mostly their time setting up and getting nurses freed up ( from other cath lab things going on ) and getting the doctor in to do the procedure.   Where I had mine done ( Albany Medical Center in New York ) they do 20 cardiac caths per day.   FOR ANYONE NERVOUSE, DON'T BE.  I'M THE BIGGEST BABY AND I CAME OUT OF IT FINDING THAT IT WAS EASIER AND LESS COMFORTABLE THAN GETTING A CAVITY FILLED.  HONESTLY!  In my case, the thallium test was a false positive and they found that all my arteries where healthy.  I'm going cold with coffee which is the only thing the doctors can definitely pin my palpitations to my habits.

[wes]

Brother has Coronarty Artery Disease.  Has had 7 stents and one CABG that failed.  Most recent attack shows that his LAD is completely blocked.  What does that mean - I know he is not getting enough blood to the front of his heart - so does that mean he will continue to have problems.  Doctors here say there is nothing they can do for him.  So what is his time span of life?  How critical is this LAD portion of his heart?  If you could give me feedback in layman terms I would appreciate it.  My husband has had liver transplant so I have a fairly good working knowledge of medicine.  Thank you for your time.