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artski
i am a 59 yr old male that works out 6 days a week and has no symptoms but had both parents die of heart disease (one heart attack one stroke by the age of 60). my ecg is considered "different" and combined with family history went through a series of tests (nuclear stress test, regular stress test both normal) but angiogram showed 90% long blockage in the LAD which cannot be stented and 70% blockage in 2 other arteries.
i have differing opinions from cardiologists as to whether to have a triple bypass or medical therapy with reduced exercise intensity because i have no symptoms.
i really don't want to have to alter my lifestyle or live with the fear of an attack at any time but the thought of a bypass is scaring considering i have no symptoms now and son't want to feel worse later.
i have differing opinions from cardiologists as to whether to have a triple bypass or medical therapy with reduced exercise intensity because i have no symptoms.
i really don't want to have to alter my lifestyle or live with the fear of an attack at any time but the thought of a bypass is scaring considering i have no symptoms now and son't want to feel worse later.
Best Answer
With such an extensive blockage in your LAD and having no symptoms PLUS working out so much, I would suggest that the Cardiologist is not giving you the full picture. You must have developed several collateral vessels (natural bypasses) which are doing a pretty good job. In such a case, they should evaluate where this bypass feed is coming from and ensure that vessel has no restrictions. If this source vessel closes up, it will affect the LAD too and almost certainly you will end up in a fatal situation. The other 2 vessels have 70% blockages, but are they above or below the collateral feeds? Before you jump to any conclusions I would ask more questions.
I also have heard that the artery lasts longer as the bypass vessel than a vein does. If you don't get a satisfactory answer to that question, I believe that is one situation in which, yes, I would seriously consider postponing the surgery for a second opinion on the whole thing.
Make sure they use your Left Internal Mammary Artery (Lima) from your chest as a graft to your LAD if this vessel is clean. Being an artery, as opposed to using veins, it will last a heck of a lot longer and give better results. You want this surgery to last and I'm sure you don't want to go for another bypass in 10 years.
But wait, you've already scheduled surgery, so I don't want to throw a monkey wrench into your plans by suggesting a second opinion. If you're good to go, then great. Good luck, and let us hear from you when you're able.
A bypass operation is scary, but what happened to your parents is scary, too. Assuming your doctors are interpreting all the tests correctly, a bypass operation seems like it might be the only play you have with the cards you were dealt. It never hurts to get a second opinion, just to make sure that another cardiologist (or team) sees your test results the same way. You would not have to do all the tests over again, just provide the records for review. If the second opinion is the same as the first one, you have more peace of mind about your choice.
those (the odd EKG and the bad family history) were exactly what got the family physicians attention. with the silent ischema factor i have decided to have the bypass, sceduled for the middle of March. it was the "defective warning system" comment that finally made the difference. until that information i could never rationalize in my mind how i could work out so oftern and to such an intensity, have no symptoms but be that seriously blocked. now it starts to make sense and i really don't want to go the rest of my life wondering if every time i work out it was going to cause an attack without any warning.
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