Stress tests and ischemia

[Petros]

My father is 69 years old. 3.5 years ago (spring 1996),he underwent an angiogram where it was detected that he has 40% blockage in the artery on the left side of his heart, very close to the main artery,and 60% and 50% blockage in two places in the right coronary artery. Since then, he has been aunder medication,and underwent 4 stress tests, one each year (autumn 1996,1997,1998 and 1999). The first two tests were negative for ischemia, the one performed in 1998 showed some ischemia,but according to the doctor, it was nothing to worry about, almost negligible. However, in the 1999 stress test,performed a few days ago, the doctor diagnosed that the ischemia has "grown". So,he suggested that we undergo another test( thalium i think) and maybe an angiogram again. What i want is to know your medical opinion, based on your expertise. Is it possible that my father situtation has deteriorated so much, that he has to undergo a heart surgery? Also,is the 40% blockage near the main artery bad? I am asking,because the doctors said 3 years ago that the blockages in the right coronary were not to be a very big worry.
Thank you in advance,
Petros



underwent an angiogram where it was detected that he has 95% blockage in the artery on the left side of his heart, extremely close to the main artery. A single bypass has been suggested. Considering his age and general good health, I have concerns of him going through this procedure. Although we have been told if it is not corrected, he is at great risk for a massive heart attack.
thanks for your help.

[danco]

A related discussion, small artery disease was started.

[CCF CARDIO MD - DLB]

Yes, it is possible that your father's situation has deteriorated to the point of needing bypass surgery, and further testing is indicated. The 40% blockage near the main artery could potentially be a serious problem if it has progressed in severity. Likewise, the other blockages could also have progressed.

[Petros]

Please ignore the last part of my message (after my name). My browser seems to have a problem.

Genuine message:

My father is 69 years old. 3.5 years ago (spring 1996),he underwent an angiogram where it was detected that he has 40% blockage in the artery on the left side of his heart, very close to the main artery,and 60% and 50% blockage in two places in the right coronary artery. Since then, he has been aunder medication,and underwent 4 stress tests, one each year (autumn 1996,1997,1998 and 1999). The first two tests were negative for ischemia, the one performed in 1998 showed some ischemia,but according to the doctor, it was nothing to worry about, almost negligible. However, in the 1999 stress test,performed a few days ago, the doctor diagnosed that the ischemia has "grown". So,he suggested that we undergo another test( thalium i think) and maybe an angiogram again. What i want is to know your medical opinion, based on your expertise. Is it possible that my father situtation has deteriorated so much, that he has to undergo a heart surgery? Also,is the 40% blockage near the main artery bad? I am asking,because the doctors said 3 years ago that the blockages in the right coronary were not to be a very big worry.
Thank you in advance,
Petros

[CCF CARDIO MD - DLB]

Based on what you have written, it sounds like surgery is a reasonable option. With a 95% blockage, his risk of having a large heart attack is substantial and medications alone are unlikely to reduce this risk.