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Forestalling a future heart attack/stroke

I am male and 61 years old living in UK.  For about 10 years I have been taking losartan for hypertension and also "statins" to lower my cholesterol level.  Otherwise the only major medical occurrence was a total colectomy 3 years ago following torrential diverticular bleeding.  My diet includes a moderate amount of saturated fats/dairy products etc as well as a fondness for chocolate!!  Also I have experienced infrequent (~4x/year) chest pains - but an ECG trace was normal.

I have endured the anguish of too many friends dying from heart attacks and, on the assumption that perhaps I am at a higher level of risk of suffering a heart attack and/or a stroke (both of which I understand originate from a blood clot becoming mechanically lodged in a narrowed artery) would I be well advised to contemplate the following series of procedures as a preventative measure before the onset of a possible emergency??

- a coronary angiography plus an angiography of the "brain
  supplying arteries"
- if these arteries are found to be narrowed, an angioplasty
  to widen the affected arteries - or the insertion of what I
  believe is called a "stent"
- I also recall seeing a TV programme some years ago which
  demonstrated what loooked like a "coring" of narrowed arteries
  (i.e. like the way in which a cylindrical section of the
  centre of an apple is "cored out" with a hollow metal device).
  Is this technique still performed where narrowed arteries are
  discovered in order to physically de-restrict them?

Any other suggestions to lessen future risks?  

Many thanks.
1 Responses
74076 tn?1189759432
Hello,

I understand your concerns and share your love of chocolate.

- a coronary angiography plus an angiography of the "brain
supplying arteries"

it does not sound like your symptoms are bad enough to justify this.  Stents do not prevent heart attacks, the treat angina.  If you are not having exercise related or exertional chest pain, a  stent will not help you.

- if these arteries are found to be narrowed, an angioplasty
to widen the affected arteries - or the insertion of what I
believe is called a "stent"

See above answer.
- I also recall seeing a TV programme some years ago which
demonstrated what loooked like a "coring" of narrowed arteries
(i.e. like the way in which a cylindrical section of the
centre of an apple is "cored out" with a hollow metal device).
Is this technique still performed where narrowed arteries are
discovered in order to physically de-restrict them?

This is only done in severely occluded vessels.  Again, if you are not having angina, I would not orer any tests at this time.  The best thing is still risk factor reduction -- no smoking, healthy diet, statin for high cholesteral, blood pressure and blood sugar control, etc...

Any other suggestions to lessen future risks?

It sounds like you are on the right track.  Invasive tests should be reserved for clear indications.  Remember, there is a risk of complications with any invasive test.  If that risk outweights the benefits, it is not worth proceeding.

I hope this helps.  Good luck and thanks for posting.
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