blockage they conceder no important

[rayg]

i am a 54 year old male who in the past 2 years have had 2 stents and a double by pass. i now have a blockage in the septrum that was stented and is now blocked again. i am in constant discomfort with pain and heavyness in my chest with shortness in breath. the doctors dont want to open the blockage? it seems like i block up quite fast. i now have a prob with sleeping and constant flutters with alot a shortness of breath. are the doctors trying to tell me there is nothing more to do with me or what? i have hypertension with a bp of about 190/110 constantly, but lately it was 66/49 while hospitalized. it occasionally drops low and i get dizzy. the doctor said if it was that low they would not have let me go home but they did. what is this a sign of? please help as i am very concerned about this prob and i am tired of feeling bad.

[CCF-M.D.-MJM]

Hi rayg,

You have several frustrating problems.   The first is that the septum is difficult to stent.  If that stent is closing off, there may be more risk to placing another stent than your doctors are willing to take.  This is probably a good time to go to a tertiary referral center like the Cleveland Clinic, Mayo Clinic, Michigan or a host of other major teaching hospital across the country.  A second opinion may be very helpful.  

Hospitals like this often have sub-sub specialist that will help with things like prevention, revascularization, etc.

There is not a good explanation as to why your blood pressure is high at home and low in the hospital.  Have you had  your blood pressure cuff checked for accuracy.  Take it to your doctors appointment and check yourself after your doctor checks  your blood pressue and make sure they care close.  Also make sure you are checking it in the same arm.  Sometimes there are blockages in the arm or shoulder arteries that are on one side and not the other making the blood pressure drastically different.

It is possible that you have very difficult to control blood pressure, but other causes should be ruled out first.

Regarding the fluttering, a holter, event monitor or home telemetry should easily answer the question as to what are causing these symptoms.  You will just need to document the exact time they happen.

I hope this answers your questions and that you feel better soon.  Good luck and thanks for posting.

[rayg]

forgot to tell you that i am on plavix, a asprin a day and lipitor plus toporalxl. i still have high closterol and my bp is uncontrollable, i had high bp since i was small. i had a mi 21 days after the last stent was placed after the double by pass. also on bp meds. my ef was 42% on last stress test.

[MaryRoe]

I do not know where you live but CC doc here gave good advice.  I too have an area in the LAD septal that they cannot stent as I was told it would be too dangerous for me and a by-pass would not be in my favor. But, everyone is different and what may not work in my case would work in yours.  You need to be at a place like CC doctor mentioned.  If you can get to the Cleveland Clinic in Cleveland for an evaluation..it is well worth peace of mind.  Many go there from all over the world for heart issues.  Home BP monitors are not all what they are cracked up to be. I did take mine to the Cardio's office and my numbers one time were better in his office with the wall mounted device and another time my unit was better.  Also, do you have large upper arms?  Some cuff's will not give a good reading with large arms.  Also, you mentioned you had high BP since a young person.  Did they do kidney testing on you?  Did they do a 24 hour Urine collection test looking for a Pheocytoma tumor (butchered the spelling on this one) These tumors can cause high blood pressure and once the tumor is removed BP is usually back to normal ranges.

Back to the BP...some folks can have a condition called Thoracic Outlet Syndrome (TOS) where there is a blockage/Kink/compression in the Brachial Plexus area and or surrounding tissues.  Doppler/ultrasound scans in this area with arms in various positions can rule this in or out.  Good Luck To You. ....Help is out there but sometimes we have to look a bit harder than someone else.  Good Luck To You.

[veteranjack]

I just got my results from the new 64 slice CT scan and it showed a 50-70% blockage in the proximal LAD.  There was concern because of the location.  Cath was recommended.  I have had normal EKG and normal ECHO since with the exception of trace regurgitation in the tricuspid.  3 brothers with bypass on the back side of the heart.  I'd like to avoid a Cath if possible (had one in 1990 that was fine).  Any suggestions of comments?

[MaryRoe]

Jack, did you have recently any Nuclear studies done, i.e. dobutermine, Cardiolite, Thallium for a comparison to the 64Slice CT scan.  Do you have symptoms? Every test has false postives and to various degrees? If it is a true 50% BLOCKAGE, most doctors will not stent this area and treat medicinally.  Are you on statins now?  Good Luck to you.

[MaryRoe]

Jack, did you recently have any Nuclear studies done, i.e. Dobutermine, Cardiolite, Thallium for a comparison to the 64Slice CT scan.  Do you have symptoms? Every test has false postives and to various degrees? If it is a true 50% BLOCKAGE, most doctors will not stent this area and treat medicinally.  Are you on statins now?  Good Luck to you.

