Angiography booked for tommorow

[mike_no]

Hi all,

My dad had an MI last Sunday along with a cardogenic shock, the doctor has advised angiography at the earliest, I'm taking him for an angiography tomorrow.

I wanted to know, in case there are blood clots found what's the percentage of clotage that would require angioplasty. Secondly, can angioplasty be avoided by any sort of medicine / procedure ?

Awaiting a few response to the question

Thanks

Mike

[MysteryChemist]

Typically, they will put in stent if the narrowing is 70% or greater, assuming it is in a position where they can get to it. Bypass surgery (CABG) is also used to fixed these problems, depending on where the narrowing is located. If there is a blood clot, they may fix or leave it alone depending on the circumstances.

Usually, they will put the patient on statins, aspirin, beta blocker, etc.  The statins along with a low fat diet and exercise will help keep the blockages from progressing.  If he smokes, he should stop as as possible. When I had my MI, they put it one stent where it was block( the circumflex).  The LAD was fine.  The right coronary artery was 50% narrow so it wasn't stented. They told me the statin, diet, etc would take care of the right coronary artery.  Eighteen months later, I feel great with no problems. I am 55

Hope this helps and good luck!!.

[mike_no]

Thanks for taking your time to respond to my question, it did help :)

I've got my dad back at home, angiography and angioplasty done, with 2 stentings, one to cover up for 95 % blockage and the other one for 75%.

He's generally feeling good however sometimes complaints about a mild pain in the heart area, I'm wondering what' s that pain about now ?

I'd really appreciate your response on this one.

[MysteryChemist]

I think you should discuss it with your dad's cardiologist.  I am not a doctor.  The pain could be from inserting the stents, which appears to be a minor problem, to a problem with the stents.  You really need to talk to the cardiologist about this.. I think most cardiologists welcome questions

[mike_no]

Right, I have an appointment with him for this saturday, I'd definitely ask him about it.

You have been very helpful, I thank you from the bottom of my heart.

If you ever have any question or queries concerning HIV and it's transmission please come on over to the HIV forum, I'd be glad to answer your queries there (I'm not a doc either however I know my stuffs when it comes to this virus through thorough research on the subject)

One last question, due to financial constraints I had to choose the ordinary stents (not the medicated ones) do you think, it's very poor when it comes to performance ?

Best Regards
Mike

[MysteryChemist]

I have a bare metal stent and haven't had a problems (18 months out) but bare metals have a higher rate of restenosis; they can close back up.  (Most of the time, but not always, the closure is gradual so the symptons are angnia and or shortness of breath.)

DES ( drug or medicated stents) don't have this problem (restenoisis) but they have recently been shown to have a small but significant risk of heart attack after they take you off Plavix. (Plavix is blood thinner).  Right now, if you have DES, they want you on a Plavix for at least a year although some Drs think you may be on Plavix for life.  You must be prepared to take plavix every day. Plavix is expensive so you have to make sure you have insurance coverage.  

Do you anticipate any surgeries for your father in the near future? If he will have have surgery or out patient procedure where you may bleed, the surgeon may require that he stop taking plavix for a number of days before the surgery, increasing his chances of a heart attack.  I understand that there may ways around this problem, but you need to make sure your cardiologist will go to bat for you in this types of situation, i.e. he/she must be willing to work with the surgeon to figure a way around this problem.

The DES controversy flared up last year and hasn't been resolved as far as I know. DES sales are down 41% this year in the USA.

I'm happy with my bare metal stent.  I don't think you should feel bad about your choice.  Each type has problems and benefits.

Good luck!

[mike_no]

Thanks once again for all that info,it's been very helpful, stay well.

Mike