40-50% Artery Blocakge

[dnhimmatramka]

I am a 76 years old man.

I am having this continual giddiness .So I decided to undergo an angiography and here is what my report says:

My MDCT coronary Angiography shows the follwing results:

Proximal LAD shows fibrocalcified plaques causing 40%-50% narrowing.Another calcified plaque causing 50% narrowing.

Proximal RCA shows multiple small soft plaque causing 20%,30% narrowing and smal calcified plaque causing 45% ,50% narrowing respectively,distal to it RCA,PDA,PLV shows satisfactory pacification.

Proximal ramus intermedius shows calcified plaque causing 50% to 60% narrowing ,distal to it shows satisfactory opacification.


I had consulted 2 doctors and got 2 different suggestions from them .One told me immediately stop all physical actively immediately and go for a bypass whereas the other one said that all is fine and continue to work as usual.

I am quite confused about it.Is it related in someway to my blockage in the arteries?Or is it alright to happen at this age.

Please Help Me.

[ed34]

Well before going onto your results, and blockages, I am more aimed at your dizziness. I assume your blood pressure is in normal ranges? and I assume they did an Ultrasound of your heart to establish it was pumping enough blood volume? If your blood pressure is normal, and your heart looks fine on an Ultrasound, then why do they believe the heart is the issue here? Did they do a doppler test on your Carotid arteries in your neck? or did they examine them during the Angiogram?
With regards to blockages, it is a fallacy that small blockages have no effect, in fact, a 1% blockage could have tremendous implications. I learned this only very recently during an Angiography procedure on my LCX. The monitor showed no blockages and yet when they passed a flow sensor down the artery, the drop off from halfway down was dramatic.
Imagine water flowing down an angled piece of glass. The water will flow freely and smoothly, the flow rate will be constant. Now do the same thing using rocks. The turbulence will greatly affect the flow rate. When the surface of the artery lining is damaged, it affects the flow and if the damage is along a fair distance, the flow rate will decrease a lot. Those damaged areas can be too small for the eye to detect. This causes a problem, well it has been known as a problem for years but Cardiologists seem to be ignoring it, in that they have to ASSUME your largest blockages are causing the problems. In reality a 70% blockage could have less effect than a 1% because it depends on a few factors such as distance of the blockage. If I was in your position, I would have a meeting with the cardiologist who recommends a bypass, and ask "how do you know any of those blockages are causing a problem, did you use Fractional Flow Rate analysis during the procedure"?  From such contradicting opinions, it's obvious they didn't use the equipment at their disposal and you could add to the statistics of having unnecessary procedures. What if they bypass the blockages which are NOT causing the problems? Demand answers, this is your body and this is your life. There are no guarantees with a bypass either, mine lasted a whole 3 months. There could be just one blockage causing problems, which could easily be stented.

[Occupant]

My vote is for number 2. In my case they didn't even do an Angiogram (invasive procedure) - never mind Angiography - because they didn't detect any problems during Echocardiogram and/or Nuclear Stress test. The cardiologist told me: "Unless your arteries are at least 70% blocked, we won't do anything." How did he know? He didn't, it was just a guess based on not finding anything other than some valve regurgitation.