myocardial infarction

i am a 66-year-old man with recent inferior wall MI and following are my angiography details:
left main: normal bifurcates into LAD and LCx
LAD: type III vessel shows two tandem proximal 40% stenosis followed by 80% stenosis.

LCx: nondominant vessel and is normal.

RCA: dominant vessel and shows 75% stenosis immediately after RV branch and 40% stenosis before bifurcation of PDA and PLV.

renals: normal

LIMA/RIMA: normal.

LV angio: good LV function LVEF 55%

comments: double vessel CAD with good LV function

Is angioplasty necessary in my case or i can be okay with medications.

[kenkeith]

Your angiogram does not indicate any serious problems associated with an MI as indicated by the 55% LVEF.  The general consenus of the medical community the AHA/AAC provides guidelines to not intervene with any occlusions that are not greater than 70%.  If the occlusions are greater than 70%, treat with medication, and if medication does not provide any relief to symptoms (usually angina...chest pain) then stent the appropriate occlusion.

About 7 years ago, I had an MI with a 98% blockage of RCA (stented), 100% blockage of LAD (apparently as the occlusion was occuring, there were other vessels developing to provide oxygenated blood) no intervention, and 70% blocked circ, no intervention.

With medication my heart returned to normal size, my EF went from below 29% to normal.  I do well with medication, but some individuals may not find relief from symptoms, etc. so intervention may be the only option.  There has be an extensive independant study done (COURAGE study) that establised the guidelines and that regardless of the intervention (med, stent, cabg) there is no distinquishing difference in longivity.

Hope this helps provide an insight and perspective to available treatment, and if you have any followup questions or comments you are welcome to respond.  Thanks for sharing, take care.

[diyapritesh]

thanks for the suggestion.

regards

diyapritesh

[kenkeith]

You're welcome and I wish you well going forward.