Re: Genetic Heart Disease

Posted By CCF CARDIO MD - DLB on March 22, 1999 at 16:40:14:

In Reply to: Genetic Heart Disease posted by CAP on March 18, 1999 at 18:34:23:






Pt is 56yo male with genetic heart disease.  Post CABG x5 (2 mammaries, radial and sequential vein), MI on table, sequential graft to circumflex failed immediately post-op.
Echo @ 6wks showed posterior wall down with episodes of non-sustained V-tach.
EP study and AICD. Angina post-op until angioplasties and stent to Circumflex  @ 6mos post-op.  Anastomosis of mammary to LAD found to be sutured 95% closed.  
Some angina with Thallium stress @ 6mos post stent.  Now 9 mos post stent and SOB is increasing as well as Angina.
Cardiologist just added 25 losartan and changed toprol from 50 to 25.
Other meds Folic Acid and aspirin. Imdur 50.  All QD.
BP runs 104/68.  Non-smoker, 5'8', wt 155 and active.
Should angio be repeated?  Can this be treated more aggressively?
Are there any on-going studies for Genetic Heart Disease at CCF?
Thanks in advance for any help available.





Dear CAP
I hope you are on medication to lower your cholesterol - I would shoot for an LDL cholesterol of under 100. It does not matter even if your total cholesterol is within the 'normal' range. We are doing all sorts of genetic analyses in people with premature coronary artery disease, but nothing that would directly apply to your situation (yet). I am assuming that you are on a strict diet.
If you had an abnormal Thallium test, then I think the angio should be repeated. It was not clear to me from your letter whether the Thallium images were abnormal. Also, it was not clear to me if the 95% blockage of the internal mammary was treated.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. 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.