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Heart Disease (Expert Forum)
Re: Progressive Angina following second CABG procedure
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Re: Progressive Angina following second CABG procedure
by CCF CARDIO MD DLB, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD - DLB on October 08, 1998 at 18:45:53:
In Reply to: Progressive Angina following second CABG procedure posted by Linda on October 08, 1998 at 16:48:00:
My husband, now 52, underwent his first CABG at age 40 - five grafts were used. He has a history of hypercholesteremia(sp?)which doctors have said is related to his genetic makeup. Since the initial by-pass in '86, he has taken medication for high cholesterol, and followed a relatively low fat diet. In April of 1997, (after having progressive angina for about a year), he consult the cardiologist who performed and angiogram and found one to the grafts occluded, but did not feel this could be causing his main. The graft on the left main was 40% occluded. The treatment plan included nitrates, Imdur and Altenolol, Cardizem was also taken. In September of 1997, the angina became significant, and a second angiogram revealed the left main to be 100% occluded. Our cardiologist was astounded at this progression. A 4 vessel CABG was performed, and my husband had an excellent recovery, returning to his work (he is a pastor) in six weeks and feeling better than he had in a few years.
For the past two months, he has experienced angina upon exertion. For a few weeks, he was able to control this by controlling his activity. However, the pain is intensifying and our family doctor has restarted the Imdur and the Altenolol. Since starting this, my husband states he is not experiencing any chest pain.
He is scheduled to see his cardiologist soon, and I am concerned the cardiologist may say since the Imdur is working, let's just keep doing that, rather than taking the aggressive diagnostic approach to determine what is causing the angina. Is my concern valid, and am I being reasonable in wanting to determine if there is further progression of the disease process. Our theory is - if the left main went from 40% blockage to 100% in 5 months, what could have happened in the last year?
Thank you for your consideration of this query.
Dear Linda
I would also favor an aggressive diagnostic approach. The fact that the Imdur works is good, but the fact that he needs it at all is concerning. Your husband has very aggressive coronary artery disease and it is important to try to keep it from progressing. What is his cholesterol level and what medication is he taking?
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.
In Reply to: Progressive Angina following second CABG procedure posted by Linda on October 08, 1998 at 16:48:00:
My husband, now 52, underwent his first CABG at age 40 - five grafts were used. He has a history of hypercholesteremia(sp?)which doctors have said is related to his genetic makeup. Since the initial by-pass in '86, he has taken medication for high cholesterol, and followed a relatively low fat diet. In April of 1997, (after having progressive angina for about a year), he consult the cardiologist who performed and angiogram and found one to the grafts occluded, but did not feel this could be causing his main. The graft on the left main was 40% occluded. The treatment plan included nitrates, Imdur and Altenolol, Cardizem was also taken. In September of 1997, the angina became significant, and a second angiogram revealed the left main to be 100% occluded. Our cardiologist was astounded at this progression. A 4 vessel CABG was performed, and my husband had an excellent recovery, returning to his work (he is a pastor) in six weeks and feeling better than he had in a few years.
For the past two months, he has experienced angina upon exertion. For a few weeks, he was able to control this by controlling his activity. However, the pain is intensifying and our family doctor has restarted the Imdur and the Altenolol. Since starting this, my husband states he is not experiencing any chest pain.
He is scheduled to see his cardiologist soon, and I am concerned the cardiologist may say since the Imdur is working, let's just keep doing that, rather than taking the aggressive diagnostic approach to determine what is causing the angina. Is my concern valid, and am I being reasonable in wanting to determine if there is further progression of the disease process. Our theory is - if the left main went from 40% blockage to 100% in 5 months, what could have happened in the last year?
Thank you for your consideration of this query.
Dear Linda
I would also favor an aggressive diagnostic approach. The fact that the Imdur works is good, but the fact that he needs it at all is concerning. Your husband has very aggressive coronary artery disease and it is important to try to keep it from progressing. What is his cholesterol level and what medication is he taking?
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.
