Will only medication help and is the current on good enough

[joshaan]

My mother who will be 80 next month was often complaining of breathlessness, weakness and pain sometimes in her chest and rib cage. Her daily BP count was never over 140/85 but pulse was high, always between 90 to 105.  She is not obese, no diabetes or any serious ailments.  Of late her breathlessness was getting worse, with loss of appetite and feeling of weakness.  We had several ECG's and an Echo ( doppler) test done and turned out negative.  Only thing that came up was that her haemoglobin level was way low at 7.2.
  
However things took a turn in March this year when she complained of severe pain on both sides of her rib cage upto the armpits.  The ECG this time showed some irregularities and she was asked to undergo an Angiogram. It turned out that there were clots in her Right Coronary Artery which showed a blockage.  She was given "clot busters" and Heparin and was given 2 pints of blood.  She was asked to undergo an Angioplasty with 2 stents to be put in but she was adamant that she did not want it as she preferred to take the route of medication and she is too weak to undergo another procedure.  She was given Ecosprin 150mg Atorvstatin 40mg and Clopidogrel 75mg along with the Beta and calcium blocker ( Amlez) that she used to take and some antacid and tonics.  She also take Stugeron for her chronic dizziness.

I took a second opinion from another specialist who said the treatment is aggressive but good and looking at the angio said that the blockage looked 60%.  Though she is hypersensitive to medicines she has tolerated the drugs well and her breathlessness has reduced.  She should have gone earler but after 2 months on visiting her cardiologist he has changed her medication where one tablet to be taken before bedtime is made up of Ecosprin 75+Clopigodrel 75+Atorvastatin 20.  Even though the dosage is lower she seems to be having problems in the mornings like having severe headaches, depression and heaviness in the head.  She was given Clonazepam 0.25mg and Franxit ( Flupentixole 5mg + Melitracin 10 mg) probably to counter this depression which she isnt taking for the reason that she does not like to exist in a sedated way all day long.  

Please I would welocme any suggestions, or discussions from someone in a similar situation or any medically qualified personnel to give their opinion if we are indeed on the right track.  I want that my mother to have a qualitative life and be around for many more years to come.  Please help and thanks in advance  

[Flycaster305]

If stents are placed, I believe all cardiologists will continue Plavix  for at least three months and sometimes for life, depending upon the type of stent that is installed.  Coated stents usually require Plavix for at least a year.  81mg aspirin is usually prescribed for life as well.  I've been taking a statin for at least ten years and suspect I will for the rest of my life.  I detest the bruising effect on my skin that Plavix and Aspirin cause, but it's far better to get bruises than clots.

[joshaan]

Hello there,

Thanks for your prompt response.  I will check out the operative report fo the angio.  Just one question.  Does one still continue with medication ( blood thinners, statins, etc) in the event the required stents are put in place.  

I wish you good health and all the best.  We'll be in touch.

[Flycaster305]

I'm sorry your Mom is having these problems.  I'm not a health professional, but chest pain and shortness of breath certainly are red flags for blockages.  

Normally, insurance companies don't want to pay for stents when the blockages are less than 70%.  I'd request for an operative report from the Angiogram and read what was reported.  The fact that they wanted to do a stent but didn't do it on the spot surpises me, as it isn't much more invasive than the angiogram.  As for being invasive, I suppose it is, but I've had so many of them and so many stents I find a root canal more intrusive.  Stents have helped me a great deal.  Treating blockages with medication is necessary, but I believe medications are more intrusive in one's life than a stent.  There are very good arguements both ways on this issue, stents vs. medication.  

To repeat, I'd look at the operative report during the first stent and see what was reported.  If you have trouble understanding it, print it here, someone will be able to transcribe/translate the information to you.  Stay in touch.