Clogged Arteries

[lolathechi]

Hi

I was wondering what are the symptons of clogged arteries? Is a stress test used to determine that? If your arteries are begining to clog can this reverse with diet and exercise?

Also they say the vagus nerve is related to a lot of pvcs, if this is so why dont they have a medication that will "relax" your vagus nerve to stop these horrible things??

Thanks so much!

[MinnieM]

Thanks Echo.  Yes, I am on Beta Blockers.  First TopolXL up to 75mg and the gradient was not coming down fast enough (my thoughts) and he switched me to 12.5 x 2 a day of Coreg.  I nearly croaked on that amoutn so reduced to 6.5 x 2 a day and hated this as well so a phone call told me to get back on the TOPOLXL till he seesz me next week.  

I am not sure what my Gradient is:  mean or "what was the other things you mentioned". It is not listed anywhere on this report. All it says:(8/10/2005)   DOPPLER FINDINGS "LVOT SV=106ml. LVOT CO =9.3 L/MIN.  Mild (1/4) mitral regurgitation.  Unable to estimate PAP. Estimated RA pressure 5-10 mmHG. Pulmonary vein flow is suggestive of normal left atrial pressure.  

Comments:  A 16 mmHG LVOT gradient noted. Compared with prior study of 7/6/05, no significant change. Decreased from 6/11/2005 study which showed a 30mmHG gradient.  

Echo, I had another Echi in 9/4/2005 and do not have that report yet but told the gradient has not decreased any further.  This is why the cardio placed me on Coreg but I am unable to handle this.

Is what I am having in his office called a serial echo?  Thanks much.  You are very valuable. My cardio relies so much on the ECHO tech.
I still feel like *&%^%$^* and tire esily.

[EchoTech]

Thank you for the compliment.  I hope things are going better for you.

[EchoTech]

Sorry, I forgot to add that aortic regurgitation is exactly the same thing as aortic insuffieciency, it's just a different name for it.

[EchoTech]

again, I'm not  a doctor, but I think it would be a good idea and share this information with your cardiologist.  If it's been more than a year since you've last seen the haeart doc, I would re-visit him.  I am a little unclear on the stenting vs. surgery.  Usually they'll try to stent vessels unless they are extremely tortuous ( they zig zag  and have a lot of severe curves), the vessel is too small, or it is at a branch artery. As a general rule, plaque in the vessels either stays the same or gets worse. If they can't stent the 2 that are life threatenting, then surgery would be another viable option and the only one that I can think of right now.
  The bottom line is, if it were me, I would either visit with the cardiologist again or get a second opinion from another cardiologist if you don't like the first.  It sure sounds like you need either surgery or the stents, and the relief that you get when you take the nitro just makes me more suspicious.  I would also suggest that you ramp down the exercise until you see the doctor.  
  And for the record, no doctor or surgeon can ever "guarantee" anything.  They are not God and can not give you a 100% prediction on anything.  There is no test out there that is 100% right all the time which is why they do multiple tests to reconfirm and make sure the information is right. You could ask for percentages and/or probabilities of the likely hood of a heart attack or further angina and they percentages that you would make it through procedures and complication rates.  This would help you make a better choice for yourself.  For them to make a statement of a guarantee would just be like them begging to get sued.  Good luck.

[EchoTech]

Well, the test you are having is an echo, but it is done in a serial fashion, so it means that they do one after another, after another, etc. until your cardiologist is satisfied.  There is a difference between the peak and mean gradients, but it sounds like you've stabilized the gradient, so it is quite possible that they might just sit and watch it for a while.  There are some people that take the type of medicine that you are on and it can take a while before you get used to it.  If memory serves me correctly, it can be  anywhere from a few weeks up to six months.  I hope this helps a little bit.

[EchoTech]

I re-read your post from 08/14.  It would appear that your symptoms are worsening and that you did get a second opinion.  It is a high proability that they would recommend open heart surgery again.  I can see them wanting to put it off so that they can do both the  valve surgery and bypasses together instead of doing the bypasses now and then getting valve surgery in a few years.  If it were me (this my lay opinion and I'm not doctor), I would inquire about getting both the valve and the vessels done at the same time.  Surgeons at the facility that I work at do it and it is not a totally uncommon thing to do.  I believe that there is some more risk with replacing the valve a little early, but do you really want to go through open heart surgery twice within five year window?  For the valve surgery they'll probably give you two options.. One is a mechanical valve and another is a bioprosthetic valve.  There are a bunch of considerations advantages/disadvantages with each one, but I suspect they would lean slightly to the mechanical valve with your age being the primary factor.  I hope this helps and if you have any more questions, I'll try to help.