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How to live with 100 PerCent Blocked LAD
My husband has been seeing a well known preventive cardiologist in Houston for two years after being diagnosed with severe CAD and 100 Per cent blockage of the LAD and one other artery. He has been a marathoner, played full court basket ball until he was 55 (ten years ago). After his younger brother died from a heart attack at age 48 and his dad at age 62 plus discovery that his stamina was really decreasing... he had a calcium tomography showing he was in the 95th percentile of having a cardiac event in five years. Five years later he repeated the CT scan and his numbers doubled. At that point he had a PET scan showing the severe CAD in all of his arteries. the cardiologist wanted him to do an angiogram; but he refused because of familial issues with invasive procedures and chose to begin the two year program to reverse CAD. the cardiologist suspected his CAD was genetic looking at the PET scan vs his athletic fitness, perfect cholesterol panel, etc. He was diagnosed iwth LPa ... a genetic component to CAD with a score of 130. Normal is 30. He has been on Lipitor, Plavix, and 200 mg of Niaspan plus following the severely restricted fat (15 gm day) 100 per cent of the time for the past two years. His appointment this past week for the repeat PET scan two years later showed NO change. 100 per cent blockage of the LAD and 100 per cent blockage of another artery 9lower down). He is not a candidate for bypass surgery. He is asymtomatic with plans to cut back fat even more drastically. Obvioiusly he has collateral circulation but that is not enough under heavy stress. My questions are ... will this unblock the blockages? Is there any medication that will clean the arteries? What happens to the heart with such inadequate flow:
I wish you the best! Vegan is good!
My spouse's total cholesterol was about 150 and his other numbers right on the money. For him, it is the hidden LP(a) that is a genetic component affecting only 3% of the male population that does not show up in the regular cholesterol testing. Hidden back there... it potentiates the bad cholesterol. Being asymptomatic and seeing a regular cardiologist he would never have known the severity of his condition without the PET scan that caused the cardiologist to order this special test from Berkley Labs.
My spouse's total cholesterol was about 150 and his other numbers right on the money. For him, it is the hidden LP(a) that is a genetic component affecting only 3% of the male population that does not show up in the regular cholesterol testing. Hidden back there... it potentiates the bad cholesterol. Being asymptomatic and seeing a regular cardiologist he would never have known the severity of his condition without the PET scan that caused the cardiologist to order this special test from Berkley Labs.
Read Caldwell Esselstyn's book "Heart Attack Proof" and go 100% vegan. No animal or dairy products and not oil.
dr caldwell esselstyn says this:
Total cholesterol <150
LDL <80
If you can do that, your triglycerides will be OK. Same for HDL.
All the other vegan diet proponents say <150 too for total cholesterol.
so that's what i am hoping alan and i can achieve. less than 150 for total cholesterol
you are in the same zone and won't die from cardia problems. More than 150 you could be
at risk for vulnerable plaque. That is the deadly plaque that ruptures without
warning - causing sudden heart attack.
dr caldwell esselstyn says this:
Total cholesterol <150
LDL <80
If you can do that, your triglycerides will be OK. Same for HDL.
All the other vegan diet proponents say <150 too for total cholesterol.
so that's what i am hoping alan and i can achieve. less than 150 for total cholesterol
you are in the same zone and won't die from cardia problems. More than 150 you could be
at risk for vulnerable plaque. That is the deadly plaque that ruptures without
warning - causing sudden heart attack.
I think I answered this question above! If not, look at other comments. I had intended to reply to you with the lab results. 2100 is shockingly high.
His cholesterol panel was good; he was lean (an athlete all of his life) but the PET scan in 2010 was a shocker so the dr ordered a test from Berkley Labs, cardiologists do not often request, called LP(a) . The high on this test should be 30. My spouse's score was 120. It is a genetic component that affects 3 percent of the male population causing the LDL to potentiate and it does not show up in regular cholesterol tests. The remedy is megadoses of Niaspan. He takes 2000 mg Niaspan per day. Regular Niacin over the counter is not the answer. I posted his entire PET lab report including the July cholesterol test regular panel. The LP(a) score was still high in July at 35. We are waiting for the test results from Berkley taken ten days ago.
oops i failed to edit comments from an email I sent to a cousin who is a cardiologist!
