PVC / Stress Test / Angiogram

[southflguy]

Hello,

I'm a 68 year old white latin male with a history of high blood pressure.  I have had my blood pressure well under control for the past few years and my cholesterol level is well below 200 now.  On a recent EKG it showed I was having a form of arrhythmia.  The doctor referred to it as an extra heartbeat, which apparently is a PVC.  He ordered a stress test on me (I had one done a year ago and it was fine).  He said this time the stress test came back somewhere in the middle.  Not bad, not great so he wants to do an Angiogram to find out why I am experiencing this arrhythmia.  He scared me because he spoke of blockages and surgery and all that.  Of course he also said that it may come up clean and the arrhythmia is not related to a blockage.  I also have a family history and my father had bypass surgery in the 80s when he was in his early 60s.  I guess my question is could a blockage form so quickly within a year?  Is this an appropriate test given my current information?  What are the chances of bypass vs. a stent?  When would a bypass be appropriate and a stent could not deal with it?  Or medications?  Sorry, but I'm very nervous about all of this.  Thanks!

[ed34]

Firstly, I'm not a great believer in family history. For example, my Mother died from Atherosclerosis a few years ago, and I was found to have the problem three years ago. However, our common link is smoking. My older brother who has never smoked has never had heart problems and continues to have normal blood pressure too. There are some links through family history such as heavy drinking and smoking which can be broken, but not really classed as genetic. There is also bad diet, if your parents raise you on junk food and you continue to eat the same way as an adult, you are bound to get problems. There are many family history traits which can be broken to lower risk.
Don't start worrying about bypass surgery or stents yet, medication might be sufficient IF the cause is found to be a blockage. There are lots of medications which help with rhythm and dilate arteries for a greater flow.
The usual decision on stent or bypass lies with the actual state of the disease and the extent of the blockage. If an artery has for example 20 blockages which are extensive but small in size, a Cardiologist is not going to spend hours installing 20 stents, he will opt for bypass. Some vessels are not ideal for bypass and so stenting is the preferred method, but they will probably see how you tolerate medication first. Cross bridges when you come to them, otherwise you will suffer too much stress.