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RCA Block
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RCA Block

I had a stent put in my Left coronary artery last week. I have a 100% block in my RCA that the intervention doctor told me has likely been there for years. I have grown new viens and tributaries around the RCA blockage, so he said he wasn't going to worry about it. I have no damage to my heart that they can see. He says that I may have microscopic damage, but should be fine provided I take the meds, exercise, eat right and not smoke. The angina is gone.


This discussion is related to Can someone live with 100% blockage of right artery?.
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367994_tn?1304957193
I have a totally blocked Left side artery (LAD), and the natural bypass wth "collateral vessels" provides adequate blood supply to the area that is/was normally perfused with the LAD.  The diagnosis was made about 7 years ago and I take a nitrate for some blockage of other vessels and never have had an associated symptoms, and the heart is now normal size and functioning normally (except for a mitral valve) and I feel well.  I take the nitrate prior to going to the health center to prevent some chest pain (angina) with my exercise routine.

You should be all right with the medciation.  A nitrate to prevent angina indicates it is appropriate and is dilating the vessel to increase blood flow.  Also, I take medication to reduce the heart's workload, and that returned my heart to normal size and function.

Thanks for sharing your experience.  Take care and I wish you well going forward.

Ken
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1635396_tn?1301886847
I went to the gym yesterday and today, and did 1/2 hour on the treadmill each day. 3.2 to 3.5 mph with incline a few times, and jogging for a couple of minutes. Heart rate got to 105 once but mostly stayed in the 80's while walking.
BP after was 117 over 67.
Felt good.
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367994_tn?1304957193
I do about the same...3.4 MPH with METs at 4.4.  With the incline you are probably doing 4.8 to 5.0 METs and that should keep you going for a long time.  I'm going on 8 years without any progression verified by tests. You are probably on a beta blocker to keep your heart rate slower than what it would be without the med.

You don't have angina with the exercise?  
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1346447_tn?1327866172
You can manage with medicines provided you control your chlorostrol your food your exercise. Colateral blood circulation helps you circumvate 100 % block. My case is similar one. In fact I have avoided bypass surgery after second openion from the doctor. You may go through my all postings.
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976897_tn?1379171202
It is very common for the RCA to develop cross feeds and adapt for good flow, so there is no real concern there. Mine was seen to be that was in Feb 07 and was probably like it for many years prior. It's just a shame the left artery and circumflex don't have the same level of ability. Now your left artery is opened, you say you have no symptoms which is great, but obviously take it easy for a few weeks so your heart can fully recover/adapt back to normality.
My own experiences have shown that meds, healthy diet, exercise etc haven't really been enough to keep the disease from creating further problems, mine seems to be related to stress. Whenever problems arise at home causing stress, it seems within weeks I start to feel worse and blockages develop quite quickly. Recently, I developed blockages of 99% x2 which started to form just after xmas and I rapidly started to feel the effects. Then last week I had a heart attack. I wish you all the best with your heart and I'm sure you will make the right adjustments to ensure a healthy life.
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237039_tn?1264261657
You asked the poster if he has angina with exercise, so I am wondering if you do?  This is what baffles me. I have the cononary artery spasms that wake from a dead sleep as many as 5 times. I get the spasms with some exertion, but not at all during my walks. I don't measure the distance, just walk briskly for an hour a day.  I NEVER have any angina pain. What?  I will never understand this. The spasms are awful and make me feel like I am about to die.  Can these cause a heart attack? Hmmm
They stented my RCA and that is really the only area that was stented. Twice. A stent in a stent.
Thanks, Ally
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1635396_tn?1301886847
I have no angina now. I had it after about 4 minutes on treadmill before the stent but  I could lift weights for an hour.
My son died a year ago and I had to fight for my grandson through the spring. So everything got off track, and there was a lot of stress.

Now today I went to the gym and did about 16 minutes of treadmill. HR around high 80's with some 90's while inclined.

BP when done was 132 over 77 with 63 HR

Went to eliptical after for 10 minutes and got HR up to about 115 for a minute, then let it slow down.

The funny thing is, on these pills, I wasn't even breathing hard any of the time.

BP was 138 over 85,   5 minutes after I was done eliptical HR was 77 but slowed after about 5 minutes.

I have not had a heart attack fortunately, and hopefully we can keep it that way for a long time.
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367994_tn?1304957193
Ally,
I have a circumflex occlusion that is a little more than 70% and not stented going on 8 years. I take a nitrate 3 times a week before going to the health center....I have no angina with moderate exertion with a nitrate, and I don't have angina with regular everyday living experiences.

My understanding is if there is angina that indicates the heart cells are not getting sufficient blood/oxygen, and that could cause some marginally weak heart cells to go into a low oxygen level (hibernate) and not function normally (hypokinesis).  There are many heart cells (million or more?) with varying degrees of viablity so occasional angina may not be very harmful on the relatively few heart cells.

My doctor recognizes a brisk walk without any symptoms (with med) as a heart condition that doesn't require intervention and to continue the exercise as there are beneficial results...

Obviously, your brisk walk is beneficial for you, but to have chest pain for other activities but not for an aerobic exercise is very unusual as you acknowledge!  Has the doctor considered other sources?

Ken




  
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976897_tn?1379171202
"There are many heart cells (million or more?) with varying degrees of viablity so occasional angina may not be very harmful on the relatively few heart cells."

Yes this is true but it's all about timing. For example, if you exercise several times a day and provoke angina, then the cells will likely not have enough recovery time and damage will deepen. But we have to remember that angina is simply the symptom, not the actual physical part. When we feel discomfort, we simply know something is wrong, but not to what degree. A high level of pain doesn't necessarily mean more cells involved, so it's not really a reliable method of control.
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1346447_tn?1327866172
Stress is very important part in heart attack. Rather than physical stress here I talk about psychological stress. If you are type a personality then it will be with you.If you are perfectionist then you have problem. Accumulated psychological stress though does not bring heart attack immediatly but it is going to happen. Find out your own solution for that. For me I try to avoid the people who bring me such stress.From the information you gave this part is not clear. You may please modify to that extent.
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976897_tn?1379171202
"For me I try to avoid the people who bring me such stress"

I agree fully, but to achieve a full relief of stress, one would have to completely restructure our society. For example, the UK now has record breaking unemployment, huge cost increases and a whole multitude of stress related issues. We can't hide from everyone.
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1635396_tn?1301886847
The Stress doesn't cause the problem, its how you deal with the stress. If you bury it, then it rots you from the inside out.
If you spaz you are probably better off, because  you dump it.
I am just very thankful that I did not have a heart attack, that my angina is gone, that I have no visible heart damage, and that I am still here.

So.............Off to the gym
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