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Interventional Cardiology (Expert Forum)
2 main arteries now closed
Answered by
Truman Medical Center
MO
Questions in the Interventional Cardiology forum are answered by medical professionals affiliated with the Truman Medical Center. Topics covered include acute coronary syndrome, angina , atrial fibrillation , cardiac catheterization , cardiomyopathy , drug abuse & cardiac disease, echocardiography , heart failure , hypertension & heart disease , lipid management , minorities and heart disease, peripheral vascular disease prevention, valvular heart disease , women’s heart health, and the warning signs of a heart attack.
2 main arteries now closed
by Husbandndshlp, Jul 06, 2008 05:09PM
My wife is 44, juvenile diabetic for 38 yrs and within 3 years has had multiple stents, then CABG x4 and since then her LcX totally closed down. The RCA closed down too including the vein graft she had during bypass. She still has the mammary artery to her LAD and sequential vein grafts to the diagonal and 1st marginal. Even with the LcX closed she had no collaterals but her heart suffered no further damage. Her EF is 50. My questions are 1) she is totally exhausted since the lxc closure. Is this normal? 2) how can it be that with no collaterals she has suffered no further damage to the heart muscle, 3) do we need to worry about the vein grafts and 4) how do you ensure the mammary artery stays in good shape? She can't have a CTA b/c of arm problems and can't get them over her head and a stress test is no good because she has a very bad knee injury. Thanks for your help.
Doctor's Answer
by Douglas Bogart, MD, Jul 08, 2008 07:20AM
, Jul 08, 2008 07:20AMTo: Husbandndship
You wife may have these symptoms due to the severe coronary artery disease and with a reasonably good left ventricle these symptoms should improve with medical management.
The fact that she did not have heart damage with the closure of the circumflex may mean that there are microscopic collaterals that are keeping this part of the heart alive. They may to small to be seen with the angiogram. The best way to ensure both the vein grafts and the internal mammary is medical management with control of the diabetes and aggressive statin therapy.
The fact that she did not have heart damage with the closure of the circumflex may mean that there are microscopic collaterals that are keeping this part of the heart alive. They may to small to be seen with the angiogram. The best way to ensure both the vein grafts and the internal mammary is medical management with control of the diabetes and aggressive statin therapy.
