What % Before They Do A By Pass

[ChatterAlly]

I just left the hospital AMA because I wanted to, but before I did the cath showed a 50% blockage in a vessel that cannot be stented.  I will have to go back to a facility that performs interventions like this.  My question is this, if they wait until a vessel is more than 70% blocked before they stent, is this the same rule for by pass?

Thanks, Val

[Flycaster305]

I was hoping to hear that your spasms are relieved by the medication, sorry to hear you are still having them.  Hopefully the Cardio can bring this to an end for you.

[ed34]

I start them tomorrow so I will report back here and let you know if I feel any change.

[ChatterAlly]

Let me know how that goes, because I am desperate here for answers.  As I sit here I am having the same chest pain.  I take the Norvasc for the spasms, but that isn't enough.  Thanks.

[ed34]

I would be very surprised if a 70% blockage would cause angina at rest, such as sitting down in the evening. It may be noticed upon a lot of exertion but then it would vanish when you relax again. If you have bouts of angina when at rest, then I would bet my money on the spasms or another blockage somewhere. A blockage will cause what's known as 'stable' angina which means you will get angina when expected, such as when walking. If you have angina at rest through a blockage, then this would be there continually and not suddenly vanish and would require emergency treatment.
I went to my Doctor today funny enough and we had a long discussion about my symptoms which are getting worse again. At long last he has agreed to give me nitro patches recommended by my cardiologist. I pick them up tomorrow and he wants me to use them to see if my LAD is having spasms.

[ChatterAlly]

For the past couple of weeks I have had nothing but bouts with angina.  Day and night.  Angina should not be a problem when you are asleep.  Whether or not it is being cause by vasospasms or the occulsion remains to be seen.  I have the pictures from yesterday's cath and will take that to the cardio.  But I am still having chest pain.  Much more so than anyone should have to endure.  I just pray I get more answers and soon.  Thanks to all!

[kenkeith]

Why it can't be strented may be relevant. For instance, a section may be twisted (tortuous vessel) and that area may be a section that impedes normal blood flow notwithstanding an occlusion, etc.  There can be an exception regarding degree of occlusion.  For instance, if pain can not be successfully managed, there may not be a choice.

" When the channel is reduced by more than 50% (of the diameter) the artery may become obstructed enough to decrease blood flow to the heart muscle during times of increased need (exercise, emotional stress, etc.). During such times, the blood pressure and heart rate are both elevated and increase the need of oxygen and nutrients by the heart muscle".  The 50 to 70%.usually can be successfully treated with medication.  

[ChatterAlly]

Thanks!  I thought so.  The majority of the chest pains I am having are actually coronary artery spasms.  (vasospasms) You should see what they do to the monitors when I have them.  Those are no fun to have.  I will need to discuss with the cardio I see next week what I can do about those.  I am taking Norvasc for that but obviously I need something more or something else.  Thanks again.

[ed34]

Yes, because a main coronary artery is not considered life threatening while under 70%. A bypass or stenting should hopefully have the same results, so the guidelines are the same.
A 50% blockage sounds huge but in coronary artery terms it isnt, and if you make the necessary lifestyle changes and take advised medication then it may never increase or may even reduce slightly.