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211940 tn?1267884866
Right Coronary Artery malformation
I went to see my Cardiologist, for the results of my heart cath, and heart CT scan.
With mixed results, he told me there was an issue with an artery being pinched off, and sent me directly to see a surgeon.  The surgeon looked at the results, did a quick exam and determined, though I have the issue, no surgery was needed.  He said the constant "pressure" I feel, that gets worse with exertion was intercostal spasms or pressure,  and that it was not being caused by the artery issue.  Well, hello, he knew I have MS, and an MS Hug, which I had explained to my heart Dr. as feeling like an "ace bandage" wrapped around your chest, snugly or tightly, and feeling like having a ton of bricks on your chest. So, anyways, short of it, no surgery, at least, at this time.  I wasn't expecting to hear any type of possibility of surgery, in the first place, but I am relieved I won't be having open heart surgery, but it concerns me that I do have the artery issue.

What my Cardiologist told me (and the Surgeon confirmed) was:
I was born with a heart malformation, whereby the Right Coronary Artery, doesn't follow the "normal" path.  In travels between the heart and aorta, therefore when the heart "pumps", it temporarily squeezes off the RCA, yes, that means, it temporarily cuts off blood flow.

What the Surgeon said, was as he looked at the results of the Heart Cath. and Heart CT, was he didn't see any "schema" or anything indicating a significant blood flow problem.

Remember, he was told I have MS, and an MS Hug.

So, during his physical exam of me, he pressed on my chest, rib-cage, etc.
[Note: I fell off my back porch, back in 2009, one of the results was a severe chest contusion]
Yes, the pressure hurt, my chest has hurt since the fall, duh.

Since he believed, that he "duplicated" the results, by pressing on my chest, etc.  He believes it's not a heart issue, but a chest wall issue.  Hence, the intercostal spasms, "theory".

Is this issue with my RCA (Right Coronary Artery), something I should be concerned about, or since the Surgeon didn't think it is an issue, let it go?
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Avatar universal
you should probably go on the ACHD website and find a Clinic and a Adult Congenital Heart Defect SPECIALIST and have your heart checked out...  
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63984 tn?1385441539
I agree with Bubba, you have a complicated issue that needs to be sorted out by a specialist.  Are you in an area close to where a teaching hospital is located?  
Chest pain that is increased with direct physical pressure is rarely cardiac in nature, but it is possible to have physical discomfort as well as cardiac discomfort.  The fact that they didn't find any blockages is very good news, but the fact that your aorta and RCA fight each other is disturbing.  Have you had this symptom for a long time?  I wonder why surgery wouldn't be an option, bypassing the area of conflict between the RCA and aorta?  I'm not a health professional, but those are the two questions I would ask.
Also, drugs like Imdur and Ranexa helped my near constant angina by maximizing the blood flow to the heart muscle, I wonder if they would be a good drug mix.  Keep us informed.
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976897 tn?1379171202
As another perspective. Your Cardiologist did the right thing in sending you to a cardio surgeon for a second opinion. These guys really know their stuff. I think his opinion is that although the right artery is being pinched with each contraction, there is adequate flow to the heart muscle. His job would be to weigh up whether you would feel any benefit against the risk of the risk of surgery etc. If he doesn't feel that you will feel any benefit, then I doubt if you will, after all, it's been like that all your life. It is obviously your right to seek another opinion, and for peace of mind this would probably be a good idea. However, if a surgeon feels you are at high risk of heart damage, then you would be on the operating table.
Perhaps a simple way to prove the point would be to ask for a nuclear perfusion scan which shows how much oxygen is getting to all areas of the heart.
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