OHHH. Thank you for sharing this harrowing story, I just received his PET written report and feel a lot more confident that he knows his own body and family's history with invasive procedures: a younger brother died at age 48 and dad at age 62 after bypass. Mom died a few years ago three mos after bypass. They don't have good veins. I am going to post his lab report here:
Good Morning! I had failed to include the second page of the test results. Ron is optimistic that he can keep the heart stabilized. I would be grateful if Bill could tell me he agrees. love and hugs, Cynthia
1.) The Relative PET images a large, severe, septal apical and mid inferior, stress induced defect involving 25 per cent to 35 per cent of the left ventricle in the distribution of the mid LAD and mid Posterior Descending (right) coronary arteries.
2.) Absolute Myocardial perfusion combining CFR and max cc/min/gm show severely reducted flow capacity throughout the hear in addition to the localized stress induced abnormality reported above.
3.) The CT scan done for the attenuation of PET data shows moderate coronary calcification throughout the coronary arteries. These results indicate sever diffuse calcific coronary atherosclerosis in addition to severe stenosis indicated above.
4.) Gated PET perfusion images showed normal left ventricular contraction. The ejection fraction was 61% at stress.
5.) The current study, 5455 on 1/4/2012 compared to the previous study 3111 on 1/14/2010 shows no change, indicating stability of diffuse calcific cornonary atherosclerosis.
6.) Based on the PET scan, coronary arteriography with potentioal revascularization procedures is appropriate due to the size and severity of the rest-stress PET scan abnormalities. Whike I recommended a coronary arteriogram just as after the PET two years ago, in view of the stable images, absence of symptoms and good exercise capacity you elected to continue the medical management with my concurrence
INDICATION: Chronic ischemic heart disease; unspecified (414 90)
Brief History: Patient i a 64 year old asymptomatic male who is seen for routine follow-up PET scan to assess status of CAD. He came for initial screening PET two years ago due to strong family history of CAD and was found to have a large, severe, septal and apical, stress induced defect involving 25 per cent of the apex. He refused cardiac catherization and began strict lifestyle changes and medication. He has been exercising up to 4-5 hours a day until the last six months when he developed knee problems. His diet is excellent and lipids have been well controlled, intitial Lp (a) of 120 reduced to normal.
Description: Myocardial persfusion imaging was carried out by positron emission tomography (PET) with computed tomography (CT) attentuation correction. Imaging was done at rest and during dipryidmole stress (142 mcg/kg/min administered intravenously over four minutes) using N-13 Ammonia (18.4mCi at rest. 1.3 at stress).
Procedure: There were no complications with the procedure. The patient had no angina but had less than 1 mm ST changes on EKG after dipyridamole, had a headache and a sensation of fullness resolving after intraveous Aminophylline.
Baseline blood pressure was 90/53, heart rate was 43. At maxiumum stress, blood pressure was 93/46, heart rate 59, a normal response after dipyridmoklle stress.
Results: Relative Myocardial Perfusion Images: The relative PET images a large, severe, septal, apical and mid inferior stress induced defect involving 25 % to 30 % of the left ventricle in the distribution of the mid Left Anterior Descending and mid Posterior (Right) Coronary artery.
Absolute Coronary Flow Reserve and Mycardial Perfusion (cc/min/gm): Fort he whole heart, absolute mycardial perfusion (cc/min/gm) averaged 0.46 at resting conditioins, 0.96 after dipyridamole stress and coronary flow reserve averaged 2.05 for the whole heart, indicating that cornonary blood flow during stres increases to 205% of the baseline level. Rest flow is low due to low blood pressure and heart rate.
Average maximum absolute perfusion is severely reduced and absolute cornonary flow reserve is moderately reduced diffusely in addition to the localized stress defect above,. In the septal-apical-inferior region of the stress induced defect, the coronary flow reserve is 1.25 indicating severely reduced capacity for increased coronary blood flow to only 125% of baseline levels.
Coronary Flow Map with Plot of CFR and MAX cc/min/gm
Low flow thresholds of 0.9 cc/min/gm and CFR of 1.7 identify patients with myocardial ischemia. Reduced but adequate flow capacity with no ischemia may be due to adequate CFR associated with low rest flow despite limited max stress flow in cc/min/gm, as commonly seen with beta blockers.
