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confusion regarding cath result
I had a cath done 5 months after getting stent for cto of lad and another One month ago w/ ultrasound that said there was a 20% restenosis in stent on report. I got the disc and took to top guy to review and he said stent was wide open ie, no stenosis. How can something that would appear to be cut and dry objective observation be so differently interpreted especially since cath report is rather specific about the appearance of the lesion eg, smooth, irregular. I get so flustered that I walk out w/ more ?s than answers and it is impossible to get these people on the phone to clarify. They get most annoyed when it is they who are the problem.
Best Answer
Heart attack seems to mean different things to different people and so I think we should agree on a definition before I answer. I have even been under different Cardiologists who use the term to mean different things. Technically and medically, heart attack means myocardial infarction. This is when the blood supply to a part of the heart muscle is completely cut off and the muscle starts to die, never to be revived again. Some people refer to very bad symptoms (Angina) as having a heart attack, because the heart is under attack but the blood supply is not cut off totally. With a 99% blockage it can feel very nasty. All my experiences have been with the latter. When I have been to hospital (three times with severe angina), they have always found my troponin marker to be high and said "you are having a heart attack". When I ask "do you really mean a heart attack or am I suffering severe angina without 100% blockage" they just give me a blank look as if to say "idiot" and walk off. I was put on beta blockers after my first episode in 2007 and it was to rest my heart, to allow stunned cells to recover.
yeah I get it for me its b/c there is a small part of the wall that is hypokinetic ie. dead and the ? is whether that was a result of a small mi or a residue of defect from cto lad. the only reason I care is b/c i was told bb treatment is indicated when there is a bonafide heart attack. whatever, i just want to give my body the best,most appropriate treatment w/ minimal side effects. being six months out from stent don't know if heart still needs bb crutch so guess ill just have to ask dr. but the contradictory opinions on basic issues makes things harder than they should be. last ? did u and do u continue to take bb for angina or as a temp thing to allow cells to recover?
was this recent heart attack your first? I was told by stent dr. that I didn't need betablockers b/c in his opinion didn't have a heart attack. two weeks after stent had a very scary rhythm episode and they gave a little lopressor but I soon stopped it. this last dr, I brought my discs to look at said he believes I did have a heart attack and prescribed bystolic. I told him I didn't have high blood pressure but he didn't care. were u given betablockers after stent to lad w/ no heart attack or only after attack?
I am the same. I was prescribed 5mg of Bisoprolol and the alarms were going off every time I went to sleep. My heart rate was dropping into the low 20's. They reduced my dosage to 2.5mg but still couldn't get my rate up when sleeping and was discharged. I decided to let my heart kind of reboot itself, so I stopped the Bisoprolol until my heart rate was normal. I then had 1.25mg prescribed as I requested from my Doctor and my heart felt great. I now take this dosage twice a day and can handle it nicely. We have become good friends and without it, angina it much much worse. I tried many other beta blockers but my heart was not reacting properly to them. One brand even sent my rhythm crazy. Bisoprolol doesn't seem to touch my blood pressure, which is why I need ace inhibitors in the form of Ramipril. When I last spoke with my Cardiologist about Aspirin, he said "You need to take Clopidogrel (Plavix) and Aspirin, but I'm happy enough if you take one or the other".
I dont take beta blockers. tiny dose dropped my pressure and hr too low. everyone is different and that is part of the problem. In the future, as medicine matures, everything will be personalized genetically and they will be aghast at how things done now. As for diet, 20% of cholesterol comes from diet and I have always eaten low fat, sugar, cholesterol diet and it meant nothing. as for trusting drs. I trust technical capability on the table of my stent dr. outside of that, I would only say trust but verify.
I'm in usa, new york to be exact, so i go by mg/dc. I only know aspirin therapy can amplify preexisting stomach/esophageal issues. Statins for me are a difficult issue, would like to get a particle test so I know exactly what the deal is and how aggressive to be. wish I could ignore the side effects but its obvious there is a problem, tsh, blood sugar, a1c all going up. hope you can figure a way to handle the aspirin b/c u need it.
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