[rayg]

my bp was taken in the hosp and the doctors office. i do have a bp machine but seldom use it. i was 17 when i went in the army in 1968 but i was frist turned down due to high blood pressure. had to get a doctor to make up a false report so i could get in. after my tour i was ready to get out and was hosp with high bp. could have gotten a medical discharge due to this but did not. my septrum was stented and my doctor said he recieved alot of negative remarks from doctors in the hosp. i live in maryland. been to the univ. of md. seen prof there in cardio he just told me that i had about 4 decent years left go and enjoy life???? i would say i have had about 12 card caths in 2 years. im tired. forgot to tell you also in those years had a double hernia operation, a bladder cancer cysto 4 times a cancer spot taken off my nose in the coner of my eye etc etc...........i prob forgot something.

[rayg]

take it from a expert about caths, i make the put me to sleep. i had a blockage opened by angio and boy did it hurt, so now i go to sleep. dont want to scare you but the last 2 times i had it done i a had a major bleeding prob after the surgery, i coughed once and opened up the artery after the cath in the hallway and the other just bled? it still dont bother me to get it done anymore if you need it get it done. i also had my kidneys checked several times to let maryroe know. good luck jack.

[ellentx]

THANKS MARYRO, I AM LEARNIG A LOT. RECENTLY DIASGNOSED WITH BLOCKAGES BUT I THINK I MAY HAVE THE TOS TOO.  GETTING TESTED FOR THIS NEXT WEEK.  I WAS SURPRISED YOU MENTIONED THIS.  THANKS.

[veteranjack]

I have only had the test mentioned.  My new stress is in March.  Last stress in 2004 was fine.  Some chest pain but find that anti-inflam. drugs work for it.  Had costocondritis? a few years ago, Bextra helped when nothing else did.  My concern is that the hospital doing the 64 CT is trying to make a name for itself.  I do take Zocor for high Trigl. but to be honest, I stopped for 6 months and started eating oats with bran buds and my levels were the same as when they were w/ meds.  In good range.  I used to run 5-10 and play basketball until an accident left me unable.  so my exercise is limited now.  Last stress chemical and not treadmill.

[rayg]

i just left the doctors office again no answers. he showed me that the septum was blocked pretty good and is prob causing my pain. he said he was looking into laser treatment to see if that can open up the septum since its too small to stent. wants me to take nitro pill 3 times a day to see if it helps. my bp was 186/98 again not as high as always. im tired of going to doctors. i had a scare this saturday with bad chest pain, into my neck and back and got really cold. took nitro and about 1/2 it was gone. took 3 pills. told doctor this and he did not say anything. office backed up with people so little time is spent. i need a good work up in the hospital for a few days to get to the bottom of this. need to find laser surgery location in maryland. thanks for you reply......

[veteranjack]

Had my strees stest yesterday and have been sick since.  I think they put my BP too high because he had to give me 2 shots to bring it down and then had the pharmacy give me my BP med there.  I have been having chest pain since.  Miserable.  The headache went away.  I am at a loss and don't know wether to go to the hospital or wait and see.  Any ideas?  They called today and said something about ejection .5? and the need to see the cadiologist.  Thanks

[Skair-De-Kat]

Hi,
I'm a 53 hrs old black male, 6'.2", 195 lbs, reasonably fit, jog 2-3 miles comfortably, play golf (walk 18 holes with mile or no discomfort). Five yrs ago I had 2 surgeries on my lower spine to 'correct' a herniated disc that shot severe sciatic pains down by left leg. I now suffer with chronic leg pain, but still struggle through it to keep fit. For the past 3 months I've been having a funny kind of pain in my left chest..funny because sometimes it feels like it's under the left rib cage, then it's in the left shoulder blade, often with slight weakness down the arm (more noticeably in the elbow, an tingling in the fingers of the left hand. The doctors initially told me that "it maybe just a muscular strain from my golf activity"; however they did an EKG, X-Rays, Stress test and blood work. The results were mostly all good; i.e no high cholesterol level, no high blood pressure, EXCEPT that I have a blockage in the left side of the heart which require a cath & stent insertion. I've been put on METOPROLOL, NITROGLYSERIN, and ASPIRIN. Given my previous experience,I am petrified of any invasive procedure, also concerned that I may become dependant on these type of drugs for the rest of a docile lifestyle. Can drugs 'un-block' the clog without cath or stent surgery?