Therefore, quantifying severity of coronary artery disease requires integrated analysis of both CFR and maximal stress cc/min/gm show the floolowing as percent of the left ventricle:
9% No ischemia, minimally reduced flow capacity
44% No ischemia. Mildly reduced flow capacity
15% Moderately reduced flow capacity
32% Severely reduced flow capacity
Other Findings:
1.) The CT scan done for attentuation of PET data shows moderate coronary calcificatioin throughout the coronary arteries.
2.) These results indicate severe diffuse calcific coronary atherosclerosis in addition to severe stenosis indicated abov.
3.) Gated PET perfusion images showed normal left ventricula contraction. The ejection fraction was 61% at stress.
Comparison to Prior Study: The current study, 5455 on 1/4/2-12 compared to the previous study 3111 on 1/14/2010 shows no change when considering using N-13 ammonia now compared to RB-82 two years ago. This result indicates stability of severe calcific coronary atherosclerosis.
Diagnoses: Chronic ischemic heart disease: unspecified (414.9)
Hypercholesterolemia (272.0)
Elevated LP(a)
Chronic ischemic heart disease: unspecified (414.90)
Special Comments: Based on the PET scan, coronary arteriography with potential revascularization procedures is appropriate due to the size and/or severity of the rest-stress PET scan abnormalities. While I recommended a coronary arteriogram as after the PET two years ago, in view of stable images, absence of symptoms and good exercise capapcity, you elected to continue medical management, with my concurrence.
Recommendations: Risk factors for progressive coronary atherosclerosis are well controlled with lipid profile on July 1, 2-11 showing total cholesterol at 121 mg/dl, triglycerides 40, LDL 50 and HD 63 while on Lipitor 20 mg once a day and Niaspan 2000 mg before bed.
Continue the current low fat diet (10-20 mg fat day), low carbohydrate, high protein food with at least 80 gm protein from non-fat dairy products, veggie burgers, egg white omelets, protein supplements, fish, beans, chicken, or urkey breast meat, extra lean pork and soy protein products.
Exercise 4 to 5 days per week by fast walking 30 to 45 minutes per day and or other activity including repititive weight lifting, stationary bicycling as knee injury permit.
Good Morning! I had failed to include the second page of the test results. Ron is optimistic that he can keep the heart stabilized. I would be grateful if Bill could tell me he agrees. love and hugs, Cynthia
1.) The Relative PET images a large, severe, septal apical and mid inferior, stress induced defect involving 25 per cent to 35 per cent of the left ventricle in the distribution of the mid LAD and mid Posterior Descending (right) coronary arteries.
2.) Absolute Myocardial perfusion combining CFR and max cc/min/gm show severely reducted flow capacity throughout the hear in addition to the localized stress induced abnormality reported above.
3.) The CT scan done for the attenuation of PET data shows moderate coronary calcification throughout the coronary arteries. These results indicate sever diffuse calcific coronary atherosclerosis in addition to severe stenosis indicated above.
4.) Gated PET perfusion images showed normal left ventricular contraction. The ejection fraction was 61% at stress.
5.) The current study, 5455 on 1/4/2012 compared to the previous study 3111 on 1/14/2010 shows no change, indicating stability of diffuse calcific cornonary atherosclerosis.
6.) Based on the PET scan, coronary arteriography with potentioal revascularization procedures is appropriate due to the size and severity of the rest-stress PET scan abnormalities. Whike I recommended a coronary arteriogram just as after the PET two years ago, in view of the stable images, absence of symptoms and good exercise capacity you elected to continue the medical management with my concurrence
INDICATION: Chronic ischemic heart disease; unspecified (414 90)
Brief History: Patient i a 64 year old asymptomatic male who is seen for routine follow-up PET scan to assess status of CAD. He came for initial screening PET two years ago due to strong family history of CAD and was found to have a large, severe, septal and apical, stress induced defect involving 25 per cent of the apex. He refused cardiac catherization and began strict lifestyle changes and medication. He has been exercising up to 4-5 hours a day until the last six months when he developed knee problems. His diet is excellent and lipids have been well controlled, intitial Lp (a) of 120 reduced to normal.
