CABG

[nagrajjain]

"After six years I have second heart attack.IWMI.Angiography shows all three major vessle blocks to the extent of 90% at near end and 70% block at far end.Physical capacity of body is normal. No pain even during exercise. May be due to colateral circulation. Advised CABG. Fearing problems after surgery not feeling to do that.Please advise."

[nagrajjain]

From 2D-echo my LV dimensions are ok. All rest dimensions of heart are also ok. Cardiac out must affect the patient some way or the other. I am physically and mentally very normal person.I can give you a coy of Echo report if you want.Thank you.Before my second heart attack my usual blood pressure was 140/90. Copy of my notes I discussed with doctor is below for your information.

Copy of note----

[kenkeith]

Yes, there should be a concern to get your pressure under control.  I missed reading your other post. Yes, I understood the significance of your comments.  What did your doctor say about the high blood pressure?  Is this an isolated reading and not sustained?

I will add an insight to what is termed left ventricle diastolic dysfunction. LVDD can be occur from high blood pressure, and the result can be the thickening of the heart  walls. The thickening (dimensions) of the heart walls can be a condition and a normal EF can be misleading.. An echo can determine if the walls are normal size, and I believe that has been ruled out by your medical provider otherwise you would have posed different questions..

With LVDD the heart chamber does not relax very well due to the inflexibility of the thickened heart walls.  With reduced capacity (filling disorder) the heart can still pump the same percentage of blood into circulation...but the amount of blood pumped into circulation is reduced.  If not effectively treated the reduced amount of blood/oxygen will eventually go to the LV and will cause heart failure (low cardiac output).  Your low normal heart rate does not support a cardiac output problem.  With low CO It woud rise to put more blood into circulation...likely over 100 bpm at rest.

From reading all the posts, your doctor has never told you there were abnormal heart wall dimensions and apparently not an issue!  Isolated blood pressure you have cited is not very high but nevertheless can be problematic if sustained for a period of time and should be treated...we all can agree on that.

[nagrajjain]

Thank you for your concern. During second openion that is taken care of. As soon as it normalises I will let you know. I am called after two months again.

[ed34]

"My blood pressure 175/105"

WHAT? you are on the verge of severe hypertension stage 3. Your BP needs to be seriously looked into and medicated if needed. With BP THAT high, you are asking for another heart attack :(

[kenkeith]

Very good news.  I wish you well in the long term also.

[nagrajjain]

Second openion in my favour.Not going for bypass. i will manage with medicine.Thank you.Your replies helped me to understand nad communicate in effective way with medical practisioner.Thank you MedHelp.