Sir my father just had a coronary arteriography and and the results are'
Left Coronary Artery
Left Main System: bifurcating vessel mild irregularities.
Left Anterior Descending Artery: Diffusely diseased vessel with severe proximal and mild disease. First diagonal branch is a fair sized vessel with severe diffuse disease.
Left Circumflex Artery: Co-dominant vessel with mild proximal and mid disease. first obtuse marginal branch is a fair sized vessel with mild disease. Second obtuse marginal branch is a small sized vessel with mild to moderate disease.
Right Coronary Artery: Co-dominant vessel with total proximal occlusion. Distal RCA visualized by bridging collarterals and collaterals from left system.
LV Angiogram: Fair LV systolic function.
Ejection fraction 50%.
Sir' kindly tell me what this all means & please explain how many vessels disease I have, what percentage of disease is there' and what should you advise in this scenario because I am a patient of Hypertension' My Trop T and cardiac enzymes are normal. please reply me in detail
Thanking you in anticipation.
The results clearly show a lot of plaque in the Coronary Arteries. The Left Anterior descending and Right Coronary arteries are the worst (LAD/RCA).
The Right coronary Artery has opened some vessels to act as a bridge, a natural bypass to partially feed blood past the blockage at the top, but also some vessels have opened up lower down, getting their feed from the left side. The LAD is severely diseased at the top, so I'm guessing the collaterals are being fed from the Circumflex. I would say that he is basically living off of one vessel, the Circumflex which is helping all the heart. There is just mild disease in this vessel at the moment, but if the disease gets worse and affects the flow of blood, then ALL the coronary arteries will be affected making the situation very critical. If the circumflex pressure drops enough, it is likely the collaterals feeding the right will shut down. If the Circumflex is also feeding the LAD, then serious isn't a strong enough word if the circumflex blocks.
I can only see two possible choices here. First is to have the circumflex cleaned up, with stents to give a greater flow for the collaterals. It is also vital this vessel remains clean. Second is bypass surgery which will require probably a triple or quadruple.
Do you suffer a lot of emotional stress in your life? something is causing such a high level of disease.
Personally, if this was my heart, I would go for option 2. I would have the circumflex fully opened with stents and let nature take care of the rest with the collaterals.
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