Description: Myocardial persfusion imaging was carried out by positron emission tomography (PET) with computed tomography (CT) attentuation correction. Imaging was done at rest and during dipryidmole stress (142 mcg/kg/min administered intravenously over four minutes) using N-13 Ammonia (18.4mCi at rest. 1.3 at stress).
Procedure: There were no complications with the procedure. The patient had no angina but had less than 1 mm ST changes on EKG after dipyridamole, had a headache and a sensation of fullness resolving after intraveous Aminophylline.
Baseline blood pressure was 90/53, heart rate was 43. At maxiumum stress, blood pressure was 93/46, heart rate 59, a normal response after dipyridmoklle stress.
Results: Relative Myocardial Perfusion Images: The relative PET images a large, severe, septal, apical and mid inferior stress induced defect involving 25 % to 30 % of the left ventricle in the distribution of the mid Left Anterior Descending and mid Posterior (Right) Coronary artery.
Absolute Coronary Flow Reserve and Mycardial Perfusion (cc/min/gm): Fort he whole heart, absolute mycardial perfusion (cc/min/gm) averaged 0.46 at resting conditioins, 0.96 after dipyridamole stress and coronary flow reserve averaged 2.05 for the whole heart, indicating that cornonary blood flow during stres increases to 205% of the baseline level. Rest flow is low due to low blood pressure and heart rate.
Average maximum absolute perfusion is severely reduced and absolute cornonary flow reserve is moderately reduced diffusely in addition to the localized stress defect above,. In the septal-apical-inferior region of the stress induced defect, the coronary flow reserve is 1.25 indicating severely reduced capacity for increased coronary blood flow to only 125% of baseline levels.
Coronary Flow Map with Plot of CFR and MAX cc/min/gm
Low flow thresholds of 0.9 cc/min/gm and CFR of 1.7 identify patients with myocardial ischemia. Reduced but adequate flow capacity with no ischemia may be due to adequate CFR associated with low rest flow despite limited max stress flow in cc/min/gm, as commonly seen with beta blockers.
Therefore, quantifying severity of coronary artery disease requires integrated analysis of both CFR and maximal stress cc/min/gm show the floolowing as percent of the left ventricle:
9% No ischemia, minimally reduced flow capacity
44% No ischemia. Mildly reduced flow capacity
15% Moderately reduced flow capacity
32% Severely reduced flow capacity
Other Findings:
1.) The CT scan done for attentuation of PET data shows moderate coronary calcificatioin throughout the coronary arteries.
2.) These results indicate severe diffuse calcific coronary atherosclerosis in addition to severe stenosis indicated abov.
3.) Gated PET perfusion images showed normal left ventricula contraction. The ejection fraction was 61% at stress.
Comparison to Prior Study: The current study, 5455 on 1/4/2-12 compared to the previous study 3111 on 1/14/2010 shows no change when considering using N-13 ammonia now compared to RB-82 two years ago. This result indicates stability of severe calcific coronary atherosclerosis.
Diagnoses: Chronic ischemic heart disease: unspecified (414.9)
Hypercholesterolemia (272.0)
Elevated LP(a)
Chronic ischemic heart disease: unspecified (414.90)
Special Comments: Based on the PET scan, coronary arteriography with potential revascularization procedures is appropriate due to the size and/or severity of the rest-stress PET scan abnormalities. While I recommended a coronary arteriogram as after the PET two years ago, in view of stable images, absence of symptoms and good exercise capapcity, you elected to continue medical management, with my concurrence.
Recommendations: Risk factors for progressive coronary atherosclerosis are well controlled with lipid profile on July 1, 2-11 showing total cholesterol at 121 mg/dl, triglycerides 40, LDL 50 and HD 63 while on Lipitor 20 mg once a day and Niaspan 2000 mg before bed.
Continue the current low fat diet (10-20 mg fat day), low carbohydrate, high protein food with at least 80 gm protein from non-fat dairy products, veggie burgers, egg white omelets, protein supplements, fish, beans, chicken, or urkey breast meat, extra lean pork and soy protein products.
Exercise 4 to 5 days per week by fast walking 30 to 45 minutes per day and or other activity including repititive weight lifting, stationary bicycling as knee injury permit.
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