Heart Disease of Father(Age 70+)

[shnbhattacharya]

Hi, my father got angiography and detected few blockages like double vessel coronary disease and treated with angioplasty PTCA to RCA done with Pronova stent 3.5X28mm on 9th august 2011 but angioplasty to LCX is not done (PCTA-LCX). Recently he is getting faint and having syncope attack in last 2years four times. The holter monitor done couple of times but it's was fine till the last holter got some bad points. below is the description :-
This time father was admitted to hospital on 31/12/2012.Holter moniter shows the basic rhythm to sinus. The max and min heart rates were 112 at 7.40am and 32 at 7.46am with an average heart rate of 75bp. Few tachy brady episodes with short sinus pauses(max- 2.4sec at 7.46am) noted. Complete heart blockage also noted (7.47am to 7.48am)- 1min. Few isolated ventricular ectopics noted. No significant ST-T changes observed. Patient had no symptom while holter monitoring. All the blood reports like CBC are normal with a little high on potassium and little less on sodium noted. There was a chest infection treated with antibiotics tajact injection. Chest x-ray is also clear. my dad is looking little tired and feeling drowsiness most of the time. Is it something really serious, I am really tensed doctor. ECG also done on jan 2nd it's normal with limits.
He is taking the medicines given below.Deplat -A 150,Rozavel 20,Olsar H40,Prolomet XL 100,Pantocid DSR.BloodPress-130/80 on 25/1/2013

[Atif_Shah]

My mother age 56-year report is given below..Kindly tell me how sererve is the disease and condition of heart/coronary arteries and also your usefull recommendation:

CORONARY ARTERIOGRAPHY:

Left Coronary Artery:
Left Main Stem: Normal Bifurcating vessel
Left Anterior Descending Artery:
                 Tight proximal stenosis followed by total mid occlusion. Distal vessel not visualized.

Left Circumflex Artery:
                 Mild generalized diffuse disease.

Right Coronary Artery:
               Dominant vessel with total proximal occlusion. Distal vessel fills retrogradely from left system.

LV ANGIOGRAM:
• Not done.
• To be accessed on Echo

======================================================
Scan Protocols:
Acquisition 64 x .625 helical 0.35sec Beta Blocker Mepressor 100 mg PO 10 mg iv Left Main
Kv 120 Gating Artifact: No LAD
mA Modulated Breathing Artifact: No LCX
Contrast 50ml Study Quality: Diagnostic RCA
HR 68min Complication: None Rl
Wt/Ht 82kg/143cm Risk Factor HTN; Hyperlipidemia;FH Total
ECG

Left Main Stem:
• Normal bifurcating vessel.
Left Anterior Descending Artery:
• Tight proximal stenosis with total occlusion after diagonal branch. Dista LAD is normal but ends short of apex. A fair sized diagonal branch shows generalized diffuse disease.
Left Circumflex Artery:
• Moderate proximal stenosis with mild distal disease. Obtuse marginal branches show mild irregularities.
Right Coronary Artery:
• Dominant vessel with total mid occlusion. Distal vessel shows generalized diffuse disease.
LV Angiogram:
• EDV = 110ml
• ESV =34ml
• Ejection Fraction= 69%
CONCLUSION:
 Three vessel coronary artery disease.
 Good LV systolic function.

[CCF HeartMD6]

Fatigue can be caused by a variety of reasons related to the heart.  In your father's case, it would/could include CAD or an arrhythmia.  If he is having episodes of true syncope (blacking out), it would be important to ensure there is not an issue with his previously placed stent (to the RCA) or if this is related to what was seen on his holter monitor.  It is unclear how long his episodes of tachy-brady were in duration, and/or if he was truly having complete heart block (as reported above).  I would ensure that the actual holter images are reviewed by his cardiologist (not just the report) to make sure that this is not a result of a serious arrhtyhmia that needs to be addressed.  Otherewise, his blood pressure looks like it is within an acceptable range.