Re: Collaterals

Posted By CCF CARDIO MD - CRC on March 25, 1999 at 11:56:11:

In Reply to: Collaterals posted by Misty on March 25, 1999 at 10:26:25:






I under went CABGx3 at 31 years of age.At that time angiogram showed "severe,diffuse disease of all vessels".Two years ago at age 42,I had to have redo bypasses.The surgeon was unable to go through the sternum due to both the IMAs adhered to the underside of the sternum.As a consequence,he had to do mini-cabg for one, followed 3 months later via a thoracotomy incision,to bypass the LAD.The surgeon was unable to reach the right coronary artery to perform the necessary bypass.After the second surgery I did fairly well except for mild angina with exertion.The angina progressingly worsened so my dr.decided to perform angioplasty 4 months after last surg.The right saph. vein graft had already totally occluded but he did find a new 95% blockage right below the new bypass to the LAD that he was able to open.He said I had enough retrograde flow from the left system to help prevent an MI, or that if I did have one it would involve only a small area.My heart muscle is in good shape,ejection fraction is"lower limits of normal"& I have mild to moderate angina wiyh exertion. My question is if I push myself on treadmill & go beyond the point I usually stop due to angina, might I develop enough collateral circulation to eliminate the angina completely? Incidently, I also have PVD,for which I've had aorta-femerol endarterectomy & therefore need to develop colaterals for that also. My cholesterol is controlled through diet & Zocor & LDL is below 100.That you for your time.
      Misty





Dear Misty,
Wow, it sounds as if you have a terrible predisposition towards developing coronary artery disease.  Do you smoke or have a strong family history?  Diabetes?  As far as your question goes it is somewhat difficult to answer.  The simple answer is probably yes.  However, there are risks to pushing yourself to hard and if you are going to do this it should be with your doctor's approval and then done in cardiac rehab under monitoring.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.