Remedy for totally ocluded circumflex with 15 inches of stents already

[santafe918]

My friend has had 9 stents in the circumflex in his ventricle.  He has recently been told that it is totally occluded.  It cannot be stented further.  He sweats a lot has chest pain a lot and yet when taken to the emergency the blood test showed he was not having a heart attack and blood pressure was only a little high.  He is a diabetic, with shortness of breath trying to quit smoking with chantix.  Is he a candidate for bypass or not and will that also stop up as well?

[kenkeith]

Your friend may not having a heart attack (heart muscle cell damage often necrosis) due to ischemia (lack of blood flow), but if the heart cells are not receiving enough blood they may not immediately die as in a heart attack.  However, ischemia can permanently damage heart cells over a period of time.  Having chest pain (angina) is an indiction the heart is not receiving enough blood and shoold be treated.

Sometimes a completely occluded vessel will develop collateral vessels that naturally bypasses and feeds into the blood deficit area.  Smoking constricts blood vessels and that adds to the burden of the heart to pump enough blood to meet demand.  May not need further treatment such as a bypass.  Medication and not smoking may relieve the chest pain (angina).